Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective:To identify risk factors for mortality in patients with cirrhosis and portal hypertension compli-cated by esophagogastric variceal bleeding(EVB)after transjugular intrahepatic portosystemic shunt(TIPS),and to estab-lish a prediction model.Methods:Clinical data of 80 patients who underwent TIPS from March 2022 to March 2024 were retrospectively analyzed.Based on 28-day outcomes,patients were divided into survival(n=65)and death(n=15)groups.Univariate and multivariate logistic regression analyses were used to determine independent predictors,and the model's calibration and discrimination were assessed by the Hosmer-Lemeshow test and ROC curve.Results:Inde-pendent risk factors for death included Child-pugh score(OR=2.653),MELD score(OR=1.924),bleeding volume(OR=1.754),portal vein thrombosis(OR=3.247),and hepatic encephalopathy(OR=2.834).The model demonstrated good cali-bration(Hosmer-Lemeshow χ2=7.142,P=0.521)and discrimination,with an AUC of 0.873(95%CI:0.773-0.939),sensi-tivity of 83.3%,and specificity of 87.7%.Conclusion:Child-pugh score,MELD score,bleeding volume,portal vein thrombosis,and hepatic encephalopathy are independent predictors of post-TIPS mortality in cirrhotic patients with EVB.Emergency TIPS carries higher mortality risk than elective TIPS.The proposed model shows strong predictive perfor-mance and may aid in individualized prognosis assessment and therapeutic decision-making.

Objective:To prepare nanoscale docetaxel-loaded lipid microbubbles(DLLM),characterize their physical and chemical properties,evaluate their biosafety and anti-tumor effects in vitro,and explore their potential as a targeted delivery system for chemotherapeutic drugs.Methods:DLLM was prepared by thin film hydration method.The morphology,particle size and distribution were characterized by transmission electron microscopy,scanning electron microscopy and particle size analyzer.The drug encapsulation efficiency was determined by high performance liquid chromatography.Human hepatoma HepG2 cells were used as a model to set up the control group(Control group),the docetaxel group(DOC group),the docetaxel-loaded lipid microbubbles group(DLLM group)and the docetaxel-loaded lipid microbubbles+ultrasound group(DLLM+US group).The cell morphology was observed by optical microscope,the cell survival rate was detected by CCK-8 method,and the apoptosis was detected by flow cytometry.The biocompatibility of microbubbles and their mediated ultrasound-enhanced anti-tumor effect were evaluated.Results:The prepared DLLM was regular spherical,with a particle size distribution range of 200-600 nm,an average particle size of 380 nm,and an encapsulation efficiency of 80.3％±2.6％.The cell viability of the DOC group and the DLLM+US group was significantly lower than that of the Control group(P＜0.01),and the apoptosis rate was significantly increased(P＜0.01).The cell viability of the DLLM+US group was lower than that of the DOC group(P＜0.05),and the apoptosis rate was higher than that of the DOC group(P＜0.05).There was no significant difference in cell viability and apoptosis rate between the DLLM group and the Control group(P＞0.05).Conclusions:The nano-scale DLLM prepared in this experiment has uniform particle size,high encapsulation efficiency,good stability and biocompatibility.DLLM can enhance the killing and pro-apoptotic effects of docetaxel on HepG2 cells under ultrasound irradiation.

Objective:To explore the effect of continuous passive motion(CPM)exercise instrument assisted tuina massage in postoperative rehabilitation of elderly patients with hip fracture.Methods:This study was a prospective randomized controlled study,a total of 78 elderly patients with hip fracture were admitted to our hospital from July 2022 to July 2024 were selected,they were divided into control group(routine rehabilitation training combined with tuina massage intervention,n=39)and study group(CPM exerciser intervention on the basis of control group,n=39)by random number table method.The harris hip function scale(HHS)score,visual analogue scale(VAS)score,excellent rate of hip joint function recovery,berg balance scale(BBS)score and 36-item short-form(SF-36)score were compared between two groups before intervention,1 month and 3 months after intervention.Results:The HHS score,BBS score and SF-36 score in the study group were higher than those in the control group at 1 month and 3 months after intervention,and the VAS score was lower than that in the control group(P＜0.05).The excellent rate of hip joint function recovery in the study group was higher than that in the control group(P＜0.05).Conclusion:The application of CPM exerciser instrument assisted tuina massage in the postoperative rehabilitation of elderly patients with hip fracture,can enhance the balance of patients,promote the recovery of hip function,reduce postoperative pain and improve the quality of life of patients.

Objective To propose a preventive maintenance strategy of the heating,ventilation and air-conditioning(HVAC)system in pharmacy intravenous admixture services(PIVAS)based on the reliability centered maintenance(RCM)method so as to provide references for PIVAS equipment maintenance.Methods Firstly,a HVAC system RCM review team was formed,and the failure modes and impacts of important functional components of the equipment were analyzed to clarify the consequences of the failure of each functional component under the premise of ensuring the safety and integrity of the equipment and with the goal of minimizing the loss of maintenance downtime and the consumption of maintenance resources.Secondly,with a standardized logical decision-making procedure the preventive maintenance strategy was determined and implemented based on the consequences of functional failure.Finally,statistical analyses were carried out on such equipment indicators as performance parameter qualification rate,failure rate and maintenance cost before and after the RCM method-based strategy was executed,in order to evaluate the efficacy of the strategy.Results The RCM method-based preventive maintenance strategy had the performance qualification rate increased from 97.47%to 99.06%(χ2=24.139,P<0.01),the failure rate decreased from 0.24%to 0.03%(χ2=13.519,P<0.01)and the maintenance cost reduced by 11.5%,from RMB 134,200 to 118,700.Conclusion The RCM method-based preventive maintenance strategy provides reliable equipment for PIVAS and lowers the maintenance cost effectively,and references are given for the development of automated and intelligent equipment maintenance strategies for PIVAS.[Chinese Medical Equipment Journal,2025,46(10):78-83]

Objective To explore the correlation between fasting blood glucose(FBG)level and fractional flow reserve(FFR)in patients with borderline coronary artery disease,and to clarify its potential influence on FFR measurement.Methods From August 2020 to August 2023,the data of 135 patients with coronary atherosclerotic heart disease who received coronary angiography and FFR evaluation in the Fourth Affiliated Hospital of Harbin Medical University were retrospectively collected.According to the exclusion and inclusion criteria,85 cases of borderline diseased vessels of single coronary artery with stenosis degree of 50％-80％were screened out,and they were divided into FBG≥6.1 mmol/L group(47 cases)and FBG＜6.1 mmol/L group(38 cases).The baseline data,angiographic and functional indexes of the two groups were compared,and the correlation between FBG and FFR was analyzed.Results Compared with the FBG＜6.1 mmol/L group,the FBG≥6.1 mmol/L group had a higher proportion of FFR negative results(72.3％vs.23.7％,P＜0.001),and the FFR measurement values were generally increased[0.84(0.80,0.90)vs.0.75(0.68,0.80),P＜0.001],with statistically significant differences.Pearson correlation analysis was performed on all lesions,and FFR＞0.80(negative result)was positively correlated with FBG≥6.1 mmol/L(r=0.484,P＜0.001).Conclusions Among the patients with borderline coronary artery disease(50％-80％stenosis)included in this study,FBG≥6.1 mmol/L is significantly correlated with FFR＞0.80.For patients with borderline coronary lesions with elevated FBG,the influence of blood glucose factors should be carefully considered in clinical interpretation of FFR results.

Conventional X-ray coronary angiography using iodinated contrast media is the gold standard technique for diagnosing coronary artery disease and determining treatment strategies,including percutaneous coronary intervention(PCI).However,severe allergy to iodinated contrast agents and renal insufficiency,as well as severely hyperthyroid patients,limit the use of iodinated contrast agents,especially in the face of acute coronary syndromes requiring emergency PCI.Gadolinium-based contrast agent is mainly developed for use in magnetic resonance imaging examinations,and there are few studies on whether it can be used for coronary angiography.We report a case of a patient who had a severe allergic reaction to an iodine contrast agent,and ultimately had a successful complex coronary intervention guided by the application of Gadolinium-based contrast agent combined with intravascular ultrasound.This case and a review of the relevant literature provide new ideas for coronary artery examination and treatment in patients with contraindications to iodine.

Objective:To prepare nanoscale docetaxel-loaded lipid microbubbles(DLLM),characterize their physical and chemical properties,evaluate their biosafety and anti-tumor effects in vitro,and explore their potential as a targeted delivery system for chemotherapeutic drugs.Methods:DLLM was prepared by thin film hydration method.The morphology,particle size and distribution were characterized by transmission electron microscopy,scanning electron microscopy and particle size analyzer.The drug encapsulation efficiency was determined by high performance liquid chromatography.Human hepatoma HepG2 cells were used as a model to set up the control group(Control group),the docetaxel group(DOC group),the docetaxel-loaded lipid microbubbles group(DLLM group)and the docetaxel-loaded lipid microbubbles+ultrasound group(DLLM+US group).The cell morphology was observed by optical microscope,the cell survival rate was detected by CCK-8 method,and the apoptosis was detected by flow cytometry.The biocompatibility of microbubbles and their mediated ultrasound-enhanced anti-tumor effect were evaluated.Results:The prepared DLLM was regular spherical,with a particle size distribution range of 200-600 nm,an average particle size of 380 nm,and an encapsulation efficiency of 80.3％±2.6％.The cell viability of the DOC group and the DLLM+US group was significantly lower than that of the Control group(P＜0.01),and the apoptosis rate was significantly increased(P＜0.01).The cell viability of the DLLM+US group was lower than that of the DOC group(P＜0.05),and the apoptosis rate was higher than that of the DOC group(P＜0.05).There was no significant difference in cell viability and apoptosis rate between the DLLM group and the Control group(P＞0.05).Conclusions:The nano-scale DLLM prepared in this experiment has uniform particle size,high encapsulation efficiency,good stability and biocompatibility.DLLM can enhance the killing and pro-apoptotic effects of docetaxel on HepG2 cells under ultrasound irradiation.

Objective:To explore the effect of continuous passive motion(CPM)exercise instrument assisted tuina massage in postoperative rehabilitation of elderly patients with hip fracture.Methods:This study was a prospective randomized controlled study,a total of 78 elderly patients with hip fracture were admitted to our hospital from July 2022 to July 2024 were selected,they were divided into control group(routine rehabilitation training combined with tuina massage intervention,n=39)and study group(CPM exerciser intervention on the basis of control group,n=39)by random number table method.The harris hip function scale(HHS)score,visual analogue scale(VAS)score,excellent rate of hip joint function recovery,berg balance scale(BBS)score and 36-item short-form(SF-36)score were compared between two groups before intervention,1 month and 3 months after intervention.Results:The HHS score,BBS score and SF-36 score in the study group were higher than those in the control group at 1 month and 3 months after intervention,and the VAS score was lower than that in the control group(P＜0.05).The excellent rate of hip joint function recovery in the study group was higher than that in the control group(P＜0.05).Conclusion:The application of CPM exerciser instrument assisted tuina massage in the postoperative rehabilitation of elderly patients with hip fracture,can enhance the balance of patients,promote the recovery of hip function,reduce postoperative pain and improve the quality of life of patients.

Objective To propose a preventive maintenance strategy of the heating,ventilation and air-conditioning(HVAC)system in pharmacy intravenous admixture services(PIVAS)based on the reliability centered maintenance(RCM)method so as to provide references for PIVAS equipment maintenance.Methods Firstly,a HVAC system RCM review team was formed,and the failure modes and impacts of important functional components of the equipment were analyzed to clarify the consequences of the failure of each functional component under the premise of ensuring the safety and integrity of the equipment and with the goal of minimizing the loss of maintenance downtime and the consumption of maintenance resources.Secondly,with a standardized logical decision-making procedure the preventive maintenance strategy was determined and implemented based on the consequences of functional failure.Finally,statistical analyses were carried out on such equipment indicators as performance parameter qualification rate,failure rate and maintenance cost before and after the RCM method-based strategy was executed,in order to evaluate the efficacy of the strategy.Results The RCM method-based preventive maintenance strategy had the performance qualification rate increased from 97.47%to 99.06%(χ2=24.139,P<0.01),the failure rate decreased from 0.24%to 0.03%(χ2=13.519,P<0.01)and the maintenance cost reduced by 11.5%,from RMB 134,200 to 118,700.Conclusion The RCM method-based preventive maintenance strategy provides reliable equipment for PIVAS and lowers the maintenance cost effectively,and references are given for the development of automated and intelligent equipment maintenance strategies for PIVAS.[Chinese Medical Equipment Journal,2025,46(10):78-83]