Objective·To measure the parameters of the uterine artery,umbilical artery and middle cerebral artery in a rat model of preeclampsia(PE)by Doppler ultrasound,and compare the pathological changes in placental blood vessels and pregnancy outcomes,in order to provide an effective method and reference for evaluating placental function in PE animal models.Methods·PE(n=8)and normal pregnancy(NP,n=8)groups in Sprague-Dawley(SD)rat models were established by intraperitoneal injections of N'-nitro-L-arginine methylesterhydrochloride(L-NAME)and 0.9%sodium chloride solution.Blood pressure and proteinuria indexes were detected to evaluate whether the model was successfully established.On gestational day 19(GD19),Doppler ultrasound was utilized to measure the parameters of the uterine artery,umbilical artery and the fetal middle cerebral artery in both the PE and NP groups.After termination of the pregnancies,placental function was evaluated through the pathology of placental blood vessels and the quality of the fetuses and placentas.Results·In the PE group,both blood pressure(GD15:P=0.001;GD19:P=0.001)and proteinuria(GD15:P=0.001;GD19:P=0.001)were significantly higher than those in the NP group.The pulsatility index(PI)of the umbilical artery and uterine artery was notably elevated in the PE group compared to the NP group(both P=0.000).Furthermore,the resistance index(RI)of the fetal middle cerebral artery was significantly lower than that in the PE group(P=0.000).While the number of fetal rats did not differ significantly,the quality of placental and fetal rats was notably lower in the PE group(P=0.006 and P=0.000,respectively).Immunohistochemical staining of placental tissue revealed that the number of placental micro vessel densities in the PE group was less than that in the NP group(P=0.001).Correlation analysis revealed that placental micro vessel density,fetal quality and placental quality were inversely related with the RI of the umbilical artery and the PI and RI of the uterine artery,and positively correlated with the S/D,PI and RI of the fetal middle cerebral artery(all P<0.05).Conculsion·Doppler ultrasound assessment of the uterine artery,umbilical artery and middle cerebral artery indices in L-NAME-induced PE rat models effectively reflects pregnancy outcomes and placental vascular pathology.This method is valuable for evaluating placental vascular perfusion in PE rat models,offering practicality and convenience for research involving animal models.

Objective To study the effects of ultrasound-guided quadratus lumborum block(QLB)on intraoperative hemodynamics and opioid dosage in emergency patients with ectopic pregnancy.Methods A total of 70 patients with ectopic pregnancy undergoing laparoscopic surgery in Langfang People's Hospital from January 2021 to February 2024 were selected as subjects.According to the different anesthesia methods,the patients were divided into the control group and the study group,with 35 cases in each group.The control group was given general anesthesia,while the study group additionally added ultrasound-guided QLB.The intraoperative sedation effect,hemodynamics,postoperative pain,incidence of adverse reactions and opioid use at different times(admission,entry,intubation,skin incision,extubation,and discharge)were observed in the two groups.Results There were no statistically significant differences in the onset time of sedation,the rate of salvage sedation,the incidence of intraoperative body movements,the modified observer's assessment of alert/sedation(MOAA/S)at each time,and the hemodynamics at the time of admission,entry and intubation between the two groups.The mean arterial pressure(MAP),systolic blood pressure(SBP)and heart rate(HR)in the study group were significantly lower than those in the control group during skin incision,extubation and discharge[skin incision:MAP(mmHg,1 mmHg≈0.133 kPa)was 85.24±4.59 vs.96.95±4.68,SBP(mmHg)was 92.24±4.85 vs.99.49±5.13,HR(times/min)was 85.33±2.96 vs.94.51±2.92;extubation:MAP(mmHg)was 94.84±5.02 vs.102.05±5.13,SBP(mmHg)was 96.48±4.72 vs.105.03±5.07,HR(times/min)was 95.51±4.95 vs.102.49±5.87;discharge:MAP(mmHg)was 86.14±4.99 vs.93.71±5.25,SBP(mmHg)was 96.48±4.69 vs.104.37±5.02,HR(times/min)was 84.05±4.57 vs.90.51±4.86,all P<0.05]and pulse oxygen saturation(SpO2)was higher than those in the control group(skin incision:0.988 5±0.012 2 vs.0.965 4±0.012 3,extubation:0.974 7±0.012 4 vs.0.963 2±0.012 1,discharge:0.981 1±0.012 4 vs.0.970 3±0.012 3,all P<0.05).The resting numeric rating scale(NRS)scores and active NRS scores in the study group were lower than those in the control group at 3,6,12,and 24 hours after surgery,the random time was prolonged,the resting NRS and active NRS in the two groups gradually increased,reaching a peak at 24 hours after surgery,and the resting NRS and active NRS in the study group were significantly lower than those in the control group(resting NRS:3.86±0.82 vs.4.53±1.04,active NRS:4.26±1.05 vs.4.85±1.13,all P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group[11.43%(4/35)vs.34.29%(12/35),P<0.05].The dosage of Sufentanil in 24 hours and 48 hours,the number of analgesic pump in 48 hours and the number of relief analgesia cases in the study group were lower than those in the control group[the dosage of Sufentanil in 24 hours(μg):23.28±4.02 vs.36.14±4.57,the dosage of Sufentanil in 48 hours(μg):41.61±4.82 vs.59.33±6.25,the number of analgesic pump in 48 hours(times):2.94±1.22 vs.6.15±1.71,the proportion of relief analgesia:8.57%(3/35)vs.28.57%(10/35),all P<0.05].Conclusion Ultrasound-guided QLB can reduce hemodynamic fluctuations,relieve postoperative pain,reduce adverse reactions and opioid use in emergency patients with ectopic pregnancy,demonstrating a positive impact.

Objective To observe the effect of quadratus lumborum block(QLB)anesthesia on intraoperative blood gas indexes and postoperative recovery in female uremic patients with peritoneal dialysis catheterization.Methods A total of 70 female uremic patients with peritoneal dialysis catheterization admitted to Langfang People's Hospital from January 2021 to December 2023 were selected as the research objects.According to the random number table method,they were divided into the control group and the study group,with 35 cases in each group.The control group was given conventional local infiltration anesthesia,whereas the study group was given QLB anesthesia.The changes of mean arterial pressure(MAP),heart rate(HR),blood gas indexes[pulse oxygen saturation(SpO2),arterial partial pressure of carbon dioxide(PaCO2)]and numeric rating scale(NRS)score,at different points pain factors[5-hydroxytryptamine(5-HT),substance P(SP),norepinephrine(NE)]before operation and 24 hours after operation,postoperative recovery(time to get out of bed for the first time,exhaust time,length of hospital stay)and adverse reactions were observed in the two groups.Results There was no significant difference in MAP,HR,blood gas index and NRS score between the two groups at the admission.The MAP,HR,PaCO2 in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture,and leaving the room,and SpO2 was significantly higher than that in the control group,and NRS score in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture(all P<0.05).There was no significant difference in the levels of 5-HT,SP and NE between the two groups before operation,but the levels of 5-HT,SP and NE at 24 hours after operation were significantly higher than those before operation,but the levels of 5-HT,SP and NE in the study group were lower than those in the control group.The first ambulation time,exhaust time and hospitalization time in the study group were significantly shorter than those in the control group(all P<0.05).The incidence of nausea and vomiting,constipation,pruritus,dizziness and other adverse reactions in the study group was significantly lower than that in the control group(all P<0.05).Conclusion QLB can reduce the fluctuation of intraoperative blood gas indexes in female uremic patients with peritoneal dialysis catheter,relieve postoperative pain,reduce the level of pain factors and reduce the occurrence of adverse reactions,and has a good effect on promoting postoperative recovery of patients.

Covalently closed circular DNA(cccDNA)in hepatocytes is the replication intermediate of hepa-titis B virus(HBV),which is closely related to HBV replication.Meanwhile,it is the transcriptional template of pregenomic RNA(pgRNA),and most of the HBV RNA in serum is derived from unreversed transcribed pgRNA.In recent years,many studies have demonstrated that HBV RNA has an important role in monitoring disease progression and predicting the prognosis of chronic HBV-infected patients,and is a potential biomarker of chronic viral hepatitis B.This article provides an overview of the molecular characterisation of HBV RNA,detection methods and research progress in clinical applications.

OBJECTIVE: To analyze the clinical characteristics of patients with emergency in-hospital cardiac arrest (IHCA) in Kashgar, Xinjiang Uygur Autonomous Region and the factors affecting the success rate of cardiopulmonary resuscitation. METHODS: Retrospectively selected patients who had cardiac arrest and cardiopulmonary resuscitation in the emergency department of the People's Hospital of 6 counties and cities in Kashgar area from January 2019 to January 2022. The clinical data of all patients were collected, including gender, age, major underlying diseases, the beginning and duration of resuscitation, the number of electric defibrillation acute physiology and chronic health evaluation II (APACHE II). According to whether the resuscitation was successful, all patients were divided into successful resuscitation group and failed resuscitation group. The clinical characteristics of the two groups were compared. Then, the influencing factors of the success rate of cardiopulmonary resuscitation in IHCA patients were analyzed by binary Logistic regression. RESULTS: A total of 1 376 patients were enrolled, including 1 117 cases of failed resuscitation and 259 cases of successful resuscitation. The success rate of resuscitation was 18.82%. Compared with the resuscitation failure group, the patients in the successful resuscitation group were younger (age: 49.10±20.99 vs. 58.44±18.32), the resuscitation start time was earlier [resuscitation start time ≤ 5 minutes: 76.45% (198/259) vs. 66.61% (744/1 117)], the proportion of cardiovascular and cerebrovascular diseases was lower [cardiovascular disease: 49.42% (128/259) vs. 58.19% (650/1 117), cerebrovascular disease: 17.37% (45/259) vs. 21.58% (241/1 117)], the number of electric defibrillation was lower [times: 0 (0, 2) vs. 1 (0, 1)], the proportion of endotracheal intubation was more [80.31% (208/259) vs. 55.60% (621/1 117)], APACHE II score was lower (13.75±8.03 vs. 17.90±4.63), and the difference was statistically significant (all P < 0.01). Binary Logistic regression analysis showed that age, start time of resuscitation, ventilation mode and APACHE II score were protective factors affecting the success rate of cardiopulmonary resuscitation in patients with emergency IHCA [age: odds ratio (OR) = 0.982, 95% confidence interval (95%CI) was 0.973-0.991, P < 0.001; resuscitation start time ≤ 5 minutes: OR = 0.629, 95%CI was 0.409-0.966, P = 0.034; tracheal intubation assisted ventilation: OR = 0.243, 95%CI was 0.149-0.397, P < 0.001; low APACHE II score: OR = 0.871, 95%CI was 0.836-0.907, P < 0.001], while underlying diseases (cardiovascular diseases) are a risk factor affecting the success rate of cardiopulmonary resuscitation (OR = 1.190, 95%CI was 1.015-1.395, P = 0.036). CONCLUSIONS Age, resuscitation start time, ventilation mode, APACHE II score and major underlying diseases (cardiovascular diseases) have a greater impact on the success rate of resuscitation in IHCA patients. The above factors are conducive to improving or formulating more effective rescue strategies for IHCA patients, so as to achieve the purpose of improving the success rate of clinical treatment.
Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Cardiopulmonary Resuscitation ; Heart Arrest/therapy* ; Electric Countershock ; Hospitals

Objective:To investigate the efficacy of venetoclax-based combined regimen in treatment of adult patients with acute myeloid leukemia (AML).Methods:The data of 50 adult AML (non-acute promyelocytic leukemia) who received venetoclax-based combined regimen in the First Affiliated Hospital of Xiamen University, Dongguan People's Hospital, the First Hospital of Longyan City, Jieyang People's Hospital from December 2018 to May 2021 were retrospectively analyzed. Different doses venetoclax combined with demethylation drugs or low-dose chemotherapy regimen were used to analyze the therapeutic efficacy. The related factors influencing efficacy were analyzed by using logistic regression.Results:The composite complete remission (CR) rate of 50 AML patients was 62.0% (31/50), the overall response rate (ORR) was 76.0% (38/50); 28 patients achieved effectiveness [CR and partial remission (PR)] after the first cycle and could achieve effectiveness by 3 courses of treatment at the latest. Among 50 patients, 28 cases were newly diagnosed AML, the composite CR rate was 60.8% (17/28), ORR was 78.6% (22/28); 22 cases were recurrent and relapsed, the composite CR rate was 63.6% (14/22), ORR was 72.7% (16/22); and there was no statistically significant difference of ORR between the both groups ( χ2 = 0.23, P = 0.743). Logistic regression multivariate analysis showed age was the only independent influencing factor for the treatment effectiveness ( OR = 8.451, 95% CI 1.306-54.697, P = 0.025). The median duration time of patients receiving venetoclax treatment regimen was 4.5 months (1.1-15.0 months); 16 cases who had treatment effectiveness finally relapsed, the median time of maintaining effectiveness was 5 months (1.1-11.0 months). Additionally, the common treatment-related adverse reactions included bone marrow suppression after treatment, followed by some gastrointestinal reactions like nausea, vomiting and stomachache. In addition, no patient stopped medication for more than 1 week due to bone marrow suppression related complications. Conclusion:Venetoclax-based combined regimen shows a good short-term efficacy in treatment of AML. It is also effective and tolerable for elderly patients receiving reduced dose therapy.

Objective The resting-state functional magnetic resonance imaging (rs-fMRI) method was used to observe brain activity and its functional connection upon electroacupuncture stimulation at bilateral uterine acupoints (EX-CA1), as well as to investigate the mechanism of acupuncture in the treatment of gynecological diseases. Methods Twenty-two healthy female subjects were stimulated by electroacupuncture at bilateral uterine acupoints; rs-fMRI data of the brain were acquired and standardized. Degree centrality (DC), amplitude of low-frequency fluctuation (ALFF), and regional homogeneity (ReHo) were used to analyze local spontaneous brain activity via acupuncture. An independent component analysis was used to evaluate the functional connectivity of the resting brain networks after acupuncture. Results Analytical results showed that the neural activity intensity of the precuneus lobe, orbitofrontal cortex, lingual gyrus, amygdala, and posterior central gyrus decreased after acupuncture (voxel P < 0.001, cluster P < 0.05). Functional connectivity analysis revealed weakened auditory and right frontal-parietal networks (voxel P < 0.001, cluster P < 0.05), enhanced visual network (voxel P < 0.001, cluster P < 0.05), and synergistic auditory network and hypothalamic-pituitary system. Conclusion Significant differences in neural activity and functional connectivity in specific brain regions were observed after acupuncture intervention at uterine acupoints; the hypothalamic-pituitary system also showed various active states in different brain regions. It is speculated that the effective mechanism of acupuncture at uterine acupoints is related to the regulation of reproductive hormones, emotional changes, and somatic sensations. Therefore, the methods used in this study could clarify the neural mechanism of uterine-point acupuncture in the treatment of gynecological diseases and may serve as a reference for other studies pertaining to acupuncture.

Objective:To establish a risk prediction model for hospital acute heart failure in elderly patients with chronic heart failure (CHF) .Methods:From January 2018 to December 2020, 619 elderly CHF patients admitted to the Cardiovascular Department of Peking University Third Hospital were selected as the research object by convenience sampling. The patients were divided into the occurrence group ( n=55) and the non-occurrence group ( n=564) according to whether the patients had acute heart failure in hospital. Binomial Logistic regression was used to explore the independent risk factors of acute heart failure in elderly CHF patients. The nomogram model was constructed by R software, and its prediction effect was verified. Results:Binomial Logistic regression showed that high heart rate at admission [ OR=1.021, 95% CI (1.003, 1.039) ], history of cerebrovascular disease [ OR=2.253, 95% CI (1.197, 4.240) ], constipation [ OR=10.382, 95% CI (1.376, 78.308) ], arrhythmia [ OR=2.051, 95% CI (1.079, 3.898) , taking aspirin [ OR=2.741, 95% CI (1.447, 5.193) ], intravenous diuretics [ OR=6.326, 95% CI (2.629, 15.220) ]and high level of N-terminal forebrain natriuretic peptide [ OR=3.511, 95% CI (1.890, 6.521) ]were independent risk factors for hospital onset of acute heart failure in elderly patients with CHF, and the use of vasodilator was a protective factor. The nomogram model was validated. The area under the receiver operating characteristic curve ( AUC) of the subject was 0.808 [95% CI (0.753, 0.864) ], the AUC of internal validation was 0.821 [95% CI (0.764, 0.871) ], and the calibration curve was a straight line with a slope close to 1. Conclusions:There are many risk factors of hospital acute heart failure in elderly CHF patients. The prediction model based on risk factors has good discrimination and calibration, and can predict the risk of acute heart failure in elderly CHF patients in hospital.

Objective To evaluate the adenoma detection rate( ADR)of fecal occult blood test (FOBT)-positive population in colorectal cancer screening programme and to analyse potential influence of“resection and discard”strategy on ADR. Methods Data of patients who paticipated in the Shanghai color-ectal cancer screening programme with FOBT-positive and received colonoscopy in the Digestive Endoscopic Center of Changhai Hospital from July 2013 to July 2014 were retrospectively analysed. ADR was calculated and compared by different genders. Multivariate logistic regression model was used to analyse the risk factors of polyp resection without retrieval. Results A total of 222 FOBT-positive patients were involved with 36. 5% male proportion. The total ADR was 19. 8%,higher in male(28. 4%)than in female(14. 9%)(P=0. 015). The independent risk factors of polyp resection without retrieval were diminutive polyp( OR =15. 256,95% CI:4. 159-55. 957),located in rectum( OR = 3. 663,95% CI:1. 427-9. 398) and polyp number >2(OR= 3. 988,95%CI:1. 562-10. 187).Conclusion ADR of FOBT-positive population is approx-imately 20%in our center. Low male proportion and“resection and discard”strategy may lead to lower ADR. ADR should be calculated by different genders and advanced endoscopic technology should be employed rou-tinely to predict the pathological diagonosis of the lesions.

Objective To analyze the effect of high quality nursing in gastroscopy examination. Method 1 300 pa﹣tients underwent gastroscopy from March 2014 to June 2014 were randomly divided to control group (n= 650) and intervention group (n= 650). Patients in control group received routine nursing, and patients in intervention group received high quality nursing intervention besides the routine nursing. Patients anxiety level, open state of esophageal meatus, one-time intubation success rate, and time-consumed in gastroscopy of the two groups were compared. Result Anxiety score between the two groups at the time of reservation was not statistically significant (P> 0.05), anxiety scores of the intervention group (31.40 ± 4.20) was lower than that of control group before gas﹣troscopy, and the difference was statistically significant (P<0.01). Open rate of esophageal meatus, one-time intuba﹣tion success rate, and time-consumed in gastroscopy of the intervention group (97.1%, 95.1%and 4.52 ± 1.23 min) were significantly better than those of the control group (79.4%, 82.3%and 5.42 ± 1.53 min). Conclusion The high quality nursing in gastroscopy can alleviate the anxiety level of patients, improve the success rate of gastroscopy, re﹣duce the pain of patients, and it is worthy of clinical promoting.