Objective To establish a model of combined injury of thermal radiation and blast wave of gas explosion in closed pipeline,and investigate the characteristics of important organ injury induced by burn-blast combined injury in rats.Methods A total of 72 male SD rats(aged 8～10 weeks,weighing 200～10 g)were randomly divided into control group and mild and severe injured groups.After the model rats were inflicted with blast wave and thermal radiation,their physical parameters were detected and measured.The respiratory function of the survival rats was tested.In 24 h later,arterial blood gas analysis,blood biochemical tests,and detection for serum inflammatory factors and lung injury related protein levels were performed,and the pathological changes in the lung tissue and trachea were observed.Results The peak range of explosive blast wave overpressure was 209～493 kPa,and the temperature was 152～258 ℃.The mortality rate was 8.3％in the mild group and 53.1％in the severe group.Compared with the control group,longer inspiratory time(Ti)and relaxation time(Tr)and larger tidal volume(TV)(P＜0.05),while lower respiratory frequency(f)were observed in the 2 injured groups within 6 h after injury(P＜0.05).At 24 h after injury,the values of partial pressure of carbon dioxide(PaCO2),residual base value(BE)and bicarbonate(HCO3-)were increased significantly(P＜0.05),while partial pressure of oxygen(PaO2)was decreased(P＜0.05).The serum levels of alanine transaminase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total bilirubin(TBI)and total bile acid(TBA)were notably elevated(P＜0.05).So were the levels of IL-1 β,TNF-α and IL-6(P＜0.01).Various severities of hyperemia foci and inflammation in the tracheal mucosa were observed in the injured rats.The incidence of lung injury was high,and the pathological manifestations were dot-shaped hemorrhage to diffuse hemorrhage of the whole lobe,rupture of alveolar septum,thickening of septum,and infiltration of red blood cells and inflammatory cells.The levels of serum lung injury-related proteins were significantly increased(P＜0.05).Conclusion A rat model which can highly simulate mild to severe burn-blast combined injury is constructed,which can meet the needs for rat model in study of explosive burn-blast compound injury.The main characteristics of the injury are lung injury,respiratory dysfunction,liver damage and secondary infection.

OBJECTIVE: To investigate the high risk factors of failure of autologous arteriovenous fistula (AVF) in hemodialysis patients. METHODS: A retrospective study was conducted, patients with maintenance hemodialysis (MHD) undergoing AVF admitted to General Hospital of Western Theater Command from January 2021 to December 2022 were enrolled, including 107 patients with normal AVF and 168 patients with AVF dysfanction. According to the causes of AVF failure, the patients were divided into AVF stenosis group (n = 103) and AVF thrombosis group (n = 65). Age, gender, body mass index (BMI) and comorbidities (hypertension, diabetes, coronary heart disease) and other clinical data of all patients were collected. Hemoglobin, hematocrit, white blood cell count, neutrophil count, lymphocyte count, platelet count, C-reactive protein (CRP), high density lipoprotein, low density lipoprotein, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) within 1 month of AVF use in normal dialysis patients and 1 week before AVF failure. Multivariate Logistic regression was used to analyze the independent risk factors of AVF dysfuction in MHD patients. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of risk factors on AVF dysfuction in MHD patients. RESULTS: (1) There were significant differences in age, BMI, hypertension, hemoglobin, hematocrit, PLR and CRP [age (years): 56.94±14.32, 58.83±14.05, 51.57±13.19; BMI (kg/m²): 22.83±3.10, 21.27±4.98, 23.35±2.72; hypertension: 93.20%, 64.62%, 86.92%; hemoglobin (g/L): 110.82±22.16, 88.70±24.00, 87.95±23.45; hematocrit: 0.350±0.069, 0.282±0.076, 0.275±0.071; PLR: 197.35±113.59, 192.55±138.25, 162.12±73.25; CRP (mg/L): 10.01±4.02, 8.18±5.42, 3.17±1.30, all P < 0.05], among AVF stenosis group, AVF thrombosis group and AVF normal group, there were statistically significant differences no statistically significant difference was found in other indexes among three groups. (2) Multivariate Logistic regression analysis showed that hypertension [odds ratio (OR) = 4.849, 95% confidence interval (95%CI) was 1.278-18.397, P = 0.020], elevated CRP levels (OR = 2.104, 95%CI was 1.533-2.888, P = 0.000) were associated with AVF stenosis. Elevated CRP levels (OR = 1.984, 95%CI was 1.442-2.730, P = 0.000) was an independent risk factor for AVF thrombosis. Analysis of ROC curve showed that the area under the curve (AUC) of AVF dysfunction predicted by CRP was 0.712, 95%CI was 0.637-0.786, P = 0.000; CRP cut-off value was 1.8 mg/L, the sensitivity was 67.0%, the specificity was 83.7%. CONCLUSIONS Elevated CRP is an independent risk factor for AVF failure in hemodialysis patients, which can be used to predict the occurrence of AVF failure.
Humans ; Retrospective Studies ; Constriction, Pathologic ; Renal Dialysis/adverse effects* ; Lymphocytes ; C-Reactive Protein ; Risk Factors ; Hypertension ; Hemoglobins ; Thrombosis ; ROC Curve ; Prognosis

As a representative chemotherapeutic drug, docetaxel (DTX) has been used for breast cancer treatment for decades. However, the poor solubility of DTX limits its efficacy, and the DTX based therapy increases the metastasis risk due to the upregulation of C-X-C chemokine receptor type 4 (CXCR4) expression during the treatment. Herein, we conjugated CXCR4 antagonist peptide (CTCE) with DTX (termed CTCE-DTX) as an anti-metastasis agent to treat breast cancer. CTCE-DTX could self-assemble to nanoparticles, targeting CXCR4-upregulated metastatic tumor cells and enhancing the DTX efficacy. Thus, the CTCE-DTX NPs achieved promising efficacy on inhibiting both bone-specific metastasis and lung metastasis of triple-negative breast cancer. Our work provided a rational strategy on designing peptide-drug conjugates with synergistic anti-tumor efficacy.

The evaluation of pancreatic function includes the evaluation of endocrine function and exocrine function.Insufficiency of pancreatic endocrine function can lead to pancreatic related diabetes.The pancreatic endocrine function is often evaluated by fasting blood glucose, two hours postprandial blood glucose, and glycosylated hemoglobin.Pancreatic exocrine dysfunction can lead to abdominal pain, abdominal distension, fatty diarrhea, malnutrition, weight loss and other manifestations.Pancreatic exocrine dysfunction is often atypical, and it is difficult to accurately evaluate pancreatic exocrine function, so the evaluation of pancreatic exocrine function is particularly important.There are indirect and direct methods to evaluate pancreatic exocrine function.At present, the most commonly used direct detection method is the detection of pancreatic function under intravenous anesthesia endoscope.Fecal elastase-1 is a commonly used indirect detection method at present.

Objective: To explore and compare the preventive effect of using letrozole and gonadotropin-releasing hormone (GnRH) antagonist during luteal phase of patients at high risk for ovarian hyperstimulation syndrome (OHSS). Methods: A total of 99 infertile women undergoing in vitro fertilization and embryo transfer or intracytoplasmic sperm injection with high risk for OHSS were enrolled in this randomized controlled trial.The letrozole group (n=51) received letrozole of 7.5 mg daily for 3 days;the GnRH antagonist group (n=48) were given cetrorelix of 0.25 mg subcutaneously daily for 3 days. Both groups received support therapy combined with embryo cryopreservation. The incidence of OHSS was surveyed. And the serum concentration of estradiol, LH and progesterone on days 3, 5 and 8 after oocytes retrieval were measured. Results: There were no statistical differences in terms of baseline characteristics of patients and outcomes of controlled ovarian hyperstimulation between the two groups.The incidence of moderate and severe OHSS was found no significantly difference between letrozole group [11.8%(6/51)] and GnRH antagonist group [10.4%(5/48);P>0.05]. The estradiol concentration of the indicated days on days 3,5 and 8 after oocytes retrieval in letrozole group and GnRH antagonist group were (1 417±3 543) versus (15 210±9 921) pmol/L, (1 692±4 330) versus (18 680±11 567) pmol/L, (239±336) versus (3 582±5 427) pmol/L, respectively;compared with GnRH antagonist group, the estradiol level was significantly lower in the letrozole group (all P<0.01). The luteinizing hormone level in the letrozole group were (0.46±0.40), (0.56±0.55)and (0.67±0.58) U/L on days 3,5 and 8 after oocytes retrieval, which were significantly higher than those of GnRH antagonist group [(0.28±0.28), (0.30±0.19) and (0.45±0.37) U/L, respectively; all P<0.05]. There was no obvious differences on progesterone levels between letrozole group and GnRH antagonist group (all P>0.05),and on days 8 after oocytes retrieval,the level of progesterone in each group were significantly lower than those on day 3 and 5 after oocytes retrieval (P<0.05). Conclusion Letrozole has the same efficiency as GnRH antagonist for the prevention of OHSS, faster and cheaper to use, but its efficacy seems not to be related to the suppression of steroidogenic during the luteal phase.

Objective:To construct the intelligent medical cloud management platform of diabetes education clinic in ClassⅢ general hospital and observe the clinical effects.Methods:A total of 260 young and middle-aged patients with type 2 diabetes mellitus (T2DM) who were admitted to Department of Endocrinology in the First Affiliated Hospital of Henan University from June to December 2019 were selected by convenience sampling method. They were divided into the control group and the experimental group by the random number table method, with 130 cases in each group. Patients in the control group were given routine diabetes outpatient follow-up, while the experimental group was given group education, case management, behavioral intervention, condition supervision and online follow-up intervention based on the intelligent medical cloud management platform of the diabetes education clinic. The blood glucose control status and the self-management ability of the two groups before and after 3 months of intervention were compared.Results:After intervention for 3 months, fasting plasma glucose (FPG) , 2h plasma glucose of 75g oral glucose tolerance test (OGTT 2h PG) and hemoglobin A1c (HbA1c) of patients in two groups were reduced than those before intervention, and FPG, OGTT 2h PG and HbA1c levels in the experimental group were lower than those in the control group. The differences were statistically significant ( P<0.05) . The mean blood glucose (MBG) and mean amplitude of plasma glucose excursions (MAGE) in the experimental group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . After 3 months of intervention, blood glucose was monitored 6 833 times in the control group and 7 279 times in the experimental group. The incidence of hypoglycemia in the experimental group was lower than that in the control group [0.77% (56/7 279) vs. 2.82% (193/6 833) , χ 2=85.885, P<0.05]. After 3 months of intervention, the scores of diet, exercise, blood glucose monitoring, prevention of complications and medical compliance in the two groups were all higher than those before intervention, and the scores of diet, exercise, blood glucose monitoring and medical compliance in the experimental group were higher than those in the control group. The differences were statistically significant ( P<0.01) . Conclusions:The construction and application of intelligent medical cloud management platform of diabetes education clinic can better improve blood glucose control and improve self-management ability of patients.

Objective: To explore the genetic cause for abnormal pregnancies through detecting chromosomal copy number variations (CNVs) in abortic tissues by next generation sequencing (NGS). Methods: NGS technique was used to detect CNVs in abortion tissues. Parental chromosomal karyotypes were predicted based on the results. The aberrant chromosomal segments of the parents were accurately mapped by G-banding karyotyping analysis and fluorescence in situ hybridization (FISH). Results: In addition to numerical chromosomal aberrations, 12 microdeletion/microduplications were detected by NGS. For 8 families where both parents accepted chromosomal karyotyping, 4 carriers of chromosomal abnormalities were identified. One marker chromosome was missed by karyotyping analysis, and a mother was confirmed to carry a cryptic balanced translocation by FISH. Conclusion NGS can facilitate detection of cryptic chromosomal translocations in couples with repeated pregnancy failure and is of great value for detecting abnormal CNVs for its high sensitivity.

Objective To study the perioperative nursing of patients with uterine myoma complicated with diabetes mellitus.Methods A total of 120 patients with hysteromyoma and diabetes mellitus treated in our hospital were randomly divided into two groups, 60 patients in the observation group were given self-care, and 60 patients in the control group were given routine care, compliance, self-care ability, islet injection, diet control their blood glucose detection, postoperative anal exhaust time, wound healing time, toilet time and bed-off time after surgery, urination were observed.Results After the nursing, the observation group''s compliance, self-care ability, islet injection, diet control their blood glucose detection were significantly better, the postoperative anal exhaust time, incision healing time, first toileting time and postoperative ambulation time were shorter than that in the control group, there were significant differences between the two groups (P<0.05).Uroschesis and induced uresis patients in the observation group were significantly higher than the control group (P<0.05).Conclusion Self-care measures in patients with uterine myoma complicated with diabetes mellitus can promote the early rehabilitation and improve the nursing effect of patients with diabetes mellitus.

Objective To study the perioperative nursing of patients with uterine myoma complicated with diabetes mellitus.Methods A total of 120 patients with hysteromyoma and diabetes mellitus treated in our hospital were randomly divided into two groups, 60 patients in the observation group were given self-care, and 60 patients in the control group were given routine care, compliance, self-care ability, islet injection, diet control their blood glucose detection, postoperative anal exhaust time, wound healing time, toilet time and bed-off time after surgery, urination were observed.Results After the nursing, the observation group''s compliance, self-care ability, islet injection, diet control their blood glucose detection were significantly better, the postoperative anal exhaust time, incision healing time, first toileting time and postoperative ambulation time were shorter than that in the control group, there were significant differences between the two groups (P<0.05).Uroschesis and induced uresis patients in the observation group were significantly higher than the control group (P<0.05).Conclusion Self-care measures in patients with uterine myoma complicated with diabetes mellitus can promote the early rehabilitation and improve the nursing effect of patients with diabetes mellitus.