Objective:To explore the factors influencing employment among spinal cord injury(SCI)patients in the com-munity and construct an employment prediction model to provide scientific evidence for policymakers,health-care professionals,and social service agencies,aiming to improve the employment status and quality of life of SCI patients.Method:Using a multi-stage stratified cluster random sampling method,we recruited 809 eligible SCI patients in community rehabilitation from 18 hospitals in Jiangsu Province and 10 hospitals in Sichuan Province.We used the Least Absolute Shrinkage and Selection Operator(LASSO)model to screen factors and constructed a logistic regression model to analyze the factors influencing employment rates among individuals with SCI patients in community rehabilitation.We then performed internal validation.Result:Age(OR=0.96,95%CI:0.94-0.97),mental health score(OR=1.27,95%CI:1.10-1.47),self-perceived health score(OR=1.45,95%CI:1.14-1.87),and the number of environmental barriers(OR=0.74,95%CI:0.68-0.80)significantly influenced employment among SCI patients in community rehabilitation.The predictive perfor-mance of the logistic regression model was good,with an area under the receiver operating characteristic curve(AUC)of 0.864,a sensitivity of 72.39%,and a specificity of 88.53%.The nomogram drawn can facilitate the employment probability assessment for SCI patients in the community.Conclusion:The employment rate of SCI patients in community rehabilitation is relatively low.Influencing fac-tors such as age,years of education,family income,mental health scores,self-perceived health scores,and the number of environmental barriers can effectively predict the employment probability of SCI patients in com-munity rehabilitation.

Objective:To explore the factors influencing employment among spinal cord injury(SCI)patients in the com-munity and construct an employment prediction model to provide scientific evidence for policymakers,health-care professionals,and social service agencies,aiming to improve the employment status and quality of life of SCI patients.Method:Using a multi-stage stratified cluster random sampling method,we recruited 809 eligible SCI patients in community rehabilitation from 18 hospitals in Jiangsu Province and 10 hospitals in Sichuan Province.We used the Least Absolute Shrinkage and Selection Operator(LASSO)model to screen factors and constructed a logistic regression model to analyze the factors influencing employment rates among individuals with SCI patients in community rehabilitation.We then performed internal validation.Result:Age(OR=0.96,95%CI:0.94-0.97),mental health score(OR=1.27,95%CI:1.10-1.47),self-perceived health score(OR=1.45,95%CI:1.14-1.87),and the number of environmental barriers(OR=0.74,95%CI:0.68-0.80)significantly influenced employment among SCI patients in community rehabilitation.The predictive perfor-mance of the logistic regression model was good,with an area under the receiver operating characteristic curve(AUC)of 0.864,a sensitivity of 72.39%,and a specificity of 88.53%.The nomogram drawn can facilitate the employment probability assessment for SCI patients in the community.Conclusion:The employment rate of SCI patients in community rehabilitation is relatively low.Influencing fac-tors such as age,years of education,family income,mental health scores,self-perceived health scores,and the number of environmental barriers can effectively predict the employment probability of SCI patients in com-munity rehabilitation.

Objectives To explore the establishment and effects of a multilevel and inter-disciplinary management scheme for specialist nurses.Methods The multilevel and inter-disciplinary management scheme included establishing the pyramid hierarchical training model,exploring superimposed training mechanism for specialist nurses with horizontal expansion,vertical extension,and deep development,and constructing stereoscopic clinical evaluation and quantitative assessment system.Four hundred-forty two specialized nurses have been recruited to join the multilevel and inter-disciplinary management scheme from July 2021 to August 2023.The core competencies of specialized nurses were compared before and after the implementation of management scheme.Results The quality development of specialized nursing have been improved,and the total scores and the scores of 3 dimensions(research innovation,management,and professional development)in core competencies of specialized nurses after the intervention of multilevel and inter-disciplinary management scheme were higher than those before(P＜0.05).Conclusion The multilevel and inter-disciplinary management scheme can effectively improve the core competencies of specialized nurses,and promote the high-quality development of specialized nursing.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS), and the predictive value of Neutrophil to lymphocyte ratio (NLR).Methods:Consecutive patients with AIS received IVT in Zhengzhou People’s Hospital from January 2021 to December 2022 were retrospectively enrolled. HT was defined as no intracranial hemorrhage was found on the first imaging examination after admission, and new intracranial hemorrhage was found on the imaging examination 24 h after IVT or when symptoms worsened. sHT was defined as HT and the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 compared to admission or required surgical treatment such as intubation and decompressive craniectomy. The baseline clinical and laboratory data of the patients were collected, and NLR, lymphocyte to monocyte ratio (LMR), and platelet to neutrophil ratio (PNR) were calculated. Multivariate logistic regression analysis was used to identify the independent predictors of HT and sHT, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT and sHT after IVT. Results:A total of 196 patients were included (age 65.37±13.10 years, 124 males [63.3%]). The median baseline NIHSS score was 4 (interquartile range: 2-10). Twenty patients (10.2%) developed HT, and 12 (6.1%) developed sHT. Univariate analysis showed that there were statistically significant differences in age, baseline NIHSS score, creatinine, NLR, and stroke etiology type between the HT group and the non-HT group (all P<0.05); there were statistically significant differences in age, NLR, PNR, creatinine, baseline NIHSS score, and stroke etiological type between the sHT group and the non-sHT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of HT (odds ratio [ OR] 1.375, 95% confidence interval [ CI] 1.132-1.670; P=0.001) and sHT ( OR 1.647, 95% CI 1.177-2.304; P=0.004) after IVT. The ROC curve analysis showed that the area under the curve for predicting HT by NLR was 0.683 (95% CI 0.533-0.833; P=0.007), the optimal cutoff value was 5.78, the sensitivity and specificity were 55.0% and 84.1%, respectively. The area under the curve for predicting sHT by NLR was 0.784 (95% CI 0.720-0.839; P=0.001), the optimal cutoff value was 5.94, the sensitivity and specificity were 66.67% and 84.24%, respectively. Conclusions:A higher baseline NLR is associated with an increased risk of HT and sHT after IVT in patients with AIS, and can serve as a biomarker for predicting HT and sHT after IVT.

Frailty, which predicts high dependency and mortality, is a major challenge for healthcare systems in nations that are rapidly aging and is receiving increasing attention. Cirrhosis is often combined with frailty, which has a significant impact on patient health outcomes. Understanding the risk factors for frailty, elucidating the mechanism of cirrhosis combined with frailty, and early recognition and slowing down the occurrence and development of frailty are of great significance for the prognosis of cirrhotic patients. This article reviews the current research status of cirrhosis combined with frailty, including the definition and risk factors, mechanism, correlation, and intervention measures, in order to improve understanding and provide assistance for strengthening early identification, management, and intervention.

Objective:To investigate the effect of O-6-methylguananine-DNA methyltransferase (MGMT) gene promoter methylation status on the treatment and prognosis of elderly patients newly-diagnosed with glioblastoma (GBM).Methods:Clinical data of 65 newly-diagnosed GBM patients admitted to Tianjin Huanhu Hospital from January 2012 to December 2018 were retrospectively analyzed. All patients received intensity-modulated radiotherapy after surgery and 49 patients received temozolomide (TMZ) monotherapy. All patients were divided into the MGMT(+ ) group and MGMT(-) group according to the methylation status of MGMT promoter. Kaplan- Meier method and log-rank test were used for univariate survival analysis, and Cox regression model was used for multivariate prognostic analysis. Results:The median overall survival (OS) for all patients was 18.0 months. The median OS was 27.0 months and 15.3 months in the MGMT(+ ) group and MGMT(-) group, respectively. Univariate analysis revealed that tumor number, MGMT promoter methylation, postoperative concurrent chemoradiotherapy were significantly related to clinical prognosis ( P=0.029, P=0.001 and P<0.001). In multivariate analysis, tumor number and postoperative concurrent chemoradiotherapy were identified as significant prognostic factors for OS ( P=0.037, P=0.004). In the MGMT(+ ) group, the median OS was 27.0 months for patients receiving concurrent chemoradiotherapy and 12.0 months for radiotherapy alone ( P=0.040). In the MGMT(-) group, the median OS was 17.0 months for concurrent chemoradiotherapy patients and 10.0 months for radiotherapy alone ( P=0.122). Conclusions:MGMT promoter methylation status is significantly associated with longer OS in elderly GBM patients. Conventional fractional radiotherapy combined with concurrent and sequential TMZ chemotherapy probably yields better survival benefits.

Objective To investigate the inhibition mechanism of tetramethylpyrazine combined with cisplatin on angiogenesis in Lewis lung cancer mice and to observe the mechanism of Arresten on angiogenesis in lung cancer. Methods The model of Lewis lung adenocarcinoma mouse xenograft was established in this work, and 40 mice were randomly divided into 4 groups: 0.9% sodium chloride solution group(NS group), tetramethylpyrazine group(TMP group), cisplatin group(DDP group), tetramethylpyrazine plus cisplatin group(TMP + DDP group), 10 mice in each group.Mice in NS group were given 0.2 mL of 0.9% sodium chloride solution, mice in DDP group were given 0.2 mL of 2 mg.kg-1 of cisplatin, mice in TMP group were given 0.2 mL of 100 mg.kg-1 of tetramethylpyrazine, mice in TMP+DDP group were given 2 mg.kg-1 of cisplatin and 100 mg.kg-1 of tetramethylpyrazine, each 0.1 mL .Tumor size was measured every day to calculate the tumor volume.The mice were sacrificed to stripp the subcutaneous tumor after continuous medication. The expressions of Arresten, integrin α1β1 and VEGF were determinated by immunhistochemistry and Western blotting. Results The tumor growth of NS group was the fastest and TMP+DDP group was the slowest. Compared with NS group, the expression of Arresten in the other three groups was increased( P<0.01) , and the TMP+DDP group exhibited the highest expression;at the same time, integrin α1β1 , VEGF in the other three groups was decreased(P<0.01), and the TMP+DDP group exhibited the lowest expression.The expression of integrinα1β1 and VEGF was negatively related to Arresten, and the expression of integrin α1β1 was positively correlated with VEGF. Conclusion TMP can inhibited the growth of Lewis lung carcinoma and angiogenesis. Moreover, in combination with cisplatin, TMP can also improved the effect of chemotherapy and then the survival state of mice. The mechanism of action, which TMP suppress tumor angiogenesis may be through improving Arresten and inhibiting integrin α1β1 and VEGF. And the action mechanism of Arresten may be implemented by inhibiting the expression of VEGF by incorporation with integrinα1β1 or by itself to inhibit the expression of VEGF.

Nuclear envelope voltages of T cells were analyzed with a lumped circuitry for cells in combination with frequency domain power density of Gaussian pulses and monocycle pulses. According to the differences in geometric and electric parameters between normal and malignant T cells, circuitry analysis was performed. Theoretical evaluations indicated that apoptosis of malignant T cells was of feasibility, which could be applied in cancer therapy. The evaluations were in accord with the published experimental findings.
Animals ; Apoptosis ; radiation effects ; Electric Stimulation ; Electromagnetic Fields ; Electrophysiology ; Fourier Analysis ; Humans ; Jurkat Cells ; Nuclear Envelope ; pathology ; radiation effects ; T-Lymphocytes ; cytology ; radiation effects

Objective To provide the morphology data for the study on the molecular mechanism of tumor metastasis,we observed the expression of podoplanin on the blood vessels and lymphatics in the human colonic carcinoma.Methods We observed the expression of podoplanin on the blood vessels and lymphatics in the colonic carcinoma from the patients of the operation in the defferent stages with the methods of HE staining and podoplanin immunohistochemistry staining. Results Podoplanin has not been stained,but podoplanin was positively expressed on the colonic carcinoma lymphatics.And, The podoplanin expression positive rate of the colonic carcinoma were increased along with the increase of tumor stages and occurence of lymph nodes metastasis. Conclusion Podoplanin choosed to express in lymphatics in the colonic carcinoma and could correctly distinguish the blood vessels and lymphatic vessels,could be regarded as the specific marker to mark lymphatic vessel. And, The podoplanin expression positive rate of the colonic carcinoma were increased along with the increase of tumor stages and occurence of lymph nodes metastasis.It indicates,It was correlated with colonic carcinoma lymphatical metastasis that the count of lymphatic vessels were increased in the colonic carcinoma along with the tumor advancing.