Roxadustat is the world's first small molecule hypoxia-inducible factor prolyl hydroxylase inhibitor. Its adverse effect of causing hypothyroidism with low thyroid-stimulating hormone (TSH) is relatively rare and manifests subtly in elderly patients with multiple coexisting diseases. This article reports a case of an elderly patient with renal anemia who developed reversible low-TSH hypothyroidism after taking roxadustat for 12 days, with a significant decrease in thyroid hormone levels. After discontinuing roxadustat for 15 days, the thyroid hormone levels gradually returned to normal. Due to the worsening of renal anemia, the patient took roxadustat again, and 9 days later, the thyroid function-related indicators decreased upon re-examination, leading to the initiation of levothyroxine replacement therapy. In conjunction with relevant literature, this article analyzes the adverse reactions that occur during the oral administration of roxadustat in elderly patients with chronic kidney disease, aiming to provide reference for drug treatment of such patients.

Objective To analyze bedside radiation dose rates for interventional surgery operators in Guangdong Province, examine dose distribution patterns, and identify potential weaknesses in radiation protection, and to provide guidance for optimizing radiation monitoring and protection measures. Methods A total of 209 digital subtraction angiography devices measured in Guangdong Province between 2017 and 2024 were used as the research objects. The first and second operator positions were set at 30 cm and 90 cm horizontally from the X-ray tube focal point, respectively. Monitoring points were set up at 155, 125, 105, 80, and 20 cm above the ground. Results The median bedside radiation dose rate for interventional surgery operators in Guangdong Province was 83.0 (3.9, 1044.0) μSv/h, indicating instances of exceeding standard limits. The overall dose rates under the old and new standards were 29.8 (3.9-346.5) μSv/h and 114.0 (4.0-1044.0) μSv/h respectively. Results for both standards showed a higher dose rate at the second than the first operator position. The dose rates at the heights of 105 cm (abdomen), 125 cm (chest), and 155 cm (head) were higher in the second operator position than in the first operator position. Additionally, 71.5% and 56.8% of the highest dose rate points under the new and old standards, respectively, were concentrated at 105 cm (abdomen), 125 cm (chest) and 155 cm (head) in the second operator position. Conclusion The principle of protection optimization should be followed, auxiliary protective facilities should be placed correctly, and attention should be paid to the protection of the second surgery operator position, especially above the abdomen. The dose rate results under the new standard were lower than those under the old standard, suggesting that the measurement method may overestimate radiation exposure at the secondary operator position.

Objective To discuss the application effect of using a stone extractor balloon catheter to assist in crossing the anastomotic stenosis in treatment of anastomotic biliary stenosis after liver transplantation using endoscopic retrograde cholangiopancreatography(ERCP).Methods Clinical data of 48 patients who developed anastomotic biliary stenosis after liver transplantation and underwent ERCP treatment were collected.Upon unsuccessful use of a dilation catheter to cross the stricture,attempts were made to cross the anastomotic biliary stenosis by using a stone extractor balloon catheter.The success rate of the procedure was recorded,intraoperative conditions were observed,treatment outcomes and complications were analyzed.Results The main presenting symptoms in the 48 patients on admission were abdominal discomfort(32 patients),fever(7 patients),pruritus(4 patients),jaundice(3 patients),and no obvious symptoms(2 patients).Preoperative magnetic resonance cholangiopancreatography(MRCP)examination revealed isolated stricture of the anastomotic site in 35 cases,and stricture associated with stones in 13 cases.Using the stone extractor balloon catheter as a guide,guidewire crossing of the anastomotic stenosis was successful in 26 cases,resulting in a success rate of 54.17%(26/48).Through statistical analysis of the successful group and the failed group,there was a significant difference in whether the distal biliary dilatation between the two groups,and the difference was statistically significant(χ2 = 8.39,P = 0.004).In the 26 successfully treated cases,alanine transaminase(ALT),aspartate transaminase(AST),γ-glutamyl transpeptidase(γ-GT),alkaline phosphatase(ALP),and total bilirubin(TBiL)levels decreased significantly 48 hours after the procedure(P<0.05),and no serious complications occurred.Conclusion The use of a stone extractor balloon catheter significantly increases the success rate of crossing anastomotic stenosis in the treatment of anastomotic biliary stenosis after liver transplantation,especially in cases with distal dilatation of the common bile duct.This approach is safe and worth promoting.

This experiment aims to study the taste-masking effects of different kinds of corrigent used individually and in combination on ibuprofen oral solution, in order to optimize the taste-masking formulation. Firstly, a wide range of corrigent and the mass fractions were extensively screened using electronic tongue technology. Subsequently, a combination of sensory evaluation, analytic hierarchy process (AHP)-fuzzy mathematics evaluation, and Box-Behnken experimental design were employed to comprehensively assess the taste-masking effects of different combinations of corrigent on ibuprofen oral solution, optimize the taste-masking formulation, and validate the results. The study received ethical approval from the Review Committee of the Beijing University of Chinese Medicine (ethical code: 2024BZYLL0102). The results showed that corrigent fractions and types were screened separately through single-factor experiments. Subsequently, a Box-Behnken response surface design combined with AHP and fuzzy mathematics evaluation was used to fit a functional model: Z = 688.310 11 - 3 023.722 22X₁ - 11.477 00X₂ + 62.721 67X₃ + 14.600 00X₁X₂ - 179.666 67X₁X₃ - 3.152 00X₂X₃ + 4 031.111 11X₁² + 0.525 28X₂² + 9.772 00X₃². This model is stable and reliable, determining the optimal taste-masking formulation to be 3.9 g·L^-1 of stevioside, 100 g L^-1 of xylitol, and 30 g L^-1 of methyl-β-cyclodextrin. The comprehensive score of the verification test is 88.14, with a relative RSD of 0.39%, indicating the feasibility of this model. This study achieved the improvement of the taste of ibuprofen oral solution through a combination of objective and subjective methods. Three types of corrigent were identified for enhancing drug taste, leading to the selection of the optimal taste-masking formulation for ibuprofen oral solution. This significantly enhanced the taste of the original formulation, improved patient compliance, and offered a new approach to mitigating the undesirable taste of formulations.

To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM).

To examine the global research trends and emerging focal points in the field ofgeriatric interdisciplinary team (GIT) from 2000 to 2023, so as to offer insights and reference for related research in China.

To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM).

High-voltage pulsed electric field(HV-PEF)ablation technology has demonstrated promising applications in the clinical treatment of chronic obstructive pulmonary disease(COPD).However,its use has been limited to exploratory applications in a small number of cases,and the underlying mechanisms remain largely undefined.To facilitate broader clinical implementation,comprehensive molecular mechanism studies via extensive animal experimentation are essential.Rats,due to their ease of modeling COPD and the availability of comprehensive molecular reagents,serve as an optimal model for such studies.Consequently,the development of electrodes specifically designed for HV-PEF respiratory ablation in SD rats is of significant importance.In this study,we meticulously examined the anatomical structure of rat airways and investigated various equipment parameters,including material composition,rigidity,diameter,electrode ring dimensions,spacing between positive and negative poles,insulation coating for the catheters,welding techniques between the guidewire and electrode ring,and the design of vent holes in the catheter.Based on these considerations,we fabricated PVC ablation electrode catheters with integrated ventilation functionality.Subsequently,we employed finite element simulation to estimate the field strengths that could be applied by these electrodes.The simulation results were then validated in normal rats to assess the electrical safety and efficacy of the electrodes.These findings laid the groundwork for further investigation into the mechanisms of HV-PEF treatment for COPD.

Objective:To investigate the expression and clinical significance of CD30 in patients with diffuse large B-cell lymphoma(DLBCL).Methods:A retrospective analysis was conducted on 124 cases of primary DLBCL diagnosed at Changzhou Second People's Hospital Affiliated with Nanjing Medical University from January 2018 to July 2020.The expression of CD30 in patients with DLBCL was detected by immunohistochemical method,and the clinicopathological characteristics were analyzed and compared between CD30+and CD30-groups.Kaplan-Meier analysis was used for survival analysis.The relationship between CD30 expression and clinical features and prognosis were analyzed.Results:Among the 124 patients with DLBCL,19 patients expressed CD30,and the positive rate is 15.32％.The clinico-pathological characteristics of CD30+in patients with DLBCL were characterized by low age,more common in males,fewer extranodal lesions,lower international prognostic index(IPI),GCB type being more common in Hans subtype,and achieving better therapeutic effects(P＜0.05).However,there were no significant statistical differences in B-symptoms(P=0.323),Ann Arbor staging(P=0.197),Eastern Cooperative Oncology Group(ECOG)score(P=0.479),lactate dehydrogenase(LDH)(P=0.477),and the involvement of bone marrow(P=0.222).There were significant differences in OS and PFS between the CD30+and CD30-groups(x2=5.653,P=0.017;x2=4.109,P=0.043),the CD30+group had a better prognosis than that of the CD30-group.The results of subgroup analysis showed that the CD30+group in the IPI score=1-2,LDH elevated group had a better prognosis(P＜0.05).In the subgroups of Ann Arbor staging Ⅲ-Ⅳ(P=0.055)and non GCB type(P=0.053),the CD30+group had a good prognosis trend,but the difference was not statistically significant.The results of univariate analysis showed that the good prognosis of DLBCL patients was closely related to CD30+expression,no B-symptoms,early Ann Arbor staging,low ECOG score,normal LDH,low IPI score,fewer extranodal involvement,and obtaining the best therapeutic effect as CR(all P＜0.05).COX multivariate regression analysis showed that the presence of B-symptoms and achieving the best therapeutic effect as Non-CR were independent risk factors affecting the prognosis of DLBCL patients(P＜0.05).Conclusion:The CD30+expression in DLBCL patients indicates a good prognosis and has certain diagnostic value in evaluating the prognosis of DLBCL patients.

Objective:To evaluate the effect of dexmedetomidine on the hippocampal brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrκB) signaling pathway in a rat model of cerebral ischemia-reperfusion (I/R).Methods:Forty-five clean-grade healthy Sprague-Dawley rats, half male and half female, aged 5-6 months, weighing 200-250 g, were divided into 3 groups ( n=15 each) using a random number table method: sham operation group (group S), cerebral I/R group (group I/R), and dexmedetomidine + I/R group (group Dex). A rat model of cerebral I/R injury was established by occluding the middle cerebral artery for 90 min followed by restoring perfusion. In group Dex, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before ischemia, while the equal volume of normal saline was intraperitoneally injected in S and I/R groups. Neurological deficit scores were evaluated at 12 h of reperfusion. The rats were anesthetized and sacrificed, and the hippocampus was isolated for determination of the percentage of cerebral infarct size (by TTC method), expression of BDNF and TrκB (by Western blot), and expression of BDNF mRNA and TrκB mRNA (by real-time polymerase chain reaction) and for microscopic examination of cell apoptosis (by TUNEL method). Results:Compared with group S, the neurological deficit scores and percentage of cerebral infarct size were significantly increased, the number of apoptotic hippocampal neurons was increased, and the expression of BDNF and TrκB protein and mRNA was down-regulated in I/R and Dex groups ( P<0.05). Compared with group I/R, the neurological deficit scores and percentage of cerebral infarct size were significantly decreased, the number of apoptotic hippocampal neurons was reduced, and the expression of BDNF and TrκB protein and mRNA was up-regulated in group Dex ( P<0.05). Conclusions:The mechanism by which dexmedetomidine alleviates cerebral I/R injury may be related to activating hippocampal BDNF/TrκB signaling pathways in rats.