AIM: To evaluate the effect of remimazolam on early postoperative cognitive function in elderly patients with hip fracture based on a randomized controlled trial. METHODS: A total of 106 elderly patients, aged 65-90 years, ASA grade Ⅱ or III, who underwent hip fracture surgery under combined spinal-epidural anesthesia in the Sixth Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 and met the inclusion criteria, were selected and randomized into remimazolam group (group R) and propofol group (group P) according to the random number table, with 53 cases in each group. Patients in group P received a slow intravenous injection of propofol at a dose of 0.3-0.5 mg / kg (injection time of 1min), followed by a pump infusion at 0.5-3 mg · kg

Objective This study summarized the clinical data of IBD patients receiving upadacitinib treatment in our hospital,and provided more Chinese data to better guide the treatment of upadacitinib in Chinese IBD population.Methods Clinical data of 11 patients with IBD who received upadacitinib treatment at Anhui Provincial Hospital from March 1,2023 to September 8,2024 were retrospectively analyzed.Platelet count,ESR,CRP,disease severity score,endoscopic score,and adverse reactions were compared before treatment,at the 4th and 8th week of treatment,and clinical response rate,clinical response rate,endoscopic response rate,and endoscopic response rate were calculated.SPSS 25.0 software was used for statistical analysis.Results The platelets,ESR and CRP of patients at the 4th and 8th week after upadacitinib treatment were decreased compared with those before treatment,with statistical significance.At the 4th week,the clinical response rate was 72.72％(8/11),the clinical remission rate was 0,the clinical response rate of UC patients was 83.33％(5/6),and the clinical response rate of CD patients was 60％(3/5).At the 8th week of treatment,the clinical response rate was 100％(10/10),the clinical remission rate was 80.00％(8/10),the clinical response rate of UC patients was 100％(6/6),the clinical remission rate of UC patients was 83.33％(5/6),the clinical response rate of CD patients was 100％(4/4),and the clinical remission rate of CD was 75％(3/4).There were no adverse reactions during treatment.Three patients were re-examined by colonoscopy,all of whom were severe UC patients and achieved mucosal healing.Conclusion Upadacitinib can rapidly,effectively and sustainably control the disease in patients with moderate and severe IBD,with high safety.

Objective: To explore the dose-response relationship between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM), so as to provide insights into the cut-off values of pre-pregnancy BMI and optimizing GDM prevention and control strategies. Methods: Pregnant women that admitted to Zhengzhou Central hospital in 2021 were recruited, and demographics, family history, pregnancy and delivery history and blood glucose levels during pregnancy were collected. The dose-response relationship between pre-pregnancy BMI and GDM was analyzed using restricted cubic spline (RCS) analysis. The predictive ability of pre-pregnancy BMI for GDM risk was evaluated using receiver operating characteristic (ROC) curve. Results: A total of 2 279 participants were included in the study. The median age was 29.0 (interquartile range, 5.0) years. The median pre-pregnancy BMI was 21.1 (interquartile range, 3.8) kg/m2. There were 312 underweight women (13.69%), 825 women with low-normal weight (36.20%), 730 women with high-normal weight (32.03%), 345 overweight women (15.14%) and 67 obese women (2.94%).The prevalence of GDM was 17.20%. RCS analysis suggested a linear dose-response relationship between age, pre-pregnancy BMI and GDM (P<0.05). When pre-pregnancy BMI was higher than 21.1 kg/m2, the risk of GDM increased with pre-pregnancy BMI (P<0.05). When women aged over 29.0 years, the risk of GDM increased with age, and the dose-response relationship of GDM caused by pre-pregnancy BMI was stronger in the women aged over 29.0 years than in the women aged 29.0 years and below (P<0.05). The area under curve (AUC) was 0.654 (95%CI: 0.624-0.684). If the cut-off value of pre-pregnancy BMI was 23.0 kg/m2, the Youden index, sensitivity and specificity was 0.238, 0.472 and 0.766, respectively. If it was 24.0 kg/m2, the Youden index, sensitivity and specificity was 0.195, 0.342 and 0.853, respectively. If it was 21.1 kg/m2, the Youden index, sensitivity and specificity was 0.213, 0.676 and 0.537, respectively. Conclusions There is a linear dose-response relationship between pre-pregnancy BMI and GDM, and higher than 21.1 kg/m2 of the pre-pregnancy BMI could increase the risk of GDM.

Objective:To investigate the application and curative effect of fat grafting in supraorbital area in double blepharoplasty in patients with negative vector of the eyelid- globe.Methods:From January 2019 to January 2020, 78 patients who came to Fuzhou Meilai Huamei Beauty Hospital for double blepharoplasty were collected as patients with negative eyelid- globe vector. The patients were randomly divided into 2 groups, with 42 cases in the combined group and 36 cases in the simple group. The combined group underwent double blepharoplasty combined with fat grafting in the supraorbital area, and the simple group only underwent double blepharoplasty.Results:The postoperative follow-up was 3-12 months, with an average follow-up of 6 months. The efficacy of the combined group and the simple group was compared. There was no surgical complications in both groups. In improving the eyelid-globe vector, the combined group was higher than that of the simple group. The overall satisfaction of the combined group was higher than that of the simple group. Among them, the satisfaction of eye appearance, self-confidence, mental health, surgical results, decision-making and facial rejuvenation were all higher than those of the simple group, and there was no difference in the impact on early life between the two groups.Conclusions:Double blepharoplasty undergoing fat grafting in the supraorbital area at the same time are safe and conforms to the aesthetic standard. The patients are satisfied with the postoperative effects.

OBJECTIVE: To explore the phenotype and pathogenesis of a fetus with a rare chromosomal abnormality. METHODS: The fetus was analyzed by clinical prenatal ultrasonography, G-banding karyotyping and next generation sequencing (NGS). RESULTS: Prenatal ultrasonography of the fetus showed Dandy-Walker syndrome, growth restriction, and right-heart system dysplasia. The fetus had a chromosomal karyotype of 47,XY,t(11;22)(q23.3;q11.2),+der(22)t(11;22). Duplication of 11q23.3q25 and 22q11.1q21 were also detected by NGS. The chromosomal translocation carried by the fetus was derived from his father. CONCLUSION Duplications of chromosome 11q23.3q25 and 22q11.1q11.21 segments probably underlie the Dandy-Walker syndrome, growth restriction, and hypoplasia of the right heart system in the fetus.
Chromosome Disorders ; Chromosomes, Human ; Female ; Fetus ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic ; Trisomy

Objective To study the influence of miRNA-125b over-expression on proliferation and invasion ability of lung cancer A549 cells and its mechanism.Methods A549 cells were divided into 3 groups:miRNA-125b group(transfected with miRNA-125b mimics),NC group(transfected with NC mimics) and blank group(same volume of GIBCO serum mixed with transfection agent).The transfection and expression efficiency of miRNA-125b was detected with Q-PCR,the proliferation ability was detected with MTT,and the invasion ability was detected with the transwell chamber test.The expression level of BMF in A549 cells was detected with Western blot.Results Compared with the blank group,the expression level of miRNA-125b,proliferation ability and invasion ability in the miRNA-125b group were increased(P＜0.05);while the above indexes in the NC group demonstrated no significant change(P＞0.05).Compared with the blank group,the expression level of BMF in the miRNA-125b group was decreased (P＜0.05);while which in the NC group had no significant change(P＞0.05).Conclusion miRNA-125b can promote the proliferation and invasion ability of A549 cells via inhibiting the expression of BMF.

Background:The clinical characteristics and management approaches of inflammatory bowel disease(IBD)change accordingly with the increasing incidence of the disease. Aims:To investigate the clinical changes of IBD in the last decade(2008-2017)in Anhui Provincial Hospital. Methods:Hospitalization data of patients with newly diagnosed IBD admitted from Jan. 2008 to Nov. 2017 at the Anhui Provincial Hospital were collected,and then the clinical characteristics and management approaches were compared between Group A(2008-2012)and Group B(2013-2017). Results:A total of 515 IBD cases were enrolled in this study. Hospitalized IBD cases increased significantly from 2013 to 2017. Cases of ulcerative colitis(UC)was 3.72 times and cases of Crohn's disease(CD)was 3 times in 2017 as that in 2013. In Group A,UC mainly involved the left colon(47.8%),with mild-to-moderate activity(85.3%);while the majority of UC in Group B presented as pancolitis(54.5%),and mostly with moderate-to-severe disease(83.8%). In group B,the proportion of CD involving ileocolon(65.5%)and with moderate-to-severe disease(58.6%)was significantly increased;complications occurred in 50.9% of the CD patients,predominantly the perianal lesions(44.8%). In the past 5 years, colonoscopy and biopsied pathology were more accessible(>95%),and the detection rate of typical pathological changes, as well as the comprehensive diagnosis based on clinical,colonoscopic and pathological findings were significantly increased. In respect of treatment modalities,steroids and immunosuppressants were more frequently used in UC,and immunosuppressants,biological agents and enteral nutrition were more frequently used in CD in the past 5 years. Conclusions:The number of hospitalized IBD patients admitted in Anhui Provincial Hospital increased significantly in the past 5 years. The clinical characteristics and management approaches of IBD changed as time passed. The diagnosis and treatment were significantly improved.

Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.

Background:Irritable bowel syndrome( IBS)patients are often accompanied by anxiety,depression and other psychological abnormalities,but the effects of psychological abnormalities on daily life have not yet been fully clarified. Aims:To investigate the effects of psychological abnormalities on life quality,sleep quality and symptom severity in IBS patients. Methods:A total of 101 IBS patients admitted from Nov. 2014 to May 2015 at Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled in this study. Zung self-rating anxiety scale(SAS)and Zung self-rating depression scale(SDS)were used to evaluate the mental state;IBS-quality of life(IBS-QOL)was used to evaluate the life quality;Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality;IBS symptom severity score (IBS-SSS)was used to evaluate the symptom severity. Correlations between psychological factors,life quality,sleep quality and symptom severity were analyzed. Results:57. 4%(58 / 101)of IBS patients were accompanied by varying degrees of anxiety and/ or depression. The IBS-QOL score of 101 patients was 73. 28 ± 12. 79,in which anxiety,loss of appetite and health concerns were the most severely affected. 73. 3%(74 / 101)of IBS patients were accompanied by varying degrees of sleep disorders,in which daytime dysfunction,sleep quality and sleep efficiency were the most severely affected. Of the 101 IBS patients,the symptom of 13 cases was mild,63 cases was moderate and 25 cases was severe. IBS-SSS score was 253. 00 ± 72. 58. Correlation analysis showed that anxiety,depression were negatively correlated with life quality(r = - 0. 426,P < 0. 001;r = - 0. 501,P < 0. 001)and positively correlated with sleep quality(r = 0. 556, P = 0. 000;r = 0. 513,P = 0. 000)and symptom severity(r = 0. 231,P = 0. 020;r = 0. 357,P < 0. 001). Life quality was negatively correlated with symptom severity(r = - 0. 417,P < 0. 001). Conclusions:IBS patients have psychological abnormalities and their life and sleep qualities are decreased,the more serious the psychological abnormalities,the more damage on life and sleep qualities and the more severe the IBS symptoms.

Objective To understand the experiences of repeated hospitalization in liver cirrhosis patients with upper gastrointestinal hemorrhage, and analyze its influencing factors. Methods By using the qualitative phenomenological research methodology,10 patients who had liver cirrhosis with upper gastrointestinal hemorrhage and had experiences of repeated hospitalization were selected and the in-depth interview were conducted. The results were analyzed, concluded and refined with Colaizzz′s seven steps of phenomenological analysis. Results By means of analysis, induction and distilling, 5 themes were addressed including recurrent disease causing as the main reasons for repeated hospitalization, cognitive shortcomings of disease, high pressure of the management of the disease, needing a strong social support system, and repeated hospitalization causing psychological pressure increase. Conclusions Medical staff should improve the cultivation of professional quality, strengthen the intervention on health education and outside the hospital way of life in liver cirrhosis patients with upper gastrointestinal hemorrhage, give targeted psychological care, improve the patients cognition of disease and self-management ability, and reduce the pressure of the patient′s disease management, so as to reduce readmission rate of patients.