Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.

Objective: To evaluate the effect of Tai Chi and Qigong on patients with lumbar disc herniation (LDH). Methods: Relevant data were retrieved from nine English and Chinese databases, including Cochrane Library, PubMed, and Wanfang Data, etc. from inception to June 2024. All published randomized controlled trials assessing the effect of Tai Chi and Qigong on visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, and other health indicators in participants with LDH compared to usual medical care or other treatments were included. Grey literature, trials involving the pushing of hands (Tui Shou) or Tai Chi with weapons, and trials with co-interventions (Tai Chi/Qigong plus another treatment) were excluded. Methodological quality was analyzed using the Cochrane risk of bias tool, and evidence quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool. Results: Fourteen trials (954 patients) were included in this study. Tai Chi and Qigong were associated with lower VAS pain scores (standardized mean difference −0.55, 95% confidence interval [CI] −0.95 to −0.15, P = .01), higher JOA scores (mean difference [MD] 4.40, 95% CI 2.62 to 6.18, P < .001) and straight leg raise test results (MD 9.40°, 95% CI 7.64 to 11.15, P < .001) in patients with LDH. Furthermore, compared with usual care, Tai Chi and Qigong showed enhanced effects on pain and JOA scores. When compared to other exercises or massage, the effect on pain scores was similar but that on JOA scores was significant. Conclusions Tai Chi and Qigong may have favorable effects on VAS pain and JOA scores compared with usual care, and on JOA scores compared with other exercises or massage in patients with LDH. Given the overall poor quality of the evidence, the results of current study should be interpreted cautiously.

Objective:To explore the value of machine learning models based on multiple structural MRI features for diagnosis of Parkinson disease (PD).Methods:The clinical and imaging data of 60 PD patients (PD group) diagnosed in the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2017 to August 2019 and 56 normal elderly people (NC group) recruited from the community were retrospectively analyzed. All subjects underwent brain MR imaging. Multiple structural MRI features were extracted from cerebellum, deep nuclei and of brain cortex based on different partition templates. The Mann-Whitney U test, as well as least absolute shrinkage and selection operator regression were used to select the most discriminating features. Finally, logistic regression (LR) and linear discriminant analysis (LDA) classifier combined with the 5-fold cross-validation scheme were used to construct the models based on structural features of cerebellum, deep nuclei and cortex, and a combined model based on all features. The receiver operating characteristic curves were drawn, and the diagnostic performance and clinical net benefit of each model were evaluated by the area under curve (AUC) and the decision curve analysis (DCA). Results:In total, four cerebellum (asymmetry index of Lobule Ⅵ volume, asymmetry index of Lobule ⅦB cortical thickness, asymmetry index of total gray matter volume and absolute value of right Lobule Ⅵ gray matter volume), 3 deep nuclei (absolute value of right nucleus accumbens volume, absolute and relative value of total nucleus accumbens volume) and 3 cortex features (local gyration index of left PFm, local fractal dimension of right superior frontal gyrus and sulcal depth of left superior occipital gyrus) were selected as the most discriminating features, and the related models were constructed. In validation set, the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LR classifier were 0.692, 0.641, 0.747 and 0.816; the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LDA classifier were 0.726, 0.610, 0.752 and 0.818. The diagnostic efficiency of the combined models based on LR and LDA classifiers were significantly better than those of other models ( P<0.05). The DCA curve demonstrated that the combined models based on LR and LDA classifiers showed the highest clinical net benefit. Conclusion:The combined models with all structural features of cerebellum, deep nuclei and cortex included based on LR and LDA classifiers showed favorable performance and clinical net benefit for diagnosis of PD, which have the potential application value in clinical diagnosis.

Objective:To investigate the prevalence, risk factors and outcomes of diastasis recti abdominis (DRA) in multiparas after the second delivery.Methods:From June 2017 to September 2019, 300 multiparas with an average age of (31.7±4.0) years (26 to 43 years) after the second delivery were recruited at 6 weeks postpartum from two hospitals in Wenzhou. There were 171 multiparas with two natural births,36 multiparas with one natural birth and one caesarean delivery, and 93 multiparas with two caesarean deliveries. The interrectus distance (IRD) was measured with palpation at 6 weeks, 6 months and 12 months after delivery. Data on age, height, weight before pregnancy and delivery, baby′s birth weight, abdominal circumference before pregnancy and delivery, fetus number, delivery mode and occupation type were collected. Strength and endurance of abdominal muscle was assessed using manual muscle testing and curl-ups, low back pain was assessed using Oswestry disability index(ODI), urinary incontinence was assessed with International Consultation on Incontinence guestionnaire-incontinentia urinae (ICIQ-UI) short form (ICIQ-SF), and quality of life was assessed using 36-item short form health survey (SF-36).Results:Prevalence of DRA was 51.7%(155/300), 39.3%(116/295) and 27.7%(80/289) 6 weeks, 6 months and 12 months after delivery, respectively. Logistic regression analysis indicated that age ( OR=1.39, 95 %CI:1.02-1.91, P=0.38), abdominal circumference ratio ( OR=2.31, 95 %CI:1.23-4.33, P=0.01), twins ( OR=11.41, 95 %CI:2.15-60.76, P<0.01), and cesarean section ( OR=1.44, 95 %CI:1.06-1.95, P=0.02) were the risk factors of DRA at 12 months after delivery. At 12 months after delivery, the multiparas with DRA had weaker strength and endurance of abdominal muscle ( Z=-3.62, P<0.01; Z=-8.91, P<0.01), more serious low back pain ( Z=-2.10, P=0.04), and lower quality of life on physical health ( t=-3.34, P<0.01) than the multiparas without DRA. No difference in prevalence and severity of urinary incontinence and quality of life on psychological health was found when comparing multiparas with and without DRA (χ 2=0.66, P=0.42; Z=-1.18, P=0.24; t=0.91, P=0.36). Conclusion:Multipara after the second delivery has great likelihood for DRA.Age, abdominal circumference ratio, twins, and cesarean section are the risk factors of DRA. DRA is related to abdominal muscle dysfunction, low back pain, and quality of life.

Nursing education emphasizes the cultivation of high-quality talents, and high-fidelity simulation has been applied to the training and evaluation of nursing staff. This article summarizes the status quo of nursing education evaluation at home and abroad and the application of high-fidelity simulation in education evaluation, in order to apply high-fidelity simulation to the evaluation of nursing professionals and provide ideas for the reform of nursing education.

Objective To investigate the correlation of interleukin-1β (IL-1β) ,homocysteine (HCY) ,cysta-tin (Cys-C) and glycosylated hemoglobin (HbA1c) levels and senile type 2 diabetic peripheral neuropathy. Methods 104 patients with type 2 diabetes mellitus received in the hospital from June 2014 to December 2016 were selected as study group ,52 patients with peripheral neuropathy were served as study group A (n=52) and 52 patients with type 2 diabetes were served as study group B (n=52) ,and 52 healthy persons who under-went health assessement were taken as the control group.The Cys-C level was measured by immunoturbidime-try ,the levels of HCY and IL-1β were measured by enzyme-linked immunosorbent assay.The HbA1c level was measured by high performance liquid chromatography ,the IL-1β ,HCY ,Cys-C and HbA1c levels were com-pared in the three groups ,and the relationship between IL-1β ,HCY ,Cys-C and HbA1c levels and senile type 2 diabetic peripheral neuropathy were analyzed.Results Single factor variance analysis showed that the levels of IL-1β ,HCY ,Cys-C and HbA1c in the three groups were statistically significant (P＜0.05) ;LSD-t test showed that the IL-1β ,HCY ,Cys-C and HbA1c levels in the study group B were higher than those in control group , and IL-1β ,HCY ,Cys-C and HbA1c levels in the study group A were higher than those in the study group B , and the difference was statistically significant (P＜ 0.05) ;logisticis regression analysis showed that IL-1β , HCY ,Cys-C ,HbA1c levels were associated with type 2 diabetic peripheral neuropathy (P＜0.05) ;Spearman test showed that IL-1β ,HCY ,Cys-C ,HbA1c levels were positively correlated with type 2 diabetic peripheral neuropathy (P＜0.05).Conclusion IL-1β ,HCY ,Cys-C and HbA1c levels are positively correlated with senile type 2 diabetic peripheral neuropathy in the elderly ,and the IL-1β ,HCY ,Cys-C and HbA1c levels can be used to determine type 2 diabetic peripheral neuropathy in clinical work.

Objective: To observe the integration frequency of aadA2 resistance cassette at attI site of the integron under different concentration of streptomycin. Methods: Class 1 integron with known gene sequence was cloned into plasmid pACYC184 to produce recombinant plasmid pACIDA, meanwhile the integrase gene was cloned into plasmid pET28a to construct recombinant plasmid pETINT. These two recombinant plasmids were consecutively transformed into E. coli BL(DE3). These transformed bacteria was cultured in the LB medium at 37 ℃ overnight with addition of different concentration of streptomycin. The copy number of total integrons and the copy number of integrated aadA2 at attI site of integrons were determined by using real-time PCR. and the integration frequency is the result of the former divided by the latter. Results: The resulting frequencies were (1.97±0.24)×10^-3, (3.23±1.77)×10^-3, (3.27±0.67)×10^-3, 0.45±0.13 and 1.32±0.11, with respective streptomycin concentrations of 0, 20, 30, 40 and 50 μg/ml. The background frequency of integration without integrase overexpression was less than (1.75±0.33)×10^-7. Conclusion These findings indicate that antibiotic concentration significantly increase recombination frequency of aadA2 resistance cassette at attI site of the integron, catalyzed by integron integrase.(Chin J Lab Med, 2018, 41: 531-535)

The exogenous gene expression and its impacts on the bacterial population are important to study quorum sensing systems and synthetic biology industry. However, the behavior of exogenous protein expressing bacteria remains poorly understood. To find out which factors are playing a critical role in the growth of population and exogenous gene expression, we measured Lux-type receptor-regulated exogenous gene expression under the induction of N-acyl homoserine lactone (N-AHL) signaling molecules and impacts on the bacterial population dynamics after such stimulation. To analyze the cause of fitness burden of bacteria, we set up a hypothetical mathematical model. Previous studies often arrogate this phenomenon to the synthesis cost and the toxicity of N-AHL signaling molecule. However, we suggested another possible cause of the fitness burden.
Bacteria ; Gene Expression ; Gene Expression Regulation, Bacterial ; Quorum Sensing

Objective: To observe the protective effects of the alcohol extract, ethyl acetate extract and 1-butanol extract of Euonymus hederaceuson on H2O2-induced oxidative damage of vascular endothelial cells ECV-304.Methods: ECV-304 cells were cultured in vitro and H2O2-induced oxidative damage in ECV-304 cells was used as the model.After the treatment with ethanol extract, ethyl acetate extract or 1-butanol extract of Euonymus hederaceus (the final concentration of 400, 200, 100, 50 and 25 μg·ml-1) for 24h, the cell viability was detected by MTT assay.Hoechst staining was used to observe the cell apoptosis, and then the supernatant was collected, and the contents of SOD, NOS and NO were used to determine the effects of the extracts on the oxidative stress of vascular endothelial cells.Results: The ethanol extract, ethyl acetate extract and 1-butanol extract of Euonymus hederaceus within the concentration range of 25-400 μg·ml-1 showed no cytotoxicity on ECV-304 cells, and the ethyl acetate extract at the concentration of 400μg·ml-1 had certain proliferation effect on the cells (P<0.05).The ethyl acetate extract at the concentration of 50-400 μg·ml-1 and the 1-butanol extract at the concentration of 100-400 μg·ml-1of Euonymus hederaceus could increase the survival rate of ECV-304 cells with oxidative injury significantly, and the OD value showed significant difference when compared with that of the model group (P<0.05 or P<0.01).The ethanol extract, ethyl acetate extract and 1-butanol extract of Euonymus hederaceus could significantly improve the SOD and NO levels in ECV-304 cells with oxidative damage (P<0.05 or P<0.01), and had no notable influence on NOS level.The ethanol extract, ethyl acetate extract and 1-butanol extract of Euonymus hederaceus could inhibit the cell apoptosis with oxidative damage and improve the nuclear morphology, and the apoptosis exhibited significant difference when compared with that of the model group (P<0.01).Conclusion: The extracts of Euonymus hederaceus have protective effects on vascular endothelial cells with oxidative damage induced by H2O2.

OBJECTIVE: Tried to find the relationship between tinnitus and each testing method, provided information for objective diagnosis and treatment for tinnitus patients with sensorineural hearing loss. METHOD: The characteristics of audiology tests, including pure tone audiometric, acoustic immittance, middle ear muscle reflexes, matching test, distortion products otoacoustic emission(DPOAE) were compared in 79 ears of 69 tinnitus patients with sensorineural hearing loss. RESULT: The RI positive rate was higher in Convergence curve in tinnitus patients of sensorineural hearing loss, with the rate being 51.3%. The detection rates of DPOAE were 15.2% in patients of sensorineural hearing loss tinnitus groups, which were significant lower than those in control group. CONCLUSION Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, these data can help clinicians design needed based managements. DPOAE test is helpful for the diagnosis of lesions in some tinnitus patients.
Audiometry, Pure-Tone ; Hearing Loss, Sensorineural ; complications ; physiopathology ; Hearing Tests ; methods ; Humans ; Otoacoustic Emissions, Spontaneous ; Psychoacoustics ; Tinnitus ; complications ; physiopathology