Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

BACKGROUND:Combining seed cells with 3D bioprinting technology enables the specific construction of various tissues and organs to meet the demands of tissue repair.However,further research is needed on the promotion of angiogenesis in damaged tissues. OBJECTIVE:By cultivating a 3D scaffold structure of methacrylated gelatin loaded with fibroblasts,obtaining the supernatant,and mixing it in different proportions with a complete culture medium to simulate the cellular microenvironment during tissue repair,this study aimed to explore the role of various cellular microenvironments in promoting angiogenesis in endothelial cells. METHODS:A methacrylated gelatin scaffold structure loaded with fibroblasts was prepared using an extrusion-based 3D bioprinting process.Hydrogel scaffold extract was prepared and mixed with a complete culture medium in ratios of 1:1,1:2,and 1:4 to obtain conditioned medium.Mouse embryonic fibroblasts BALB3T3 and human umbilical vein endothelial cells were co-cultured with complete medium(control group)and hydrogel scaffold extract,respectively.Cell proliferation was assessed using the CCK-8 assay and cell viability was analyzed using live/dead staining.Three kinds of conditioned medium and complete medium(control group)were used to co-culture with human umbilical vein endothelial cells for tube formulation assay,vascular genetic testing,and immunofluorescence staining of CD31. RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the methacrylated gelatin scaffold exhibited a porous structure,and rheological results demonstrated excellent mechanical properties of the hydrogel.CCK-8 assay and live/dead cell staining showed that the hydrogel scaffold extract had no obvious cytotoxicity.(2)Tube formulation assay indicated that the hydrogel showed the total length of cell tubules in 1:1 conditioned medium group was smaller than that in the control group(P<0.05).There were no statistical differences among the four groups in the number of vascular branches formed by endothelial cells(P>0.05).(3)qRT-PCR results showed that for vascular endothelial growth factor mRNA expression,the 1:2 conditioned medium group was lower than the 1:1 conditioned medium group on day 1(P<0.01).On day 3,the expression level of vascular endothelial growth factor in the 1:2 conditioned medium group was higher than that in the control group(P<0.01).On day 5,the cytokine expression level in the 1:2 conditioned medium group was significantly higher than that in the other three groups(P<0.01 or P<0.000 1).The expression in the 1:1 conditioned medium group was significantly lower than that in the other three groups(P<0.05 or P<0.01).On day 1,the expression level of basic fibroblast growth factor in the 1:1 conditioned medium group was significantly higher than that in the control group and 1:4 conditioned medium group(P<0.01,P<0.05).The expression was higher in the 1:2 conditioned medium group than that in the control group(P<0.05).On day 3,the expression levels of cytokines in the 1:4 conditioned medium group was higher than that in the control group(P<0.05).(4)On day 3,the expression of CD31 in the 1:2 conditioned medium group was higher than that in the control group and the 1:4 conditioned medium group(P<0.05).(5)The results indicate that the resulting conditioned media can simulate the microenvironment of vascular regeneration after tissue damage,promoting the vascularization process of endothelial cells.The best promotion of vascularization in endothelial cells was observed when the ratio of supernatant to complete culture medium was 1:2.

Objective To explore the correlation between the change of the serum levels of thyroid hormone and the severity of anxiety symptoms in patients with generalized anxiety disorder after treatment with paroxetine hydrochloride.Methods 76 patients with generalized anxiety disorder treated in the Third People's Hospital of Huzhou from January to August 2023 were collected as study group,and they were divided into mild group(n=23),moderate group(n=30),and severe group(n=23),according to degree of anxiety by Hamilton anxiety scale(HAMA),69 healthy examination subjects in the same period were selected as control group.Patients in study group were treated with paroxetine hydrochloride tablets for 8 weeks,patients were evaluated anxiety symptoms,the serum levels of thyroid hormone were measured at baseline and 8 weekend,including triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),antithyroglobulin antibody(TG),anti-thyroid peroxidase antibody(TPO).Results After 8 weeks of paroxetine hydrochloride treatment,the significant efficacy rates of mild group,moderate group,and severe group were 73.9％,76.7％,and 73.9％,with no statistically significant difference in efficacy among three groups(x2=0.073,P＞0.05).In the baseline period,FT4 levels of patients in moderate group and severe group were significantly higher than those in mild group and control group,and the difference was statistically significant(P＜0.05).The severity of anxiety symptoms in the baseline period of patients in moderate group and severe group showed a low positive correlation and a significant positive correlation with FT4 levels(r=0.382、0.610,P＜0.05).After 8 weeks treatment,the FT4 levels of patients in moderate group and severe group decreased significantly compared to the baseline period,and the difference was statistically significant(t=2.847,3.042,P＜0.05).The reduction rate of HAMA score in severe group was positively correlated with the change in FT4 level during the baseline period and at the end of 8 weeks of treatment(r=0.517,P＜0.05).By a binary Logistic regression analysis showed that the higher levels of FT4 in the baseline period with the worse efficacy in moderate group and severe group.Conclusion The improvement of anxiety symptoms could be affected by high baseline levels of FT4 in generalized anxiety disorder patients with moderate to severe anxiety.

The rehabilitation compliance of stroke patients is generally low.Evaluating the rehabilitation motivation of patients is helpful to promote the rehabilitation management of patients,enhance the rehabilitation enthusiasm and compliance of patients,and improve the rehabilitation outcome.This paper reviews the existing stroke patients rehabilitation motivation assessment tools,and expounds the main contents,application status,characteristics and limitations of stroke patients rehabilitation motivation assessment tools,in order to provide references for the appropriate selection of clinical assessment tools,the rehabilitation management of stroke patients and the development of domestic localized stroke rehabilitation motivation assessment tools.

Objective:To compare the mechanical properties between our self-designed axially controlled compression spinal rod (ACCSR) and conventional spinal rod (CSR) for lumbar spondylolysis (LS).Methods:This study selected 36 ACCSRs (the ACCSR group) and 36 CSRs (the CSR group), both of which were in a diameter of 6.0 mm and manufactured in the same batch. They were subjected respectively to biomechanical tests of spinal rod and pedicle screw-rod internal fixation system. In spinal rod tests: the stiffness and yield load of the spinal rods were calculated using four-point bending tests ( n=7) and comparisons were made between the 2 groups; spinal rod fatigue tests ( n=8) recorded the successful compression loads after 2.5 million cycles of loading and compared them with the maximum force at the isthmus of a normal adult's unilateral lumbar spine (198.72 N). In tests of the pedicle screw-rod internal fixation system, the axial compression tests ( n=7) measured the axial gripping capacity, the axial torsion tests ( n=7) the torsional gripping capacity, and the lateral compression tests ( n=7) the stiffness and yield load of pedicle screws in the 2 groups respectively. Results:The stiffness [(1,543.37±61.41) N/mm] and yield load [1,338.57 (1,282.00, 1,353.80) N] of ACCSR group were significantly smaller than those of CSR group [(3,797.63±156.15) N/mm and 4,059.95 (3,813.80, 4,090.89) N] ( P<0.05). The spinal rod fatigue tests showed that the respective loads of CSR and ACCSR passing the 2.5 million fatigue tests were 640.00 N and 320.00 N, both larger than the maximum force at the unilateral lumbar isthmus of a normal adult (198.72 N). There were no significant differences between the ACCSR group and the CSR group in the axial gripping capacity and torsional gripping capacity, as well as in stiffness and yield load of screws between the 2 groups ( P>0.05). Conclusions:In fixation of LS, although the yield load, stiffness and fatigue resistance of ACCSR are inferior to those of CSR, the biomechanical properties of the two sets of pedicle screw-rod internal fixation system are comparable. The fatigue resistance of ACCSR can meet the stress requirements of the normal human isthmus.

Objective To analyze the effect of endoscopic tumor resection by submucosal tunnel(STER)on recurrence in patients with submucosal tumors(SMT)around cardia.Methods A total of 92 patients with SMT around cardia were selected and divided into the treatment group(n=46)and the control group(n=46)using random number table method.The treatment group and the control group were treated with STER and endoscopic submucosal dissection(ESD),respectively,and both groups were followed up for 12 months after surgery.Periop-erative indexes,therapeutic effects,quality of life,sleep,inflammatory indexes,immune indexes before and 1 week after surgery,complications 1 week after surgery,recurrence 12 months after surgery were compared between the two groups.Results Compared with the control group,the surgery time of the treatment group was longer,the hospital stay was shorter and treatment cost were lower,and the stripping speed was faster(P＜0.05).Compared with before surgery,scores of Pittsburgh sleep Quality index(PSQI),serum levels of interleukin-8(IL-8),inter-leukin-6(IL-6),high-sensitive C-reactive protein(hs-CRP)and whole blood levels of CD8+decreased in the two groups 1 week after surgery,and the levels were lower in the treatment group(P＜0.05).Compared with the preoperative results,the levels of whole blood CD4+and CD4+/CD8+,scores of Quality of Life Core 46 Questionnaire(QLQ-C46),Karnofsky Score(KPS)were higher in the two groups 1 week after surgery,those in the treatment group was higher(P＜0.05).1 week after surgery,the complication rate of the two groups was lower in the treat-ment group(P＜0.05),and 12 months after surgery,the recurrence rate of the two groups was not statistically significant(P＞0.05).Conclusion STER treatment for SMT around cardia was highly effective,resulting in superior perioperative outcomes,enhanced life and sleep quality,reduced systemic inflammation,and bolstered immune function.Moreover,it significantly lowered the risk of complications without raising the rates of recurrence.

Background Currently,the diagnosis of depressive disorder relies on symptomatology,which is greatly influenced by subjective factors such as clinicians' experience.Finding more accurate and reliable quantitative diagnostic methods is currently an urgent problem.Objective To explore the value of Fisher discriminant function based on inflammatory cytokines in the diagnosis of depressive disorder,so as to provide references for clinical diagnosis.Methods A total of 136 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)criteria,who underwent inpatient treatment at Hebei Mental Health Center from April 2020 to November 2020,were enrolled as study group.67 healthy participants matched for age and gender,was recruited during the same period.Serum levels of inflammatory cytokine were measured using enzyme-linked immunosorbent assay(ELISA).Fisher discriminant model was employed to establish a discriminant function for inflammatory cytokines exhibiting significant statistical differences between study group and control group,which was then validated.Results The levels of pro-inflammatory cytokines interleukin-1β(IL-1β),interleukin-6(IL-6),interferon-γ(INF-γ)and tumor necrosis factor-α(TNF-α)were higher in the study group compared with control group,with statistically significant differences(U=9.115,5.239,4.431,5.428,P<0.01).Conversely,the levels of anti-inflammatory cytokines interleukin-4(IL-4),interleukin-10(IL-10)and interleukin-13(IL-13)were lower in the study group compared with control group,with statistically significant differences(U=7.398,7.331,7.614,P<0.01).The retrospective test in Fisher discriminant function achieved a correct discrimination rate of 89.66%,and the cross validation achieved a correct discrimination rate of 88.67%.Conclusion The Fisher discriminant function developed in this study may serve as a valuable auxiliary method in the diagnosis of depressive disorder.

Objective To explore the conditions for compulsory licensing of pharmaceutical patents and the steps for implementing compulsory licensing of pharmaceutical patents.Methods The current situation and problem of compulsory licensing of pharmaceutical patents in China were analyzed by collecting the relevant laws and regulations in China,United States,India,and the World Trade Organization.The feasible practices of compulsory licensing of pharmaceutical patents among the other countries and organizations were compared.Results China needs to improve the system of compulsory licensing of pharmaceutical patents,clarify the implementation details,strengthen policy guidance,and encourage cooperation between government and enterprises to ensure the smooth implementation in emergency situations.Conclusion Compulsory licensing system and implementation rules in China for pharmaceutical patents should be supplemented and improved by absorbing the useful provisions of international organizations and relevant countries,so as to achieve the pharmaceutical supply in emergency situations and meet the needs of public health.

Objective To explore the ideas and measures to further optimize China's drug emergency approval system by comparing the drug emergency approval systems in China and other countries.Methods The current situation of China's drug emergency approval system was analyzed and compared with the relevant systems of the United States,the European Union and Japan.Results The goal of drug emergency approval in other countries is clearly positioned to accelerate the review and listing of urgently needed clinical drugs for the purpose of clinical needs,forming a multi-channel,multi-mode and multi-mechanism priority review system covering the whole process,and the regulatory system is clear,complete,and operable.The corresponding approval system in China started late and is in the stage of continuous improvement,which needs to be improved in terms of system construction,government functions,personnel optimization,and post-market supervision.Conclusion Drug regulatory authorities in China should summarize their past work experience and draw on some feasible approval models and regulatory approaches in foreign countries,further improve the system and process of the drug emergency approval system and enhance the efficiency of drug approval and the ability to protect drugs in response to emergencies.

Objective: Cognition impairments are considered as a fundamental characteristic of severe mental disorders (SMD). Recent studies suggest that hyperprolactinemia may exert a detrimental influence on cognitive performance in patients with SMD. The objective of this study was to investigate the correlation between serum prolactin levels and cognitive function in female individuals diagnosed with SMD. Methods: We conducted a study on 294 patients with SMD and 195 healthy controls, aged between 14 to 55 years old. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), while prolactin levels were measured in serum. Descriptive analysis and comparative analysis were performed to compare cognitive function and prolactin levels between groups, and linear regression models were used to explore the relationship between prolactin and cognitive function. Results: Compared to the healthy control, individuals with SMD exhibited significantly higher levels of prolactin, while scoring lower on RBANS total and every index scores. Furthermore, a negative association between prolactin levels and cognitive function (RBANS total index score, attention, and delayed memory) was observed in SMD patients. Importantly, this inverse correlation between prolactin and cognition function (RBANS total index score, total scale score, and attention) persisted in patients who were not taking medications that could potentially influence serum prolactin levels. Conclusion Our study reveals a significant correlation between elevated prolactin levels and cognitive impairment in female patients with SMD, underscoring the importance of monitoring prolactin levels in order to prevent cognitive deterioration among female SMD patients.