OBJECTIVE T o explore the distribution of pathogens and risk factors for hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy so as to provide theoretical bases for reasonable clinical use of antibiotics.METHODS Totally 118 laryngeal cancer and tracheotomy patients who were complicated with infec-tions and treated in otolaryngology head and neck surgery department of The First Medical Center of Chinese PLA General Hospital from Oct.2021 to Oct.2024 were retrospectively assigned as the infection group,meanwhile,the 118 patients who were not complicated with infections were chosen as the no infection group.The distribution and drug susceptibility rates of the pathogens isolated from clinical specimens of the patients with infections were observed,and the risk factors for the hospital-associated infections were explored.RESULTS Totally 168 strains of pathogens were isolated from the 118 patients with infections,107 of which were gram-negative bacteria,51 were gram-positive bacteria,and 10 were fungi.The result of multivariate logistic regression analysis showed that age(OR=2.435,95％CI:1.052 to 5.634),duration of tracheotomy(OR=3.525,95％CI:1.871 to 14.259),length of hospital stay(OR=2.829,95％CI:1.099 to 7.276)and complication with diabetes mellitus(OR=4.807,95％CI:1.704 to 13.557)were the risk factors for the hospital-associated infections in the laryngeal cancer pa-tients undergoing tracheotomy(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the laryngeal cancer and tracheotomy patients with hospital-associated infections.The age,duration of tracheotomy,length of hospital stay and complication with diabetes mellitus are the risk factors for the hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy.It is necessary to formulate the prevention and control measures based on the above factors so as to reduce the incidence of infec-tions.

Objective To explore the mechanism of action of jolkinolide B in the treatment of gastric cancer by network pharmacology combined with molecular docking technique.Methods The SwissTargetPrediction database was used to obtain the targets of the active compounds.Search Genecards,OMIM,Drugbank,TTD,and PharmGKB databases to obtain targets for gastric cancer.The intersection between the targets of jolkinolide B and those of gastric cancer was identified pinpoint potential targets for jolkinolide B in treating gastric cancer.The String database was utilized construct a protein-protein interaction(PPI)network.Bioconductor bioinformatics packages with R software was employed conduct Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis on the shared targets.This process revealed significant regulatory pathways crucial for jolkinolide B's efficacy in treating gastric cancer.Cytoscape 3.7.1 software was utilized create the core network of"Potential Targets of Triptolide B in Gastric Cancer Treatment",and SYBYL-X2.1.1 software was employed conduct molecular docking validation of the selected main active ingredients and critical targets.Results Jolkinolide B may target multiple proteins,including MAPK1,glycogen synthase kinae-3β(GSK-3β),and JUN,impacting the proliferation,invasion,and metastasis of gastric cancer,ultimately inhibiting its growth.Conclusion We predicted the possible molecular mechanism of jolkinolide B in the treatment of gastric cancer to provide guide information for the subsequent experimental research and clinical application.

Objective To construct a discharge preparation program for patients after total laryn-gectomy led by specialist nurses and explore its application effects.Methods A multidisciplinary team was established to construct a discharge preparation program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory.A total of 120 patients who underwent to-tal laryngectomy from April 2023 to October 2024 were selected as the study subjects.A total of 60 patients admitted from April to December 2023 were set as control group,and 60 patients admitted from January to October 2024 were set as intervention group.The intervention group implemented the discharge preparation program for patients after total laryngectomy led by specialist nurses,while the control group received conventional perioperative management after total laryngectomy.The discharge readiness,quality of discharge instruction,and incidence of complications during hospitalization on the day of discharge were compared between the two groups.Additionally,the scores of home health care experience at 1 and 3 months after discharge were compared between the two groups.Results On the day of discharge,the scores of each dimension and the total score of the discharge readinessscale in the intervention group were higher than those in the control group.The scores of the dimensions("Actually received content"and"Discharge instruction skills and effects")and the total score of the Quality of Discharge Instruction Scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).The total incidence of complications during hospitalization in the intervention group was lower than that in the control group,with a sta-tistically significant difference(P＜0.05).At 1 and 3 months after discharge,the scores of the home health care experience scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The construction of a dis-charge preparation service program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory can effectively improve the discharge readiness and quality of discharge instruction of patients undergoing total laryngectomy,reduce the incidence of complications,and im-prove the prognosis and early home health care level.

OBJECTIVE: To investigate the expression levels of EZH2 and KMT2D in patients with diffuse large B-cell lymphoma (DLBCL) and their relationship with pathological features. METHODS: 84 patients with DLBCL treated in our hospital from January 2021 to June 2022 were selected as the study subjects, and clinical characteristics such as sex, age and pathological classification of the patients were collected. Immunohistochemistry was used to detecet the expression of KMT2D and EZH2 proteins in tumor tissue cells of the DLBCL patients. The differential expression of KMT2D and EZH2 in subgroups of different sexes, ages, primary sites, clinical stages, Hans subtypes, etc. were compared. The correlation between the expression of KMT2D and EZH2 protein and BCL-6, CD79A was analyzed and validated through the interaction of protein molecular structures. We followed up and recorded the survival status of the patients for 12 months, and analyzed the factors that affect the mortality of DLBCL patients. RESULTS: The positive rate of KMT2D and EZH2 was high (over 95%) in DLBCL patients. There was no significant difference in the expression of EZH2 and KMT2D among subgroups of different sexes, ages and stages (P >0.05). However, patients with different levels of BCL-6 and CD79A expression showed differences in EZH2 and KMT2D expression (P < 0.05). EZH2 and KMT2D were positively correlated with BCL-6 (r =0.391, r =0.332) and CD79A (r =0.309, r =0.258), respectively, and there were interactions in the protein molecular structures. The risk factors for mortality in DLBCL patients include male sex (OR =1.106, 95%CI : 1.082-1.130, P < 0.001), stage II (OR =1.778, 95%CI : 1.567-2.016, P < 0.001), stage IV (OR =2.233, 95%CI : 2.021-2.467, P < 0.001), EZH2 positive (OR =2.762, 95%CI : 1.304-5.850, P =0.008), BCL-6 positive (OR =7.309, 95%CI : 1.340-39.859, P =0.022), age≥74 years (OR =3.080, 95%CI : 1.658-5.723, P < 0.001), and 63-73 years old (OR =2.400, 95%CI : 1.564-3.682, P < 0.001), while KMT2D positive (OR =0.180, 95%CI : 0.054-0.608, P =0.006) and 41-51 years old (OR =0.406, 95%CI : 0.274-0.603, P < 0.001) were factors which could reduce the risk of mortality. CONCLUSION EZH2 and KMT2D are highly expressed in patients with DLBCL, and they are positively correlated with BCL-6 and CD79A, and affect the prognosis of DLBCL patients.
Humans ; Enhancer of Zeste Homolog 2 Protein/metabolism* ; Lymphoma, Large B-Cell, Diffuse/metabolism* ; DNA-Binding Proteins/metabolism* ; Female ; Male ; Middle Aged ; Adult ; Neoplasm Proteins/metabolism* ; Aged ; Immunohistochemistry ; Proto-Oncogene Proteins c-bcl-6/metabolism* ; Prognosis

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

AIM To investigate the effects of rice wine type and wine processing method on chemical constituents and anti-coagulation effect of Angelicae sinensis Radix.METHODS Wine-washed products and wine-stir-fried products were prepared by different types and ages of rice wine,respectively,after which HPLC was adopted in the content determination of tryptophan,chlorogenic acid,vanillic acid,phthalic acid,ferulic acid,senkyunolide I,senkyunolide H,coniferyl ferulate and ligustilide,and PT,APTT,TT were detected in rabbit plasma.RESULTS Phenolic acids and volatile constituents demonstrated lower contents in the wine-stir-fried products than those in the raw product(P＜0.05),while those in the wine-washed products displayed no obvious changes(except for senkyunolide I)(P＞0.05).The contents of volatile constituents in the wine-washed products were higher than those in the wine-stir-fried products(P＜0.05).After being processed with dry rice wine,various constituents exhibited increased contents as compared with those after being processed with sweet rice wine(P＜0.05).Compared with the raw product,prolonged PT,APTT and TT were observable in the processed products prepared by 3-year semi-dry rice wine(P＜0.05).CONCLUSION The optimal rice wine type is determined to be 3-year semi-dry.Wine-washed Angelicae sinensis Radix shows high contents of ferulic acid and volatile constituents,whose activating blood and resolving stasis effect may be stronger.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

OBJECTIVE T o explore the distribution of pathogens and risk factors for hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy so as to provide theoretical bases for reasonable clinical use of antibiotics.METHODS Totally 118 laryngeal cancer and tracheotomy patients who were complicated with infec-tions and treated in otolaryngology head and neck surgery department of The First Medical Center of Chinese PLA General Hospital from Oct.2021 to Oct.2024 were retrospectively assigned as the infection group,meanwhile,the 118 patients who were not complicated with infections were chosen as the no infection group.The distribution and drug susceptibility rates of the pathogens isolated from clinical specimens of the patients with infections were observed,and the risk factors for the hospital-associated infections were explored.RESULTS Totally 168 strains of pathogens were isolated from the 118 patients with infections,107 of which were gram-negative bacteria,51 were gram-positive bacteria,and 10 were fungi.The result of multivariate logistic regression analysis showed that age(OR=2.435,95％CI:1.052 to 5.634),duration of tracheotomy(OR=3.525,95％CI:1.871 to 14.259),length of hospital stay(OR=2.829,95％CI:1.099 to 7.276)and complication with diabetes mellitus(OR=4.807,95％CI:1.704 to 13.557)were the risk factors for the hospital-associated infections in the laryngeal cancer pa-tients undergoing tracheotomy(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the laryngeal cancer and tracheotomy patients with hospital-associated infections.The age,duration of tracheotomy,length of hospital stay and complication with diabetes mellitus are the risk factors for the hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy.It is necessary to formulate the prevention and control measures based on the above factors so as to reduce the incidence of infec-tions.

Objective:To identify the risk factors for ascending aortic dilatation and develop a prediction model using LASSO-Logistic regression in patients with normally functioning bicuspid aortic valves（BAV）.Methods:Eight-four adult patients with BAV diagnosed as having normal valve function by transthoracic echocardiography who attended to the General Hospital of Ningxia Medical University between June 2024 and April 2025 were prospectively selected，there were 42 patients with ascending aortic dilatation and 42 patients without dilatation.The patients were divided into a training set（60 cases）and a test set（24 cases）using stratified random sampling at a ratio of 7 to 3 via the R caret package. All subjects underwent transthoracic echocardiography，lipid and plasma matrix metalloproteinases（MMP）and tissue inhibitors（TIMP）levels detection. The inverse probability of treatment weighting（IPTW）method was employed to control for potential confounding factors. LASSO and multifactorial binary Logistic regression was applied to screen the independent risk factors for ascending aortic dilatation of BAV and development a nomogram prediction model. The accuracy，consistency and clinical applicability of the prediction model were evaluated by applying the ROC curve，calibration curve，and decision curve analysis（DCA），respectively.Results:①After adjustment for IPTW，LASSO-Logistic regression analysis identified left ventricular global longitudinal strain（LVGLS）and plasma MMP-2 levels as independent risk factors for ascending aortic dilatation in BAV patients with normal valve function.②The nomogram prediction model constructed based on the above screening features，and the area under the curve（AUC）of ROC for the training set and test set were 0.917 and 0.903，with specificities of 0.867 and 0.917，and sensitivities of 0.933 and 0.916，respectively. ③Calibration curves demonstrated satisfactory alignment，with C-indices of 0.908（95% CI=0.879～0.937）for the training set and 0.903（95% CI=0.874 - 0.932）for the test set. Hosmer-Lemeshow goodness-of-fit tests indicated strong consistency between predicted and observed outcomes，with P-values of 0.138 and 0.750 for the training and test sets，respectively.The DCA curve demonstrated that within a threshold probability range of 0.04 - 0.90 in the test set，the clinical decision-making model provided a higher net benefit rate for patients with BAV. Conclusions:LVGLS absolute value reduction and elevated plasma MMP-2 levels are independent risk factors for predicting ascending aortic dilatation in BAV patients with normal valve function. The prediction model based on LASSO-Logistic regression has good predictive value，providing a scientific basis for clinical decision-making in patients with BAV and aortic diseases.