ObjectiveTo investigate the effect and potential mechanism of caffeic acid （CA） on severe acute pancreatitis （SAP） induced by caerulein combined with lipopolysaccharide （LPS）， and to provide a basis for the research on novel drugs for the treatment of SAP. MethodsC57BL/6J mice， aged 6 weeks， were divided into control group， model group， CA group， and octreotide acetate （OA） group， with 6 mice in each group. The mice in the control group were given injection of normal saline， and those in the other groups were given intraperitoneal injection of caerulein combined with LPS to establish a mouse model of SAP. At 1 hour after the first injection of caerulein， the mice in the CA group and the OA group were given intraperitoneal injection of CA or subcutaneous injection of OA at an interval of 8 hours. The general status of the mice was observed after 24 hours of modeling， and serum， pancreas， lung， and colon samples were collected. HE staining was used to observe the histopathological changes of the pancreas and lungs， and the serum levels of α-amylase， lipase， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， alanine aminotransferase， aspartate aminotransferase， and creatinine were measured. RT-PCR was used to measure the expression of proinflammatory factors in the pancreas and lungs； myeloperoxidase （MPO） immunohistochemistry was used to observe the degree of neutrophil infiltration； Western blot was used to measure the activation of nuclear factor-kappa B （NF-κB） and the level of citrullinated histone H3 （CitH3）， a marker for the formation of neutrophil extracellular traps （NETs）， in the pancreas and lungs， as well as the expression level of ZO-1 in colon tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the Dunnett’s t-test was used for further comparison between two groups. ResultsCompared with the control group， the model group had severe injury in the pancreas and lungs and significant increases in the activity of serum α- amylase and lipase and the levels of the proinflammatory cytokines IL-6， interleukin-1β （IL-1β）， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant increases in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. Compared with the model group， the CA group had alleviated pathological injury of the pancreas and lungs and significant reductions in the activity of serum α-amylase and the levels of the proinflammatory cytokines IL-6， IL-1β， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant reductions in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. ConclusionCA can alleviate SAP induced by caerulein combined with LPS in mice， possibly by inhibiting neutrophil recruitment and the formation of NETs.

Objective: To explore the correlation between allogeneic red blood cell (RBC) transfusion and healthcare-associated infections (HAIs) in patients undergoing coronary artery bypass grafting (CABG) during the perioperative period. Methods: A single-center retrospective cohort of 1,170 patients undergoing isolated CABG was analyzed. Multivariable logistic regression and restricted cubic splines (RCS) were employed to explore the nonlinear association between perioperative RBC transfusion (from intraoperative period to 72 hours postoperatively) and HAIs. Results: Among the 1,170 CABG patients, 109 patients (9.2%) received RBC transfusion during the operation or within 3 days after the operation. The risk of HAIs in those who received ≥4 units of RBCs during and within 3 days after the operation was 6.89 times higher than that in the non-transfusion group (95% CI: 3.65-17.20). Furthermore, there was a nonlinear threshold effect between the blood transfusion volume and postoperative HAIs (inflection point: 7.8 units). When the transfusion volume was ≤7.8 units, the risk of HAIs increased by 61% for each additional unit transfused (OR=1.61, 95% CI: 1.21-2.15). Beyond this threshold, no statistically significant association was observed (P=0.289). Conclusion: Perioperative RBC transfusion in CABG patients is associated with an increased incidence of HAIs. The perioperative blood transfusion volume has a curvilinear relationship with the risk of postoperative HAIs. When the blood transfusion volume is ≤7.8 units, the blood transfusion volume has a dose-dependent relationship with postoperative infection, with higher blood transfusion volumes correlating with greater postoperative infection risk. When the blood transfusion volume is >7.8 units, the relationship between the two is not statistically significant. The preventive effect of reducing RBC transfusion on HAIs requires further validation in the future.

To explore the chemical constituents of Ecballium elaterium and their cytotoxicity, this study employed multiple chromatographic techniques including normal-phase silica gel, MCI, octadecylsilyl(ODS), Sephadex LH-20 gel, and semi-preparative liquid chromatography for compound isolation from its active fraction. A total of 12 compounds were obtained, and they were identified according to the analysis of a variety of spectral data and literature comparison as 24Z-20,27-dihydroxy-16α,23α-epoxy-cucurbita-2-O-α-L-rhamnopyranosyl-(1→2)-β-D-glucopyranoside(1), cucurbitacin R(2), cucurbitacin B(3), cucurbitacin D(4), cucurbitacin I(5), cucurbitacin L(6), dehydrodiconiferyl alcohol(7), 3-hydroxy-4-methoxycinnamic acid(8), ferulaic acid(9), p-coumaric acid(10), rutin(11), and lariciresinol-4'-O-β-D-glucoside(12), among which compound 1 was a new compound. Compounds 2-6 had strong cytotoxicity against human lung carcinoma A549 cells with the IC_(50) values of(0.48±0.09),(0.03±0.002),(0.13±0.03),(0.87±0.14),(0.15±0.03) μmol·L~(-1), respectively, which were stronger than the positive control doxorubicin \[IC_(50)=(3.92±1.60) μmol·L~(-1)\].
Humans ; Drugs, Chinese Herbal/toxicity* ; Cell Line, Tumor ; Cucurbitaceae/chemistry* ; Cell Survival/drug effects*

Three taraxerane nortriterpenoids were isolated from mastic by using various modern chromatographic separation techniques. They were identified as(5R,8R,9R,10S,11S,12R,13S,17R,18R)-28-norlupa-11,12-epoxy-14-taraxerene-3,16-dione(1),(5R,8R,9R,10S,11S,12R,13S,17S,18S)-17-hydroxy-28-norlupa-11,12-epoxy-14-taraxerene-3-one(2), and(5R,8R,9R,10R,11S,12R,13R,14S,17S,18S)-14,17-epoxy-28-norlupa-11,12-oxidotaraxerone(3) through the high-resolution electrospray ionization mass spectrometry(HR-ESI-MS), infrared(IR), ultraviolet(UV), nuclear magnetic resonance(NMR), and single-crystal X-ray diffraction techniques as well as comparison with literature data. Compounds 1-3 were C-28 nortriterpenoids and isolated from mastic for the first time, and compounds 1-2 were new ones. In the model for RAW264.7 cell anti-inflammation induced by lipopolysaccharide(LPS), compound 1 demonstrates an inhibitory effect on nitric oxide(NO) [IC_(50)=(13.38±0.68) μmol·L~(-1)], comparable to the activity of the positive control dexamethasone [IC_(50)=(14.59±1.49) μmol·L~(-1)]. Compounds 2 and 3 exhibit weaker inhibitory effects, with IC_(50) values of(24.17±2.56) and(22.25±2.84) μmol·L~(-1), respectively.
Animals ; Mice ; Triterpenes/isolation & purification* ; Drugs, Chinese Herbal/isolation & purification* ; Mastic Resin/chemistry* ; Nitric Oxide ; Molecular Structure ; Macrophages/immunology* ; RAW 264.7 Cells

OBJECTIVE: To accurately measure human energy metabolism with high temporal resolution, a respiratory gas analysis system was designed using a breath-by-breath approach. METHODS: Firstly, indirect calorimetry was employed in respiratory gas analysis to measure the respiratory flow and concentration signals in real-time. Secondly, oxygen consumption QO2 and carbon dioxide production QCO2 were calculated through respiratory characteristic alignment and respiratory signal segmentation. Finally, metabolic indexes were calculated according to the Weir formula. Furthermore, a controlled trial was formulated for validation comparisons with the MGC ULTIMA SYSTEM PFX CARDIO2. RESULTS: The results indicate that the data points of metabolic indexes measured by this system all fall within the confidence interval when compared with those of the MGC. CONCLUSION The system has high consistency with the MGC measurement results. Thus, the system can accurately measure metabolism in real-time and provide data support for clinical nutrition assessment and therapy.
Humans ; Energy Metabolism ; Breath Tests/instrumentation* ; Calorimetry, Indirect/instrumentation* ; Equipment Design

Non-bifurcating cervical carotid artery(NBCCA)is a very rare anatomical variation of the cervical carotid artery,which may be related to the abnormal development of internal carotid artery(ICA)and external carotid artery in embryonic period.Neither carotid bulb nor a true carotid bifurcation can be observed on the ultrasound of carotid artery while a"stump-like"change was showed at the expected bifurcation level of carotid artery on DSA.Few cases has been reported in China and abroad so far.This article reported a middle-aged male with a history of hypertension and type 2 diabetes and was admitted to the hospital due to dizziness for one month.The left NBCCA accompanied with severe stenosis of the right ICA was confirmed by cerebral angiography.The patient received the right ICA stent implantation surgery as well as antihypertensive and glucose-control treatment and was discharged as his symptoms improved.Clinical data of this case and related literatures were reviewed,in order to improve clinicians'especially imaging diagnostic physicians'understanding on NBCCA to avoid misdiagnosis and related complications.

Objective To explore and construct an indicator system for performance appraisal in operating room nurses of cancer hospitals,in order to provide references for performance management.Methods From May to December 2022,the four-dimensional model of individual performance was used as the theoretical framework,and the research was carried out by literature research method,focus group interview method,Delphi expert consultation method and analytic hierarchy process,to establish the content of the performance appraisal index system of operating room nurses in cancer hospitals and the weight of each index.Results After 2 rounds of expert correspondence,29 questionnaires were sent out and 27 returned in the first round,with an expert positive coefficient of 93.10％;27 questionnaires were sent out and 27 returned in the second round,with an expert positive coefficient of 100％;expert authority coefficient of the first round was 0.941 and the second round was 0.937.In the first round,the variation coefficient of each index was 0-0.249,and the coordination coefficient was 0.201-0.352;in the second round,the variation coefficient of each index was 0-0.204,and the coordination coefficient was 0.275-0.407.Finally,a performance appraisal index system of operating room nurses in cancer hospitals was formed,which consisted of 4 first-level indicators,including task performance,interpersonal performance,adaptive performance and effort performance,11 second-level indicators and 54 third-level indicators.Conclusion The indicator system for performance appraisal in operating room nurses of cancer hospitals constructed in this study is reliable and scientific,specialized and applicable,and it can provide references for performance management.

Ten compounds were separated by various modern chromatographic methods from mastic. They were identified by HR-ESI-MS, IR, UV, NMR, quantum chemical calculation of NMR(qcc-NMR) and comparison with reported data in literature as 17β-hydroxy-28-norolean-18-en-3-one(1), 28-norolean-12,17-dien-3,11-dione(2), 28-norolean-16,18-dien-3-one(3),(24Z)-26-hydroxy-7,24-dientirucalla-3-one(4), masticadienonic acid(5)、masticadienolic acid(6)、erythrodiol(7), 3β,28-dihydroxyoleana-11,13(18)-diene(8), 3-oxo-olean-9(11),12-dien-28-oic acid(9), and 12-oleane-3,11-dione(10). Among them, compound 1 was a novel compound and compound 2 was a novel natural product. Compounds 1-2, 4, and 7-9 were isolated from mastic for the first time. Compound 1 significantly inhibited lipopolysaccharide-induced production of nitric oxide in mouse monocyte macrophage RAW264.7 cells with the IC_(50) of(7.44±0.49) μmol·L~(-1), which was more potent than the positive control, dexamethasone \[IC_(50)=(9.93±1.17) μmol·L~(-1)\]. Compounds 2-3, 5, and 9-10 also showed inhibitory effects, with the IC_(50) ranging from 14.82 to 28.82 μmol·L~(-1). Compounds 4-5, and 7 markedly inhibited the growth of human colon adenocarcinoma cells SW480, with the IC_(50) of(16.13±1.69),(27.40±1.81), and(10.01±0.10) μmol·L~(-1), respectively.
Mice ; Animals ; Mastic Resin/chemistry* ; Humans ; Macrophages/metabolism* ; Triterpenes/isolation & purification* ; Nitric Oxide ; Molecular Structure ; RAW 264.7 Cells ; Drugs, Chinese Herbal/isolation & purification*

Thyroid eye disease (TED) is an autoimmune disease closely related to Graves' disease and also the most common orbitopathy, which remains a challenge to diagnose and manage.In addition to the updated clinical practice guideline released by European Group on Graves' Orbitopathy in 2021 and the Chinese guideline released by Chinese Medical Association in 2022, a consensus statement was made by the American Thyroid Association and the European Thyroid Association in 2022.This consensus statement reviewed the latest research progress and clinical experience summarized from the last few decades as an aid to doctors involved in the management of TED.Further elucidation of key points from the consensus statement will be provided in this paper.

Objective To explore the mediating effect of nurse professional identity between the practice environment and safety behavior,in order to provide references and bases for managers to formulate scientific,reasonable and standardized interventions for nurse safety behavior.Methods A total of 1381 nurses from 5 tertiary general hospitals in Beijing were adopted for investigation from May to June 2022 by convenience sampling method.They were investigated with general information questionnaire,Nurse Safety Behavior Questionnaire,Nursing Practice Environment Assessment Scale and Nurse Professional Identity Assessment Scale.The structural equation model was used to analyze the mediating effect of nurse professional identity between practice environment and safety behavior.Results Finally,1303 nurses participated in the survey.The total scores of nurse safety behavior scale,nursing practice environment assessment scale and nurse professional identity scale were 59.0(56.0,60.0)points,3 441.0(3 066.0,3 586.0)points,131.0(115.0,150.0)points,which were all above the medium level.Nurse safety behavior was significantly positively correlated with nurse professional identity and the nurse practicing environment assessment(r=0.516,0.421,P<0.01),and was significantly positively correlated with the scores of all dimensions(P<0.01).The practice environment and professional identity can directly and positively affect the level of nurse safety behavior.The mediating test shows that nurse professional identity plays a partial mediating effect between the practice environment and safety behavior,and the mediating effect is 0.184,accounting for 46.11%of the total effect.Conclusion In this study,nurse professional identity is a mediator between the practice environment and safety behavior.Nursing managers should pay attention to the cultivation of nurses'professional identity and optimize the working environment of clinical nurses,so as to improve nurse safety behavior and ensure the safety of patients.