Acute kidney injury(AKI)is a common clinical syndrome characterized by high morbidity and mortality.It's pathogenesis is complex and involves multiple pathophysiological processes,including inflammatory responses,oxidative stress,mitochondrial dysfunction,apoptosis,and immune dysregulation. Recent studies had shown that AKI is an independent risk factor for the development and progression of chronic kidney disease(CKD), significantly impacting patient outcomes. As key effector cells in the immune response, T cells play a crucial role throughout the onset, progression and repair phases of AKI.

Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Acute kidney injury(AKI)is a common clinical syndrome characterized by high morbidity and mortality.It's pathogenesis is complex and involves multiple pathophysiological processes,including inflammatory responses,oxidative stress,mitochondrial dysfunction,apoptosis,and immune dysregulation. Recent studies had shown that AKI is an independent risk factor for the development and progression of chronic kidney disease(CKD), significantly impacting patient outcomes. As key effector cells in the immune response, T cells play a crucial role throughout the onset, progression and repair phases of AKI.

Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Objective To analyze the composition of the aqueous extract of Polygonatum Cyrtonema Hua(PCHE)and evaluate its antitumor activity in vitro and in vivo.Our aim is to provide a theoretical basis for the further development and utilization of Polygonatum Cyrtonema Hua.Methods(1)PCHE was prepared by aqueous extraction,and the chemical composition of PCHE was analyzed by UPLC-Q-TOF/MS and phenol-sulfuric acid method.The inhibitory activity on tumor cells proliferation of PCHE was detected by CCK-8 assay.Cell cycle and apoptosis were detected by flow cytometry,and the expression of apoptosis-related proteins Bcl-2 and Bax was detected by Western Blot.The inhibitory activity of PCHE-containing serum on cell proliferation was detected.(2)A B16 tumor-bearing mice model was constructed and model mice were randomly divided into the model group(saline),the positive drug group(CTX:50 mg·kg-1),and PCHE low-,medium-,and high-dose groups(55.9,111.8,223.6 mg·kg-1),and treated by gavage for 7 days.Changes in body weight and tumor volume of mice were observed during the treatment period.The mice were executed after the treatment,and the histopathological changes of heart,liver,spleen,lung,kidney and tumor were observed by hematoxylin-eosin(HE)staining.The protein expression of Bcl-2 and Bax in tumor tissues was detected by immunohistochemistry(IHC).Results The polysaccharide content of PCHE reached(10.07±1.3)%,and the flavonoid content was(0.044±0.004)%,and thirty-nine components were detected by UPLC-Q-TOF/MS,which contained antitumor components such as flavonoids(baicalein,quercetin,luteolin and rutin),organic acids(ferulic acid)and polyphenols(gallic acid),etc.PCHE exhibited the inhibitory effects on Hela,A549,4T1,B16,MFC and HepG2 cells,among which the inhibitory effect on B16 cells was the most significant(P＜0.001),and PCHE induced cell cycle arrest at G0/G1 phase in B16 cells(P＜0.001).The results of double-staining flow cytometry and Western Blot showed that PCHE significantly promoted apoptosis of B16 cells,decreased the expression of Bcl-2,and promoted the expression of Bax(P＜0.01,P＜0.001).and PCHE constituents absorbed into blood also had an inhibitory effect on B16 cells(P＜0.001).In addition,the results of in vivo activity assay showed that different doses of PCHE could inhibit tumor growth,induce tumor cell necrosis,reduce Bcl-2 expression,and increase Bax expression compared with the model group.Conclusion The ingredients in PCHE are abundant.It contains a variety of antitumor active ingredients,which can inhibit tumor growth,induce tumor cell apoptosis,show strong anti-tumor effects and be worthy of in-depth study.

Objective:To investigate the efficacy and safety of endoscopic ligation and injection sclerotherapy for internal hemorrhoids.Methods:From April 2020 to October 2023, 106 patients with grade Ⅰ to Ⅲ internal hemorrhoids who underwent endoscopic ligation or injection sclerotherapy in the First Affiliated Hospital with Nanjing Medical University (Jiangsu Province People's Hospital) were consecutively enrolled in the retrospective cohort study. Patients were divided into the ligation group ( n=70) and the injection sclerotherapy group ( n=36) according to the endoscopic treatment methods. The effective rate, hospital stay, postoperative pain, the incidence of complications, patient satisfaction and the recurrence rate of the two groups were assessed. Results:The effective rate was 95.7% (67/70) and 100.0% (36/36) respectively in the ligation group and the injection sclerotherapy group without significant difference ( P=0.549). The hospital stay was 6.0 (4.0, 7.3) days and 3.0 (2.0, 4.0) days respectively in the ligation group and the injection sclerotherapy group with significant difference ( Z=4.305, P<0.001). The incidence of 24-hour postoperative pain was 58.6% (41/70) and 11.1% (4/36) in the two groups respectively and the difference was statistically significant ( χ2=20.020, P<0.001). There were no serious postoperative adverse events such as anal stenosis or thrombotic external hemorrhoids in the two groups. Only the incidence of anal distension was significantly different between the ligation group and the injection sclerotherapy group [38.6% (27/70) VS 5.6% (2/36), χ2=11.431, P<0.001]. The patient satisfaction rate of the two groups showed no significant difference [87.1% (61/70) VS 86.1% (31/36), P=1.000]. There was 1 patient and 15 patients lost to follow-up respectively in the ligation group and the injection sclerotherapy group, and the recurrence rate of the two groups showed no significant difference [14.5% (10/69) VS 33.3% (7/21), P=0.064]. Subgroup analysis of grade Ⅰ-Ⅱ internal hemorrhoids: there were 43 patients and 29 patients in the ligation group and the injection sclerotherapy group, respectively. No significant difference was found between the two groups in terms of the effective rate, incidence of postoperative hemorrhage, incidence of uroschesis, or patient satisfaction rate ( P>0.05). The incidences of postoperative pain [65.1% (28/43) VS 10.3% (3/29), χ 2=19.016, P<0.001] and anal distension [41.9% (18/43) VS 3.4% (1/29), χ 2=11.252, P<0.001] of the ligation group were significantly higher than those of the injection sclerotherapy group. Forty-three patients in the ligation group and 17 patients in the injection sclerotherapy group completed follow-up, and the recurrence rate was 11.6% (5/43) and 23.5% (4/17), respectively, without significant difference ( P=0.256). Subgroup analysis of grade Ⅲ internal hemorrhoids: there were 27 patients in the ligation group and 7 patients in the injection sclerotherapy group, and 26 and 4 patients completed follow-up, with a recurrence rate of 19.2% (5/26) and 75.0% (3/4), respectively. Conclusion:Endoscopic ligation and injection sclerotherapy are both safe and effective for grade Ⅰ-Ⅲ internal hemorrhoids. Injection sclerotherapy demonstrates shorter hospital stays and lower incidences of postoperative pain and anal distension. For grade Ⅰ-Ⅱ internal hemorrhoids, injection sclerotherapy is recommended due to its efficacy and fewer complications. Conversely, for grade Ⅲ internal hemorrhoids, ligation is suggested to reduce recurrence rates.

Objective To investigate the application of susceptibility weighted imaging(SWI)and diffusion tensor imaging(DTI)parameters in clinical diagnosis and prognosis evaluation of mild traumatic brain injury(mTBI).Methods Forty-four mTBI patients were enrolled for observation group,and 32 healthy volunteers were selected as controls.All the patients underwent conventional magnetic resonance imaging(MRI),SWI and DTI scanning of the brain.Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)were measured in regions of interest(frontal lobe,genu of corpus callosum,external capsule,internal capsule,thalamus,splenium of corpus callosum,and semioval center).The Glasgow outcome Scale-Extended for traumatic brain injury(GOSE)-TBI was used to evaluate the prognosis at 6 months after discharge.FA and ADC values were compared between two groups by t-test.Correlations between imaging parameters and prognosis were analyzed by Spearman test.Results SWI showed microhemorrhages in 88.6%mTBI patients,with a mean number of 2.36±1.26(range 0-5)and a mean area of(349.48±225.82)mm2.The mean GOSE-TBI score was 7.50±0.51(range 7-8)in the observation group at 6 months after discharge,with 50.00%(22/44)of the patients scored 8.The hemorrhage area was negatively correlated with the GOSE-TBI score(P<0.001).The FA values of the frontal lobe,genu of corpus callosum and left internal capsule in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the FA value of the thalamus between the two groups(P>0.05).The FA values of the frontal lobe and genu of corpus callosum were positively correlated with the GOSE-TBI score(P<0.001).The FA values of the internal capsule and corpus callosum splenium were negatively correlated with the GOSE-TBI score(P<0.05).There was no significant difference in the ADC values between the two groups(P>0.05).Conclusion SWI can sensitively detect microbleeds in mTBI patients.DTI shows mild white matter injury in mTBI patients.FA value is related to the GOSE-TBI score,and is a sensitive index for evaluating the severity and prognosis of mTBI.

Modulating Tankyrases (TNKS), interactions with USP25 to promote TNKS degradation, rather than inhibiting their enzymatic activities, is emerging as an alternative/specific approach to inhibit the Wnt/β-catenin pathway. Here, we identified UAT-B, a novel neoantimycin analog isolated from Streptomyces conglobatus, as a small-molecule inhibitor of TNKS-USP25 protein-protein interaction (PPI) to overcome multi-drug resistance in colorectal cancer (CRC). The disruption of TNKS-USP25 complex formation by UAT-B led to a significant decrease in TNKS levels, triggering cell apoptosis through modulation of the Wnt/β-catenin pathway. Importantly, UAT-B successfully inhibited the CRC cells growth that harbored high TNKS levels, as demonstrated in various in vitro and in vivo studies utilizing cell line-based and patient-derived xenografts, as well as APC^min/+ spontaneous CRC models. Collectively, these findings suggest that targeting the TNKS-USP25 PPI using a small-molecule inhibitor represents a compelling therapeutic strategy for CRC treatment, and UAT-B emerges as a promising candidate for further preclinical and clinical investigations.

Objective:To explore the effect of "Internet plus" exercise prescription intervention on upper limb dysfunction and quality of life of breast cancer patients at home after surgery, so as to provide reference for health management of breast cancer patients after surgery.Methods:Adopting a prospective randomized controlled trial research method. From November 2021 to January 2023, 124 breast cancer patients in the breast and thyroid surgery department of Xiang′an Hospital Affiliated to Xiamen University were selected for the study. According to the random number table method, they were randomly divided into an intervention group (62 cases) and a control group (62 cases). The control group patients were given routine training, and the intervention group patients received routine training in the first four weeks after operation, and "Internet plus" exercise prescription intervention in the fifth week after operation. The upper limb dysfunction, quality of life before and after the intervention and motor compliance after the intervention between the two groups were compared.Results:A total of 117 patients were ultimately included, and they were all female, with 58 patients in the intervention group aged (51.01 ± 9.77) years old and 59 patients in the control group aged (51.47 ± 9.85) years old. There was no statistically significant difference in upper limb dysfunction and quality of life between the two groups of patients before intervention ( P>0.05). After the intervention, the degree of upper limb dysfunction in the intervention group was (63.55 ± 7.02) points, which were lower than that in the control group (67.13 ± 7.25) points, and the difference was statistically significant ( t = 2.71, P<0.01). After the intervention, the total score of quality of life and the scores of physiological status, social/family status, emotional status, functional status and additional attention of breast cancer patients in the intervention group were (115.27 ± 17.35), (22.65 ± 4.53), (22.79 ± 4.36), (20.96 ± 3.95), (19.56 ± 4.22), (29.31 ± 5.24) points, which were higher than those in the control group (104.28 ± 17.04), (20.57 ± 4.48), (20.85 ± 4.23), (18.75 ± 4.04), (17.18 ± 4.06), (26.93 ± 5.21) points, the differences were statistically significant ( t values were 2.44-3.46, all P<0.05). In terms of exercise compliance of breast cancer patients in the intervention group, the aerobic exercise completion rate was 91.38% (53/58), muscle strength training completion rate was 77.59% (45/58), stretching exercise completion rate was 86.21% (50/58), exercise frequency was (3.96 ± 1.13) times/week, exercise duration was (29.51 ± 7.64) min/time, which was superior to 77.97% (46/59), 57.63% (34/59), 69.49% (41/59), (3.38 ± 0.94) times/week, (23.96 ± 7.33) min/time in the control group, the differences were statistically significant ( χ2 = 4.04, 5.31, 4.73, t = 3.02, 4.01, all P<0.05). Conclusions:"Internet plus" exercise prescription intervention has the characteristics of convenience, intuition and strong operability, which is conducive to improving the upper limb dysfunction, quality of life and exercise compliance of breast cancer patients at home after surgery. It is recommended to be popularized and applied clinically.

Objective:To investigate the efficacy and safety of endoscopic ligation and injection sclerotherapy for internal hemorrhoids.Methods:From April 2020 to October 2023, 106 patients with grade Ⅰ to Ⅲ internal hemorrhoids who underwent endoscopic ligation or injection sclerotherapy in the First Affiliated Hospital with Nanjing Medical University (Jiangsu Province People's Hospital) were consecutively enrolled in the retrospective cohort study. Patients were divided into the ligation group ( n=70) and the injection sclerotherapy group ( n=36) according to the endoscopic treatment methods. The effective rate, hospital stay, postoperative pain, the incidence of complications, patient satisfaction and the recurrence rate of the two groups were assessed. Results:The effective rate was 95.7% (67/70) and 100.0% (36/36) respectively in the ligation group and the injection sclerotherapy group without significant difference ( P=0.549). The hospital stay was 6.0 (4.0, 7.3) days and 3.0 (2.0, 4.0) days respectively in the ligation group and the injection sclerotherapy group with significant difference ( Z=4.305, P<0.001). The incidence of 24-hour postoperative pain was 58.6% (41/70) and 11.1% (4/36) in the two groups respectively and the difference was statistically significant ( χ2=20.020, P<0.001). There were no serious postoperative adverse events such as anal stenosis or thrombotic external hemorrhoids in the two groups. Only the incidence of anal distension was significantly different between the ligation group and the injection sclerotherapy group [38.6% (27/70) VS 5.6% (2/36), χ2=11.431, P<0.001]. The patient satisfaction rate of the two groups showed no significant difference [87.1% (61/70) VS 86.1% (31/36), P=1.000]. There was 1 patient and 15 patients lost to follow-up respectively in the ligation group and the injection sclerotherapy group, and the recurrence rate of the two groups showed no significant difference [14.5% (10/69) VS 33.3% (7/21), P=0.064]. Subgroup analysis of grade Ⅰ-Ⅱ internal hemorrhoids: there were 43 patients and 29 patients in the ligation group and the injection sclerotherapy group, respectively. No significant difference was found between the two groups in terms of the effective rate, incidence of postoperative hemorrhage, incidence of uroschesis, or patient satisfaction rate ( P>0.05). The incidences of postoperative pain [65.1% (28/43) VS 10.3% (3/29), χ 2=19.016, P<0.001] and anal distension [41.9% (18/43) VS 3.4% (1/29), χ 2=11.252, P<0.001] of the ligation group were significantly higher than those of the injection sclerotherapy group. Forty-three patients in the ligation group and 17 patients in the injection sclerotherapy group completed follow-up, and the recurrence rate was 11.6% (5/43) and 23.5% (4/17), respectively, without significant difference ( P=0.256). Subgroup analysis of grade Ⅲ internal hemorrhoids: there were 27 patients in the ligation group and 7 patients in the injection sclerotherapy group, and 26 and 4 patients completed follow-up, with a recurrence rate of 19.2% (5/26) and 75.0% (3/4), respectively. Conclusion:Endoscopic ligation and injection sclerotherapy are both safe and effective for grade Ⅰ-Ⅲ internal hemorrhoids. Injection sclerotherapy demonstrates shorter hospital stays and lower incidences of postoperative pain and anal distension. For grade Ⅰ-Ⅱ internal hemorrhoids, injection sclerotherapy is recommended due to its efficacy and fewer complications. Conversely, for grade Ⅲ internal hemorrhoids, ligation is suggested to reduce recurrence rates.