Objective To investigate the clinical characteristics,diagnosis,treatment,and prognosis of descending necrotizing mediastinitis(DNM)to provide a reference for the early diagnosis and timely treatment of DNM.Methods Data on DNM in China was electronically retrieved from the core databases and comprehensively reviewed from June 2012 to June 2023.The infection,pathogenic microorganisms,main symptoms,comorbidities and treatment methods of DNM were analyzed.Results The data of a total of 781 DNM patients,with an average age of(52.97±5.64)years,were retrieved,including 554 males and 227 females.Odontogenic source,tonsillitis,pharyngeal abscess,sialoadenitis,upper respiratory tract infection,foreign body injury,or iatrogenic traumatic procedures are common causes.Among these,odontogenic infection is the most common source.Streptococcus sp.(n=217)and Staphylococcus sp.(n=82)were most isolated,followed by Klebsiella pneumoniae and Pseudomonas aeruginosa(equally n=59).A total of 69.4％(542/781)of DNM patients recruited in this study were discovered to have various comorbidities,and more than one-third of these patients(n=185)had diabetes.Of the broad antibiotics,carbapenem was most frequently used as treatment,and vancomycin was the most frequently coadministered.The mediastinal drainage approach varies widely,and the optimal regimen is still unknown.Seventy-two patients were treated with video-assisted thoracoscopic/mediastinoscopic surgical drainage,22 patients were treated with percutaneous catheter drainage,30 underwent the transcervical approach,and 40 underwent thoracotomy.A total of 617 patients who were selected underwent the appropriate combined operation for surgical drainage according to the specific location of the infected focus.The overall mortality rate of all 781 DNM pa-tients included was 11.2％.Conclusion The most effective diagnosis and treatment of DNM is a high degree of clini-cal vigilance followed by prompt and adequate drainage with intensive care,including hemodynamic monitoring,nutri-tional support,computer tomographic scanning repeated as necessary,and combined use of systemic antibiotics.

Objective:To explore the different categories of family resilience in cervical cancer patients and their influencing factors.Methods:From October 2022 to September 2023, 275 cervical cancer patients admitted to the First Hospital of Shanxi Medical University were selected as the study subject by convenience sampling. Cervical cancer patients were surveyed using the self-made General Information Questionnaire, Benefit Finding Scale (BFS), Connor-Davidson Resilience Scale (CD-RISC), and shortened Chinese Version of the Family Resilience Assessment Scale (FRAS-C). Latent profile analysis was used to investigate the family resilience of patients, and Logistic regression was used to analyze the influencing factors of family resilience in different categories.Results:A total of 275 questionnaires were distributed, and 253 valid questionnaires were collected, with a valid response rate of 92.0% (253/275). Family resilience of cervical cancer patients was divided into three categories of low resilience-negative coping group (18.6%, 47/253), moderate resilience-communication disorder group (59.3%, 150/253), and high resilience-inclusive understanding group (22.1%, 56/253). The per capita family monthly income, place of residence, primary caregivers, whether to undergo radiotherapy or chemotherapy, psychological resilience, and disease benefit finding were the influencing factors of family resilience in different categories of cervical cancer patients ( P<0.05) . Conclusions:The family resilience of cervical cancer patients can be divided into three latent categories. Medical and nursing staff should identify the characteristics of different categories of patients and provide targeted intervention measures to improve their family resilience.

Objective To investigate the current status of frailty in liver transplant candidates and to analyze the influencing factors.Methods The convenience sampling method was used to select 150 liver transplant candidates who were hospitalized in the Department of Liver Transplantation of a tertiary hospital in Hangzhou from July 2022 to July 2023.They were investigated by the general patient data,Fried Frailty Phenotype,Barthel Index,Nutrition Risk Screening 2002,General Health Status Scale.Statistical methods including single factor and multifactor analysis were conducted for influencing factors of frailty in liver transplant candidates.Results The pre-frailty and frailty rates in 145 liver transplant candidates were 42.07％and 45.52％,respectively,and only 12.41％were non-frailty.The results of ordered multiple Logistic regression showed that age,total bilirubin,hemoglobin,and general health status were influential factors in the frailty of liver transplant candidates(P＜0.05).Conclusion Liver transplant candidates have a high incidence of frailty.Age,total bilirubin,hemoglobin,and general health status are influential factors in frailty.Nurses should pay attention to the assessment of frailty in liver transplant candidates,and take timely and targeted nursing interventions to prevent or delay the occurrence and development of frailty.

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

Objective:To investigate the clinical efficacy of distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries.Methods:A retrospective cohort analysis was made on clinical data of 72 patients with ankle fracture accompanied with distal tibiofibular syndesmosis injuries admitted to 909th Hospital of Joint Service Support Force of PLA from September 2017 to September 2020, including 38 males and 34 females, aged 19-65 years [(42.5±12.2)years]. The fracture was type B in 30 patients, type C 1 in 29 and type C2 in 13 according to Danis-Weber classification. A total of 36 patients were treated by distal tibiofibular screw fixation combined with ligament repair (fixation+repair group) and 24 patients by distal tibiofibular screw fixation (fixation group). Operation time, intraoperative blood loss and hospital stay were recorded. Visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and ankle range of motion (ROM) were determined at 1, 3 months postoperatively and at the final follow-up. Complications were documented. Results:All patients were followed up for 12-22 months [(15.9±2.2)months]. There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups (all P>0.05). VAS in fixation+repair group was (3.1±1.0)points and (2.1±0.6)points at 1, 3 months postoperatively, significantly lower than (3.9±0.8)points and (2.6±0.8)points in fixation group (all P<0.05), but the score showed no significant difference between the two groups at the final follow-up ( P>0.05). AOFAS score in fixation+repair group was (64.7±4.0)points, (73.2±3.4)points and (87.2±3.4)points at 1, 3 months postoperatively and at the final follow-up, significantly higher than (60.1±4.9)points, (70.2±1.9)points and (84.1±2.6)points in fixation group (all P<0.05). There was no significant difference in the ROM between the two groups at 1 month postoperatively ( P>0.05), but the ROM at 3 months postoperatively and at the final follow-up in fixation+repair group [(44.4±2.9)° and (52.3±2.5)°, respectively] was significantly higher than that in fixation group [(41.4±2.7)° and (50.1±2.7)°, respectively] (all P<0.05). There was 1 patient with internal fixation loosening in fixation+repair group, with the incidence of complications of 3% (1/36). While the incidence of complications was significantly lhigher in fixation group [17%(6/36)], including 2 patients with re-separation of distal tibiofibular syndesmosis, 2 with internal fixation loosening and 2 with internal fixation breakage ( P<0.05). Conclusion:Compared with distal tibiofibular screw fixation, distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries is effective to early relieve ankle pain, improve ankle function and ROM, and reduce occurrence of complications.

This study aimed to investigate the protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice. After intratracheally giving bleomycin(3. 5 mg/kg), mice were orally administered Baibu Tang once a day for 14 consecutive days, takingnintedanib as a positive control. The anti-fibrotic effects were assessed by the hydroxyproline level and the histopathological changes in H&E or Masson stained lung tissues. The results revealed that the lung coefficient, hydroxyproline content, inflammation and collagen deposition were increased significantly in the lung tissue of the model mice. Both ethanol and water extracts of Baibu Tang significantly improved all the pathological indexes in mice, but the effect of the ethanol extract was better than that of the water extract. Baibu Tang with Baibu(root of Stemona tuberosa)containing different components(neotuberostemonine, tuberostemonine and stemoninine, respectively)could significantly reduce hydroxyproline level and collagen deposition in the lung tissue of bleomycin-induced mice, and there was no significant difference in their activity. This result showed that the changes in the chemical composition of Stemona tuberosa(Baibu, monarch drug for Baibu Tang)have little effect on the anti-fibrosis activity of Baibu Tang, and its mechanism and material basis need further investigation.

Aim To investigate the effect of Ding''s herb enema prescription on intestinal tissue related target in rat colitis induced by dextran sulfate sodium(DSS), and to elucidate the mechanism of Ding''s herb enema prescription in improving the intestinal inflammation and intestinal fibrosis.Methods Rats were fed with 3.5％ DSS.The rats were randomly divided into positive drug group, model group, Control group, and Ding''s herb enema prescription group.The positive drug group was treated with mesalazine enema, and Ding''s herb enema prescription group was treated with Ding''s herb enema prescription.The colon mucosa was taken once a day for 6 weeks.The changes of intestinal inflammatory response and intestinal fibrosis related proteins were detected by GSR-CAA-67 antibody protein array, and the differentially expressed proteins were screened out.Results Eight proteins showed statistical differences, including IFN-γ, erythropoietin(EPO), TIMP-2, TIM-1, IL-6, TIMP-1, TNF-α, IL-22 (P<0.05).On the other hand, Ding''s herb enema prescription and mesalazine significantly antagonized the effect of IL-6 and TIMP-1 (P<0.05).The antagonized effect of Ding''s embolization enema on TNF-α and IL-22 was also significant(P<0.05), but mesalazine had no similar effect (P>0.05).Conclusions Ding''s herb enema prescription has the effect of multiple targets, which may improve the intestinal inflammatory response and intestinal fibrosis to achieve the purpose of treatment of ulcerative colitis(UC).

Objective To investigate the relationship between peripheral blood mtDNA content and acute coronary syndrome. Methods A total of 244 patients who received coronary angiography(CAG)was enrolled in this study. They were divided into acute coronary syndrome(ACS)group(n=183)and control group(n=61)ac-cording to the CAG results. A quantitative real-time PCR-based method was used to measure relative content of mtDNA in peripheral blood. According to lesion blood vessel counts ,ACS patients were divided into single lesion group,double lesion group and three lesions group. Gensini score was used to quantitatively evaluate the severity of coronary stenotic lesions. Then we analyzed the relationship of mitochondrial DNA content with the lesion counts and the Gensini score. Results The ACS group had a lower mtDNA content ,as compared to controls (P <0.001).The lesion blood vessel count and mtDNA content in the single ,double and three vascular lesions group were all significanlty lower than that of the control group(P<0.05)and that of the double,three vascular lesions group were both significantly lower than that of the single vascular lesion group(P<0.05). According to the Gensi-ni score,all patients were divided into four groups,where with mtDNA content was decreased with the increase of the Gensini score(P < 0.01). The linear regression analysis showed that Gensini score was negatively correlated with mtDNA content(r=-0.644,P<0.001). ROC curve analysis showed that the area under the curve of mtDNA content for ACS diagnosis was 0.855(P<0.001),with the sensitivity and specificity of 0.756 and 0.833,respec-tively. Conclusion MtDNA content is closely associated with ACS and the Gensini score ,the latter indicating the severity of coronary stenotic lesions. MtDNA content detection has its value in the diagnosis of ACS.

Objective To explore the altered functional connectivity of the amygdala in adolescents with internet gaming disorder (IGD) using resting state functional connectivity (rsFC) and dynamic functional connectivity (dFC) analysis.Methods Thirty adolescents with IGD (IGD group) and 30 demographically matched healthy controls (HC group) were recruited.The right and left amygdala were selected as seed regions,the rsFC and dFC between 2 groups were calculated.The regions showing altered connectivity in IGD were adopted as ROIs for correlation analysis.Results Compared to HC group,IGD group had higher rsFC with the right amygdala over the right inferior temporal,middle temporal gyrus,middle frontal gyrus,lower rsFC with the right amygdala over the left inferior temporal,superior temporal and the right inferior occipital gyrus,superior occipital gyrus.The IGD group had lower rsFC with the left amygdala over the right rectal gyrus and thalamus.Compared to HC group,the IGD group showed higher dFC variance with the left amygdala over the right middle temporal and the left media frontal gyrus,and lower dFC variance over the right precuneus,inferior parietal lobe,posterior cingulate and the left postcentral gyrus.The IGD group showed higher dFC variance with the right amygdala over right middle frontal gyrus and lower dFC variance with the right amygdala over the right middle temporal,the left media frontal gyrus and paracingulate cortex,inferior parietal lobe.The rsFC between the left amygdala and right rectal gyrus was negatively correlated with Chinese Internet Addiction Scale (CIAS) scores.The dFC variance between the left amygdala over the left postcentral gyrus was positively correlated with CIAS scores.The dFC variance between the left amygdala and the right inferior parietal lobe were negatively correlated with CIAS scores.Conclusion The amygdala participates in the development of IGD.

Objective To study the diagnostic value of pencilliosis marneffei (PM)in a non-HIV-infected child with the com-bined detection of aspergillosis galactomannan,fungus Glucan(1-3)-β-D and boold culuture.Methods The venous blood specimen from the child was collected for the quantified detection of aspergillosis galactomannan,fungus Glucan(1-3)-β-D. The growth and colonial morphology of fungus was inspected with the positive blood culture and the characteristics of fun-gus smear were observed under microscope.Results The result of aspergillosis galactomannan was 14.45 μg/L and fungus Glucan (1-3)-β-D 77.14 pg/ml.Penicillium marnrffei was identified using blood culture.It was mycelia form under 25℃ and the salouraud medium produced water soluble claret-red pigment produced.It was mycelia form under 35℃ and the colony was gyri creases,the characteristic broom-like hypha and separation hypha could be found under microscope.Conclusion It is effective for the early diagnosis and therapy of PM with the combination detection of aspergillosis galactomannan,fungus Glucan (1-3)-β-D and boold culuture and have better clinical diagnosis value.