Objective By comprehensively applying the integrated technology acceptance model,we explore the accept-ability of"6S management work"among members within the medical group and analyze important influencing factors.This pro-vides theoretical support and practical guidance for promoting work progress and sustainable development.Methods In order to determine the specific items for the questionnaire,a combination of literature review and expert consultation methods was used.The entire hospital staff was stratified sampled proportionally,and an online survey was conducted to collect feedback on the ac-ceptability from 354 employees who had been employed and stably served in the hospital before 2024.The questionnaire results were statistically described using SPSS 27.0 to clarify the current satisfaction with management work and the relevant factors.Results The community influence was the highest in the independent variable with a score of(2.11±0.91),followed by per-formance expectation with a score of(2.11±0.75),and giving expectation scored the lowest with a score of only(1.99±0.46).The dependent variables of behavioural intention and satisfaction scored(1.96±0.75)and(1.97±0.85)respectively.Conclusion Using the key factors influencing the behavioural intentions and satisfaction of medical group members,such as co-operation,community influence,performance expectations,and payment expectations,recommendations are made for the contin-uous optimization of the"6S management"process.

Objective To compare the analgesic effect and the effect on the success rate of reduc-tion of three doses of remifentanil combined with dexmedetomidine in the clamping reduction of cricoarytenoid joint dislocation.Methods Fifty-one patients with cricoarytenoid joint dislocation,30 males and 21 females,aged 18-80 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were selected from April 2021 to December 2022 in the department of otolaryngology,head and neck surgery.The patients were randomly divided into three groups according to remifentanil dose:remifentanil 0.5 μg·kg-1·min-1 group(group A,n=17),remifentanil 1.0 μg·kg-1·min-1 group(group B,n=18),and remifentanil 1.5 μg·kg-1·min-1 group(group C,n=16).After admission,dexmedetomidine 0.6 μg·kg 1·h-1 was injected intravenously,and an ear,nose and throat anesthetic spray(2％lidocaine 2 ml)was used to administer surface anesthesia to the base of the tongue.A second surface anesthesia was administered to the throat at 5 minutes,and dexmedetomidine was stopped at 10 minutes.The supraglottic and periarticular cri-coarytenoid joints were subjected to superficial anesthesia for a third time under visual laryngoscope,and then remifentanil at corresponding doses was injected intravenously in three groups for 5 minutes,and the reduction operation began after the pumping was stopped.The success of the first reduction,the anesthesia quality satisfaction score of the surgeon and the recovery of remifentanil during the operation were recorded.VAS pain scores were recorded at the time of entry,3 minutes,30 minutes,and 6 hours after operation.The adverse reactions during operation and recovery were recorded.Results Compared with group B,the success rate of first reduction and the score of anesthesia quality satisfaction were significantly decreased in groups A and C(P＜0.05).Compared with group A,the ratio of additional remifentanil supplementation in groups B and C was significantly reduced,and the VAS pain score 3 minutes after surgery was significant-ly decreased(P＜0.05).Compared with group C,the proportion of mandibular manipulation ventilation in groups A and B was significantly reduced(P＜0.05).There was no significant difference in the incidence of bradyheart rate,nausea and vomiting,agitation,delirium and laryngeal spasm between the three groups.Conclusion Compared with remifentanil 0.5 and 1.5 μg·kg-1·min-1,remifentanil 1.0 μg·kg-1·min-1 combined with dexmedetomide sequential pumping provided good analgesic effect for the clamping reduction of cricoarytenoid joint dislocation,improved the success rate of the first reduction,more stable respiratory circulation and fewer perioperative adverse reactions.

Objective:To investigate the value of three-dimensional (3D) CT in diagnosing cricoarytenoid dislocation.Methods:From January 2021 to December 2021, 31 patients with unilateral cricoarytenoid dislocation who had been treated by reduction forceps at the Affiliated BenQ Hospital of Nanjing Medical University were collected retrospectively, and their voice recovered or improved significantly after therapy. The preoperative CT images were reconstructed by volume rendering (VR). The dislocated side (left and right), type of dislocation (total dislocation and subluxation), and dislocation direction (anterior, posterior, internal and external dislocation) of cricoarytenoid dislocation were observed. According to arytenoid articular surface of cricoid cartilage exposed completely or not (caused by arytenoid displacement), they were divided into complete dislocation and subluxation. According to the direction of arytenoid displacement and the part of arytenoid articular surface of cricoid cartilage exposed, they were divided into anterior, posterior, internal and external dislocation. According to the shape of the vocal cords on laryngoscope, anterior and posterior dislocation of each case was judged, and then compared with that of CT.Results:On VR images, there were 28 cases of cricoarytenoid subluxation (90.3%, 28/31) and 3 cases of complete dislocation (9.7%, 3/31). Left cricoarytenoid dislocation was 26 cases (83.9%, 26/31) and right cricoarytenoid dislocation was 5 cases (16.1%, 5/31). Posterior dislocation was 28 cases (90.3%, 28/31) and anterior dislocation was 3 cases (9.7%, 3/31). There were 23 cases of internal dislocation (74.2%, 23/31), 2 cases of external dislocation (6.4%, 2/31), and 6 cases without obvious internal and external dislocation (19.4%, 6/31). Three cases of complete dislocation were left posterior internal dislocation.There were 24 cases of left posterior dislocation (77.4%, 24/31), 4 cases of right posterior dislocation (12.9%, 4/31), 2 cases of left anterior dislocation (6.4%, 2/31) and 1 case of right anterior dislocation (3.2%, 1/31). On laryngoscope, there were 19 cases of posterior dislocation (61.3%, 19/31), 9 cases of anterior dislocation (29.0%, 9/31), 3 cases were difficult to assess (9.7%, 3/31) because of aryepiglottic fold covering. Sixteen cases (55.2%, 16/28) were consistent with 3D CT, and 12 cases (42.8%, 12/28) were inconsistent.Conclusion:The 3D CT is a reliable method to evaluate cricoarytenoid dislocation, which can show dislocated side, type and direction of cricoarytenoid dislocation clearly.

Cognitive impairment caused by chronic cerebral hypoperfusion (CCH) is associated with white matter injury (WMI), possibly through the alteration of autophagy. Here, the autophagy-lysosomal pathway (ALP) dysfunction in white matter (WM) and its relationship with cognitive impairment were investigated in rats subjected to two vessel occlusion (2VO). The results showed that cognitive impairment occurred by the 28th day after 2VO. Injury and autophagy activation of mature oligodendrocytes and neuronal axons sequentially occurred in WM by the 3rd day. By the 14th day, abnormal accumulation of autophagy substrate, lysosomal dysfunction, and the activation of mechanistic target of rapamycin (MTOR) pathway were observed in WM, paralleled with mature oligodendrocyte death. This indicates autophagy activation was followed by ALP dysfunction caused by autophagy inhibition or lysosomal dysfunction. To target the ALP dysfunction, enhanced autophagy by systemic rapamycin treatment or overexpression of Beclin1 (BECN1) in oligodendrocytes reduced mature oligodendrocyte death, and subsequently alleviated the WMI and cognitive impairment after CCH. These results reveal that early autophagy activation was followed by ALP dysfunction in WM after 2VO, which was associated with the aggravation of WMI and cognitive impairment. This study highlights that alleviating ALP dysfunction by enhancing oligodendrocyte autophagy has benefits for cognitive recovery after CCH.

BACKGROUND: SMARCA2 (SWI/SNF Related, Matrix Associated, Actin Dependent Regulator of Chromatin, Subfamily A, Member 2) is an important ATPase catalytic subunit in the switch-sucrose nonfermenting (SWI/SNF) complex. However, its relationship with the pathological features of NSCLC and its prognosis remain unclear. METHODS: We retrospectively reviewed 2390 patients with surgically resected NSCLC, constructed tissue microarrays (TMAs) and performed immunohistochemical assays. We analyzed the correlation of SAMRCA2 with clinicopathological features and evaluated its prognostic value. RESULTS: Among 2390 NSCLC cases, the negative expression ratios of SAMRCA2, SMARCA4, ARID1A, ARID1B and INI1 were 9.3%, 1.8%, 1.2%, 0.4% and 0%, respectively. In NSCLC, male sex, T3 and T4 stage, moderate and poor differentiation, tumor ≥ 2 cm, Ki67 ≥ 15%, SOX-2 negative expression, middle lobe lesion and adenocarcinoma were relative risk factors affecting SMARCA2-negative expression. In lung adenocarcinomas, high-grade nuclei, histological morphology of acinar and papillary, solid and micropapillary and TTF-1-negative expression were relative risk factors affecting SMARCA2-negative expression. Kaplan-Meier survival analysis showed that the OS was shorter in the SMARCA2-negative group. Multivariate survival analysis revealed that SMARCA2-negative expression was an independent factor correlated with a poor prognosis in NSCLC. CONCLUSION In conclusion, SMARCA2-negative expression is an independent predictor of a poor outcome of NSCLC and is a potential target for NSCLC treatment.
Adenosine Triphosphatases/metabolism* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Humans ; Male ; Retrospective Studies ; Transcription Factors/genetics*

Objective To evaluate the effect of resveratrol on inhibiting inflammatory responses of astrocytes and protecting neurons from injury in cerebral ischemic mice.Methods (1) Sixty adult male C57/BL6 mice were randomly assigned to sham-operated group,ischemic group (mice were subjected to transient global ischemia by bilateral common carotid artery occlusion after injection of 1.5％ DMSO),and resveratrol treatment group (mice were subjected to transient global ischemia after injection of 20 mg/kg resveratrol dissolved in 1.5％ DMSO),with 20 mice in each group;the neuronal damage in the ischemic mouse brains was analyzed by Cresyl Violet (CV) staining.(2) In vitro,the primary cultured astrocytes were divided into oxygen-glucose deprivation (OGD)-treated astrocytes group (DMSO was added into the culture medium of astrocytes followed by OGD treatment) and resveratrol-treated astrocytes group (DMSO and 25 μmol/L resveratrol were added into the culture medium of astrocytes followed by OGD treatment);the expressions of tumor necrosis factor (TNF)-α and interleukin (IL)-6 were analyzed by ELISA at re-oxygenation 12 h after 4 h-OGD treatment;meanwhile,the primary cultured neurons were injured by OGD treatment,and subsequently were divided into OGD-treated neurons group (neurons were incubated with culture medium of OGD-treated astrocytes) and resveratrol-treated neurons group (neurons were incubated with culture medium of resveratrol-trcated astrocytes).The neurite outgrowth and expressions of TNF-α and IL-6 in astrocytes of each group were analyzed by immunofluoresent staining,and the lactic dehydrogenase (LDH) release of OGD injured neurons was detected by LDH Kit.Results (1) CV staining showed that the degrees of hippocampal neurons injury in the resveratrol treatment group (1.50±0.34) were significantly decreased as compared with those in the ischemic group (3.17±0.31,P＜0.05).(2) ELISA showed that the expressions of TNF-α and IL-6 in the resveratrol-treated astrocytes group ([160.2±18.41] pg/mL,[241.25±42.22] pg/mL) were significantly decreased as compared with those in the OGD-treated astrocytes group ([282.4 ±17.01] pg/mL,[550.5 ±59.02] pg/mL,P＜0.05);LDH detection showed the release of LDH from the resveratrol-treated neurons (0.30±0.05) was dramatically decreased as compared with that from the OGD-treated neurons (0.62±0.08,P＜0.05);immunofluorescence staining showed that the TNF-α and lL-6 positive expressions in the resveratrol-treated astrocytes were obviously decreased as compared with those in the OGD-treated astrocytes,and the expressions of neurites of the resveratrol-treated neurons were obviously increased as compared with those in the OGD-treated neurons.Conclusion Resveratrol has neuroprotective effect on neurons in global cerebral ischemic mice,probably via down-regulating the expressions and secretion of inflammatory cytokines TNF-α and IL-6 from the astrocytes.

Objective To evaluate the effect of azitromycin upon the bronchiolitis obliterans and T helper (Th)17/regulatory T cell (Treg) balance after lung transplantation. Methods Twenty-four specific pathogen free(SPF) C57BL/6 mice were used as the donors and 48 Balb/c mice were utilized as the recipients. The Balb/c mice were randomly divided into the control (C group), azitromycin control (Cazm group), transplantation (T group) and transplantation + azitromycin groups (Tazm group), 12 mice in each group. In the T and Tazm groups, heterotopic tracheal transplantation models were established to simulate bronchiolitis obliterans after lung transplantation. From 1 d post-transplantation, intragastric administration of azitromycin was given at a dose of 30 mg/kg three times per week in the Cazm and Tazm groups. At 14 and 28 d after transplantation, the transplanted trachea was removed and peripheral blood was collected. The tracheal sample was prepared for hematoxylin-eosin (HE) staining for pathological observation. The expression levels of ROR-γt and Foxp3 messenger ribonucleic acid (mRNA) in the peripheral blood were quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). The variation in the related cytokines levels of Th17 cells and Treg in the plasma was detected by enzyme linked immunosorbent assay (ELISA). Results After heterotopic tracheal transplantation, compared with the C group, thetracheal occlusion accompanied with inflammatory infiltration was observed in the T and Tazm groups. The severity of relevant symptoms in the Tazm group was slighter than that in the T group. Compared with the T group, the expression level of ROR-γt mRNA in the Tazm group was significantly down-regulated (P<0.05). No statistical significance was identified in the expression of Foxp3 mRNA between two groups (P>0.05). Compared with the T group, the levels of interleukin (IL)-6 and IL-17 cytokines in the Tazm group were significantly down-regulated (all P<0.05). Conclusions Persistent therapy of azitromycin can delay the progression of bronchiolitis obliterans after transplantation, which is probably associated with inhibiting Th17 cell differentiation and inflammation.

Objective:To optimize the extraction process of Shenqi Lixin capsules through pharmacodynamic evaluation combined with orthogonal experiments with multi-index comprehensive evaluation.Methods:The congestive heart failure(CHF) model was established by intraperitoneal injection of doxorubicin in rats,and the LVEDD,LVESD,FS and LVEF of CHF rats were used as the indicators to screen the extraction process of the samples (process A was with the whole decoction of herbs and process B was with heterophylla powder mixed with the other herbs after boiling).The single factor tests and orthogonal tests were used to optimize the extraction process by taking the contents of astragaloside and tanshinone ⅡA and the quality of the decocted material as the indices,and adding water amount,decocting times and duration as the influencing factors.Results:Pharmacodynamic experiments indicated that the improvement effects of the samples from process B on cardiac symptoms and cardiac function in CHF rats were better than that of the samples from process A.The other medicinal materials were decocted by 12-fold amount of adding water,and repeated for 12 times with one hour for each time.The average extraction rate of astragaloside and tanshinone ⅡA was 61.82% and 50.07%,respectively,which was proven by the verification experiments.The average weight of the decoction was 6.02 g.Conclusion:The optimized extraction process of Shenq Lixin capsules is scientific,reasonable,stable and reliable.

Objective To investigate the potential of a novel preservation solution,raffinose-low potassium dextran lung preservation solution with blood (BR-LPDS) in the preservation of the isolated lungs in rats,when compared to low-potassium dextran solution (LPDS).Methods Fifty donor lungs of Sprague-Dawley rats were randomly flushed with either R-LPDS (R-LPDS group,n =25) or RLPDS modified by the addition of blood (BR-LPDS group,n =25).After reperfusion,the double lungs were kept half inflate and then the pulmonary artery and bronchus were clamped.Then the grafts were flushed with and submerged in cold preservation solution at 4 C for 24 h.And they were excised for measurement of wet-to-dry ratio,as well as histologic examination to evaluate pulmonary edema,inflammation and cleaved caspase-3 expression at 0,2,4,5,6,8,10,12,14,16,24 h.Results As compared with the R-LPDS group,the mean wet-to-dry ratio of lungs in the BR-LPDS group was significantly reduced from 4 to 10 h after reperfusion.Upon histologic examination,less inflammatory cell aggregates and lower caspase-3 activity were seen in the lungs of the BR-LPDS group from 10 to 12 h and 10 to 14 h after reperfusion,respectively.Conclusion The addition of blood to the R-LPDS solution was shown to be more effective in reducing swelling,inflammation and caspase-3 expression of donor lungs than the R-LPDS solution.Further investigation is needed to evaluate lung preservation in BR-LPD solution as a viable option for transplant.

Objective To investigate the preventive and therapeutic effect of Bushen Jiedu prescription on ionizing radiation induced sex hormone disorder.Methods Totally 72 adult rats with half male and half female were randonly divided into 6 groups,including control group,radiation group,Bushen Jiedu prescription group with male and female,with 12 rats in each group.After adaptive breeding for 2 d,the rats of Bushen Jiedu prescription group were given 0.2 ml water soluble granules of Bushen Jiedu prescription (1.38 g/ml) by gavage once a day for 10 days.At 11 d,the rats were irradiated by 5 Gy of 60Co γ-rays.24 h after radiation,6 rats in each group were executed to measure the level of sex hormone.The other rats were further gavaged with Bushen Jiedu prescription or its control once a day for 14 d,then were executed for sex hormone testing.Results At 1 d after radiation,the estrogen (E2) of female of Bushen Jiedu prescription group was significantly higher than that of radiation group (t =2.686,P ＜ 0.01).Compared with control group,the levels of follicule-stimulating hormone (FSH) (t =4.305,4.642,P ＜0.01) of male and female,the levels of luteinizing hormone (LH) of male radiation group,and Bushen Jiedu prescription group were increased (t =4.537,2.336,P ＜ 0.01).At 14 d after radiation,the levels of testosterone and luteinizing hormone in male rats of radiation group was higher than those in control group (t =-3.730,2.963,P ＜ 0.05),and the levels of E2 and progesterone of female was lower than those in control group (t =-5.424,-3.178,-2.690,-3.215,P＜0.01).Conclusions Ionizing radiation can induced sex hormone disorder,and Bushen Jiedu prescription can effectively inhibit this alteration,which indicates that Bushen Jiedu prescription is an ideal radiation protectant.