Objective:To explore the effects of intraspinal blocking analgesia on the delivery quality and puerperal pelvic floor function of primiparas.Methods:A total of 99 primiparas who delivered in the Second People′s Hospital of Wuhu City from January 2021 to April 2022 were enrolled in this study, 54 patients received intraspinal blocking analgesia (study group) and 45 patients received conventional treatment, without intraspinal blocking analgesia (control group). The delivery quality between the two groups was compared, and the pelvic floor function was evaluated and compared by pelvic floor rehabilitation therapy instrument and pelvic floor ultrasound at 6-8 weeks after delivery.Results:Vaginal delivery were successful in both groups. The total labor duration in the study group was longer than that in the control group: (8.03 ± 2.94) h vs. (6.89 ± 3.49) h, there was statistical difference ( P<0.05). The maximum value of pelvic floor rapid contraction stage, rising time and average value of continuous contraction stage in the study group were higher than those in the control group: (32.85 ± 10.13) μV vs. (14.73 ± 3.25) μV, (0.28 ± 0.06) s vs. (0.22 ± 0.05) s, (30.26 ± 5.24) μV vs. (16.74 ± 4.00) μV, there were statistical differences ( P<0.05). There were no statistical differences in other indicators such as the pre-resting stage, rapid contraction phase recovery time and post-resting stage between the two groups ( P>0.05). The rate of pelvic floor class Ⅰ and class Ⅱ muscle abnormalities at 6-8 weeks after delivery in the study group were lower than those in the control group, but there were no statistical differences ( P>0.05). The maximum Valsalva state hiatus area of levator ani muscle, maximum Valsalva state bladder posterior urethral angle, hiatus area of levator ani muscle at rest state and bladder neck degree in the study group were smaller than those in the control group: (19.09 ± 4.82) cm 2 vs. (23.00 ± 5.34) cm 2, (138.59 ± 23.14)° vs. (148.47 ± 20.38)°, (9.96 ± 2.63) cm 2 vs. (11.60 ± 2.75) cm 2, (20.13 ± 4.37) mm vs. (28.05 ± 6.52) mm, there were statistical differences ( P<0.05). Conclusions:Although intraspinal block analgesia can prolong the total labor time of primipara, but it can reduce the damage of pelvic floor function, possibly by increasing systolic period to protect pelvic floor muscles.

Objective:To evaluate the relationship between lung injury induced by cardiopulmonary bypass (CPB) and acetyltransferase p300 (p300) in rats.Methods:Eighteen SPF healthy adult male Sprague-Dawley rats, aged 12-16 weeks, weighing 350-450 g, were divided into 3 groups ( n=6 each) using a random number table method: sham operation group (S group), CPB group, and CPB+ left lung ischemia-reperfusion (I/R) group (CPB+ IR group). CPB group was connected to CPB pipeline for cardiopulmonary bypass. The lung I/R injury model was prepared by clamping the left lung hilum for 45 min followed by opening during CPB, 30 min later CPB was terminated, and mechanical ventilation was continuously performed for 1.5 h before ending the experiment in CPB+ IR group. Arterial blood gas analysis was performed and oxygenation index (OI) and respiratory index (RI) were calculated before CPB, at 10 min after opening the lung hilum, and immediately after the end of experiment. The bronchoalveolar lavage fluid (BALF) and left lung tissues were collected immediately after the end of experiment for determination of the concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in BALF and total protein in BALF and concentrations of IL-17 in lung tissues (by enzyme-linked immunosorbent assay), expression of p300, phosphorylated p300 (p-p300), and acetylated histone H3 (AC-H3) in lung tissues (by Western blot) and expression of p-p300 (using immunohistochemical staining) and for microscopic examination of the pathological changes of lung tissues (under the light microscope) which were scored. Results:Compared with S group, OI was significantly decreased and RI was increased at 10 min after opening the lung hilum and immediately after the end of experiment, the lung injury score and levels of IL-6, TNF-α and total protein in BALF and IL-17 in lung tissues were increased, and the expression of p300, p-p300 and AC-H3 was up-regulated in CPB and CPB+ IR groups ( P<0.05). Compared with CPB group, OI was significantly decreased and RI was increased at 10 min after opening the lung hilum and immediately after the end of experiment, the lung injury score and levels of IL-6, TNF-α and total protein in BALF and IL-17 in lung tissues were increased, and the expression of p300, p-p300 and AC-H3 was up-regulated in CPB+ IR group ( P<0.05). Conclusions:The mechanism by which CPB induces lung injury may be related to up-regulation of the expression of p300 and enhancement of activity of p300 in lung tissues and increased release of inflammatory factors in rats.

Objective:To investigate the value of digital medical 3D technology versus traditional 2D technology in the diagnosis and treatment of solid abdominal tumors in children. Methods:A total of 80 children with solid abdominal tumors who received surgical treatment guided by digital medical 3D technology at Guigang People's Hospital from January 2018 to January 2022 were included in the observation group. An additional 80 children with solid abdominal tumors who received surgical treatment guided by traditional 2D technology at the same hospital from January 2014 to December 2017 were included in the control group. Clinical efficacy was compared between the two groups.Results:The surgical time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay in the observation group were (111.8 ± 28.9) minutes, (26.8 ± 25.2) mL, (2.2 ± 1.2) days, (7.5 ± 1.4) days, respectively, which were significantly shorter or less than those in the control group [(193.1 ± 66.0) minutes, (86.2 ± 47.0) mL, (3.7 ± 0.9) days, (12.2 ± 3.5) days, t = 7.00, 6.88, 5.87, 7.53, all P < 0.05]. The complete surgical resection rate in the observation group was significantly higher than that in the control group [92.5% (74/80) vs. 81.3% (65/80), χ2 = 4.44, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [6.3% (5/80) vs. 16.3% (13/80), χ2 = 4.00, P < 0.05]. Conclusion:The utilization of digital medical 3D technology in the surgical treatment of solid abdominal tumors in children can markedly decrease surgical time, reduce intraoperative blood loss, promote postoperative recovery, achieve a high surgical resection rate, and minimize postoperative complications.

We previously identified a unique nucleus, the cerebrospinal fluid (CSF)-contacting nucleus. This study aims to understand its gene architecture and preliminarily suggest its functions. The results showed that there were about 19,666 genes in this nucleus, of which 913 were distinct from the dorsal raphe nucleus (non-CSF contacting). The top 40 highly-expressed genes are mainly related to energy metabolism, protein synthesis, transport, secretion, and hydrolysis. The main neurotransmitter is 5-HT. The receptors of 5-HT and GABA are abundant. The channels for Cl^-, Na⁺, K⁺, and Ca²⁺ are routinely expressed. The signaling molecules associated with the CaMK, JAK, and MAPK pathways were identified accurately. In particular, the channels of transient receptor potential associated with nociceptors and the solute carrier superfamily members associated with cell membrane transport were significantly expressed. The relationship between the main genes of the nucleus and life activities is preliminarily verified.
Rats ; Animals ; Rats, Sprague-Dawley ; Serotonin/metabolism* ; Signal Transduction ; Cerebrospinal Fluid/metabolism*

The ultra-high dose rate (UHDR) radiation has less side effect while keep comparable tumor control effect with conventional dose rate (CONV) radiation, which was named Flash effect. Recently, the Flash effect has been reported in many animal experiments with various types of radiations, animal species and body parts. However, the underlying mechanism of Flash has still been unraveled, making difficulties for the clinical application. This review pointed out the differences between the Flash effect and the UHDR effect in vitro and proposed three key scientific questions of Flash effect based on three well-known hypotheses, i. e., oxygen depletion, peroxyl radical recombination and immune cell protection. Finally, the research progresses and challenges of Flash mechanism study are concluded in order to give a clue for further deep investigation.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To explore the feasibility of synthetic diamond detector in use for Flash radiation dosimetry by designing a diamond dosimeter and conducting a series of dosimetric characteristic tests.Methods:A diamond detector system prototype with real-time current output was developed using a CIVIDEC? B1HV diamond sensor and designing a large dynamic range current measurement circuit based on the pre-integration method. The dose (dose-rate) response linearity was tested under irradiation from both electron beam and X ray ultra-high dose rate. Dose (dose-rate) calibration was performed against a medical accelerator to gain the charge-dose transfer coefficient.Results:Good linear correlation ( R2 = 0.99) between detector output charge and reference dose per pulse was shown under electron beam irradiation of 0.08-0.50 Gy/pulse. Good linearity ( R2 = 0.99) is also shown under irradiation from electron beam with ultra-high dose rate (400 Gy/s) and conventional dose rate (0.5 Gy/s). Strictly linear correlation ( R2 = 1) was shown between detector output integrated charge and reference dose under X ray irradiation at ultra-high average dose rate (75.5 Gy/s) and conventional average dose rate (0.5 Gy/s). The charge-dose and current-dose rate conversion factors for practical use were 0.751 7 μC/Gy and 0.753 5 μA·Gy·s -1, respectively. Conclusions:Considerable linearity of the diamond detector dose responses were shown under irradiation both from electron beam and X-ray beam, which could provide a relatively rapid and accurate dosimetry for Flash preclinical experiments. Furthermore, diamond detectors have great potential in the quality assurance for Flash radiotherapy.

Objective:To examine the burden of caregivers for elderly Parkinson's patients(PD)and to analyze the mediating effects of social support on primary PD caregivers' burden and their quality of life.Methods:In this cross-sectional study, 281 primary caregivers for elderly Parkinson's patients who visited the Department of Neurology's outpatient clinics of Qilu Hospital of Shandong University from January to May 2021 were surveyed via a convenience sampling method, with 242 valid questionnaires(86.1%). The Chinese versions of the Caregiver Burden Questionnaire, Social Support Rating Scale and 36-Item Short Form Health Survey were used for the investigation.Pearson correlation analysis was used to establish a structural equation model for the influence of social support in the burden and quality of life of caregivers for PD patients.The mediating effects were tested using Process v2.16.3 and re-tested using AMOS.The mediating effects were validated with Bootstrap.Results:Primary caregivers' scores on burden, social support and quality of life were(26.9±23.1), (40.5±8.7)and(593.7±163.3), respectively.Caregiver burden was negatively correlated with social support(r=-0.482, P<0.01), and social support was positively correlated with quality of life(r=0.513, P<0.01). Caregiver burden was negatively correlated with quality of life( r=-0.654, P<0.01), The validated mediating effects showed caregiver burden's direct effects on quality of life(95% CI: -0.38-0.61)and mediating effects of social support(95% CI: -0.08-0.21), not including 0, indicating that the care burden of primary caregivers for elderly PD patients was not only able to predict their quality of life, but also predict their quality of life through the mediating effects of social support(direct effect: -0.50 and mediating effect: -0.14, accounting for 78.0% and 22.0%, respectively, of the total effect of -0.64). Conclusions:Care burden and social support are important factors affecting the quality of life of primary caregivers for elderly PD patients.Reducing care burden can not only directly affect the quality of life, but also indirectly affect the quality of life by increasing social support.

Objective: To understand the homology and resistance characteristics of Streptococcus pneumoniae (S. pneumoniae) in healthy preschool children, so as to provide basis for disease transmission prevention and rational use of antibiotics. Methods: Stratified cluster random sampling method was used to sample 1 829 healthy children from six kindergartens in Shunde District, Foshan City. Nasal swabs were taken and tested for S. pneumoniae. Multi locus sequence typing was used for homology analysis. The Chi squared test and random forest analysis were used to explore the resistance characteristics. Results: The nasal carriage rate of S. pneumoniae and multidrug resistant S. pneumoniae (MDRSP) in children were 22.5%(412/1 829) and 21.3%(390/1 829), respectively. Homology analysis in sequence types showed that the total homology rates of 6 kindergartens were 93.5%(87/93), 91.1% (72/79), 89.2%(58/65), 88.9%(64/72), 86.2%(50/58), 77.8%(35/45), respectively. It was found that the highest homology rate was 82.8% (48/58) within class and 93.1% (81/87) between classes. S. pneumoniae was mainly resistant to azithromycin (97.1%, 400/412), erythromycin (92.0%, 379/412) and tetracycline (91.5%, 377/412). The dominant multidrug resistance pattern of MDRSP isolates was not sensitive to azithromycin, erythromycin, cotrimoxazole, tetracycline and clindamycin. Random forest analysis indicated that the important phenotypic markers associated with MDRSP were resistance to azithromycin, cotrimoxazole, tetracycline, clindamycin and erythromycin(MDG=8.94, 6.92, 5.80, 4.84, 2.58). Conclusion The risk of cross transmission of S. pneumoniae among preschool children is high, and direct contact is the main way of transmission. Consequently, kindergartens and health departments should take effective measures to effectively prevent and block the spread of Streptococcus pneumoniae.

Myasthenia gravis crisis (MC) often involves respiratory muscles and requires mechanical ventilation urgently. As non-invasive mechanical ventilation (NIV) technology unceasing development, its use in acute respiratory failure caused by MC shows obvious advantages. However, how to identify the occurrence of MC at early stage, predict the relevant indicators of NIV for MC treatment, and apply different ventilation strategies to improve the effect of treatment are worthy of attention. In addition, the new development of NIV modes in recent years also provides new direction for the treatment of MC. Therefore, this article reviews recent advance in the clinical application of NIV in MC to provide clinical references.