Purpose To investigate the relationship between imaging characteristics and shunt grading in acute cerebral infarction patients with right-to-left shunt.Materials and Methods The clinical and imaging data of 697 acute cerebral infarction patients who were hospitalized in the Second Affiliated Hospital of Nanchang University from January 2019 to December 2021 were collected,and the patients were divided into right-to-left shunt negative group(443 cases)and right-to-left shunt positive group(254 cases)according bubble test,compared the difference in demographic data and imaging characteristics between the two groups.In the shunt positive group,the imaging characteristics of the two groups of patients and their relationship with the shunt grade were analyzed.Results There were no statistical differences in gender,age,smoking,hyperlipidemia and history of coronary heart disease between the two groups(P>0.05),but there were statistical differences in the history of hypertension(OR=0.533,95%CI 0.380-0.748),diabetes(OR=0.649,95%CI 0.422-0.999)and cerebral infarction(OR=0.275,95%CI 0.136-0.555)(all P<0.05).The imaging characteristics of the two groups of patients showed that there were significant differences in the number of infarct foci(χ2=53.957,4.219;both P<0.05),but there was no statistical difference in the infarct location between the two groups(P>0.05).Among the patients with acute cerebral infarction combined with positive bubble test,the imaging manifestations of grading I and II patients were mainly unilateral anterior circulation or posterior circulation infarction,and deep and single infarction were more common.In patients with grading III and IV shunts,multiple infarcts with combined bilateral anterior and posterior circulations were more common.Conclusion The imaging manifestations of patients with acute cerebral infarction combined with right-to-left shunt have their own characteristics.Bubble test has high sensitivity in the diagnosis of right-to-left shunt.The comprehensive analysis can provide certain guidance for clinical practice.

Objective To explore the efficacy of thoracic endovascular aortic repair(TEVAR)for the treatment of Stanford type B aortic dissection at different intervention timing.Methods The clinical data of 126 patients with Stanford B type aortic dissection,who were admitted to authors'hospital between January 2018 and April 2023,were retrospectively analyzed.Based on the time interval from the onset of disease to receiving surgery,the patients were divided into group A(＜24 h),group B(2-7 d)and group C(8-14 d).The incidences of perioperative adverse events,including endoleak,cerebral infarction,death,aortic rupture and total complications,were compared between each other among the three groups,and survival analysis was performed according to the follow-up findings.Results A total of 126 patients with Stanford type B aortic dissection were included in this study,including 50 patients of group A,43 patients of group B,and 33 patients of group C.No statistically significant differences in the general clinical data existed between each other among the three groups(P＞0.05).The differences in the incidences of perioperative acute cerebral infarction,endoleak,infection and death between each other among the three groups were not statistically significant(P＞0.05).The difference in the overall complication rate between each other among the three groups was statistically significant(P＜0.05).Log-rank testing was used to compare the survival curves of the three groups,which showed that the cumulative 5-year recurrence rate and survival rate in group A were lower than those in group B and in group C,and the differences were statistically significant(P＜0.05).Conclusion The results of this study indicate that the patients may have high incidence of adverse events and poor short-to-middle-term curative efficacy when TEVAR is performed within 24 hours after the onset of symptoms,while the patients may have better perioperative and short-to-middle-term curative efficacy if TEVAR is carried out in 2-14 days after the onset of symptoms(J Intervent Radiol,2024,33:523-528)

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.
Allergens ; Artemisia ; COVID-19 ; Retrospective Studies ; Rhinitis, Allergic ; Skin Tests ; Humans ; Male ; Female

Objective:To evaluate and summarize the evidence on postoperative exercise in patients with rotator cuff injury, so as to provide a basis for guiding the postoperative exercise in patients with rotator cuff injury.Methods:We searched the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, British Medical Journal (BMJ) Best Practice, UpToData, China Biomedical Literature Database, WanFang Data, China National Knowledge Infrastructure, and other databases on postoperative exercise in patients with rotator cuff injury, including guidelines, evidence summaries, systematic reviews, best practice information books, clinical decision-making, recommended practices, and expert consensus. The retrieval period was from the establishment of the database to June 4, 2022.Results:A total of 30 articles were included, including one guideline, one evidence summary, one clinical decision-making, two expert consensuses, and 25 systematic reviews. 22 pieces of evidence from 12 aspects were summarized, including applicable population, exercise benefit, exercise risk, exercise assessment, exercise program, exercise method, exercise time, exercise intensity, exercise monitoring, formulation principles, management mode, and health education were summarized.Conclusions:The evidence summary process is scientific, rigorous, and comprehensive in content. In the process of evidence transformation, medical and nursing staff should select the best evidence according to specific situations and individual patient factors, so as to guide patients with rotator cuff injury to exercise safely and effectively after surgery to improve clinical outcomes.

Spermatogenesis is a continual process that occurs in the testes, in which diploid spermatogonial stem cells (SSCs) differentiate and generate haploid spermatozoa. This highly efficient and intricate process is orchestrated at multiple levels. N⁶-methyladenosine (m⁶A), an epigenetic modification prevalent in mRNAs, is implicated in the transcriptional regulation during spermatogenesis. However, the dynamics of m⁶A modification in non-rodent mammalian species remains unclear. Here, we systematically investigated the profile and role of m⁶A during spermatogenesis in pigs. By analyzing the transcriptomic distribution of m⁶A in spermatogonia, spermatocytes, and round spermatids, we identified a globally conserved m⁶A pattern between porcine and murine genes with spermatogenic function. We found that m⁶A was enriched in a group of genes that specifically encode the metabolic enzymes and regulators. In addition, transcriptomes in porcine male germ cells could be subjected to the m⁶A modification. Our data show that m⁶A plays the regulatory roles during spermatogenesis in pigs, which is similar to that in mice. Illustrations of this point are three genes (SETDB1, FOXO1, and FOXO3) that are crucial to the determination of the fate of SSCs. To the best of our knowledge, this study for the first time uncovers the expression profile and role of m⁶A during spermatogenesis in large animals and provides insights into the intricate transcriptional regulation underlying the lifelong male fertility in non-rodent mammalian species.
Animals ; Male ; Mice ; Cell Differentiation/genetics* ; Mammals/metabolism* ; Methylation ; RNA, Messenger/metabolism* ; Spermatogenesis/genetics* ; Spermatozoa/metabolism* ; Swine/genetics* ; Testis/metabolism* ; Transcriptome ; RNA Methylation/genetics*

Objective:To evaluate the effect of prophylactic octreotide administration on pancreaticoduodenectomy (PD)associated postoperative pancreatic fistula (POPF), total complications, peri-operative death and postoperative in-hospital days.Methods:From January 2020 to August 2021, 148 patients who underwent PD in the Department of Biliary-Pancreatic Surgery in Ren Ji Hospital affiliated with School of Medicine of Shanghai Jiao Tong University were recruited into this single-center randomized control double-blinded clinical trial. Patients were randomly assigned into octreotide group ( n=74) and control group ( n=74). Octreotide group was subcutaneously injected with 0.1 mg (1 ml) octreotide after preoperative anesthesia, and was subcutaneously injected with the same dose every 8 hours for 5 days, with a total of 16 doses. Control group was injected with 1 ml normal saline in the same way, and relevant clinical data and indicators of the two groups were recorded. The primary endpoint was clinically relevant pancreatic fistula, and the secondary endpoints were total complications, perioperative death and postoperative in-hospital days. Univariate and multivariate logistic regression analysis were used to screen the risk factors of clinically related POPF after PD. Results:120 patients were finally enrolled, including 61 in octreotide group and 59 in control group. There were no significant differences on age, gender ratio, body mass index, preoperative surgery rate of jaundice reduction, preoperative major biochemical indicators, operation time, intraoperative blood loss, pancreatic duct diameter, pancreatic texture and pathological type composition ratio. The total incidence of clinical relevant POPF was 8.3%, and there were no significant differences on biochemical leakage (4.9% vs 8.5%, P=0.435), grade B fistula (4.9% vs 8.5%, P=0.435) and grade C fistula (1.6% vs 1.7%, P=0.981). The total complication incidence (24.5% vs 28.8%, P=0.601), perioperative mortality (0 vs 3.3%, P=0.147) and postoperative in-hospital days (20.6±11.1 d vs 19.5±12.2 d, P=0.633) were not significantly different between two groups. Univariate analysis showed that preoperative serum albumin level <30 g/L( P<0.001) and pathological type of pancreatic ductal adenocarcinoma ( P=0.036) were independent risk factors for POPF after PD, while multivariate analysis found no statistically significant risk factors. Conclusions:Octreotide can neither reduce the incidences of POPF, total complications and postoperative mortality, nor shorten postoperative in-hospital days. However, for patients with preoperative hypoproteinemia and (or) the pathological type of pancreatic duct adenocarcinoma, the prophylactic use of octreotide during PD and after PD may reduce the occurrence of POPF.

With the transition from quantity-centric healthcare to value-centric healthcare, patient-reported outcome plays an important role in healthcare. Patient-reported outcome is an effective method for evaluating the outcome of hip replacement patients. It can be used not only in science research, but also in clinical practice and medical care quality assessment. This article reviews the patient-reported outcome measures in hip replacement, so as to provide references for clinical practice and research of clinical medical and nursing staff to accurately select appropriate patient-reported outcome measures in hip replacement.

Objective:To systematically analyze and evaluate the bleeding risk prediction model of patients with venous thromboembolism (VTE) , so as to provide a reference for nursing practice.Methods:PubMed, Web of Science, Embase, Cochrane Library, Wiley Online Library, CINAHL, Scopus, ProQuest, Clinicalkey, Wanfang, China National Knowledge Infrastructure, VIP databases were searched for bleeding risk prediction model of VTE patients. The retrieval time was from the establishment of the databases to August 19, 2021. Two researchers independently screened the literature according to the inclusion and exclusion criteria, then extracted the data and evaluated the quality of the literature.Results:Ten relevant literatures were included in this study, including 4 retrospective studies and 6 prospective studies. The area under the receiver operating characteristic curve of one model was greater than 0.7, and the C-index of four models were greater than 0.7. The prediction model contained many relevant factors, including bleeding history, age, anemia, tumor, antiplatelet therapy, gender, renal insufficiency, etc. In the evaluation of risk of bias and applicability, 10 studies had good applicability, but there were bias mainly due to insufficient number of events in the dependent variable, conversion of continuous variables into dichotomous variables and missing data were not reported. Conclusions:The research on the prediction model of bleeding risk in VTE patients is still in the development stage. In the future, risk prediction models with excellent performance in all aspects and low risk of bias can be developed and verified externally.

Animals ; Biological Transport, Active/physiology* ; Centrioles/metabolism* ; Cilia/metabolism* ; Mice ; Mice, Mutant Strains ; N-Acetylglucosaminyltransferases/metabolism*

Objective? To explore the effect of multi-mode interactive continuous nursing on home rehabilitation and complications of patients after total hip arthroplasty(THA). Methods? From January 2017 to July 2018, patients undergoing THA in Zhejiang Provincial People's Hospital were selected by purposive sampling method. They were randomly divided into two groups according to visit numbers. There were 43 effective cases in the control group and 42 in the observation group. The control group adopted the traditional telephone follow-up mode, while the observation group adopted the multi-mode interactive continuous nursing intervention. The Modified Barthel Index(MBI), Harris Hip Score(HHS) and 6-Minute Walking Tes(t 6MWT) were used to compare the rehabilitation effects of the two groups at discharge, 1, 3 and 6 months after operation, and the complications, unplanned hospital visits and hospitalizations of the two groups were compared. Results? There was no significant difference in each index between the two groups at discharge (P＞ 0.05). The scores of MBI in the observation group were (78.57±7.43), (90.36±7.76), (94.41±7.51) respectively at 1, 3 and 6 months after operation, which were higher than those in the control group [(70.35±7.60), (82.40±7.82), (91.86±8.80)], and there were significant differences between the two groups at 1 and 3 months after operation (P＜ 0.05). The scores of HHS in the observation group were (82.05±7.40), (87.52±6.94), (91.17±7.40) respectively, higher than those in the control group (78.40±7.51), (84.09±7.23), (88.37±8.46), there were significant differences between the two groups at 1 and 3 months after operation (P＜ 0.05). The distance of 6MWT in the observation group were (174.76±35.04)m, (241.55±40.67)m, (282.86±46.46) m, higher than those in the control group (151.61±42.52)m, (214.42±48.59)m, (260.35±48.05) m. There were significantly statistical differences in the 1, 3 and 6 months after operation (P＜0.05). In the observation group, there were 1 case of fracture, 9 cases of unplanned hospital visit or hospitalization, 2 cases of dislocation, 1 case of infection and 20 cases of unplanned hospital visit or hospitalization in the control group. Conclusions? Continuous nursing with multi-mode interaction can improve the effect of home rehabilitation after THA, effectively improve the early and long-term hip function of patients, prevent and reduce complications, and improve the quality of life of patients.