OBJECTIVE To analyze the influencing factors for achieving target plasma drug concentration （trough） （abbreviated as “PDC”） of vancomycin in patients from high-altitude regions and establish a predictive model for PDC using single- center data， providing references for rational clinical drug use. METHODS Inpatients with vancomycin （1 g， q12 h） administered intravenously in our hospital from January 2021 to June 2024 were retrospectively included. Demographic data， liver and kidney function and hematological indexes were collected. Spearman correlation analysis was used to evaluate the correlation between vancomycin PDC and each detection index. Univariate analysis was used to evaluate the differences of each index in patients with different PDC， and the effects of different gender， body mass index， age and underlying diseases （hypertension/diabetes） on vancomycin PDC. Based on the results of correlation analysis and univariate analysis， multiple linear stepwise regression analysis was used to obtain the independent predictors of vancomycin PDC and construct the prediction model. RESULTS A total of 141 patients were included， with an overall attainment rate of 46.81% for the target PDC of vancomycin. Correlation analysis showed that the vancomycin PDC was positively correlated with age， blood urea nitrogen， uric acid （UA）， serum creatinine （CRE） and β2- microglobulin （β2-MG）， and negatively correlated with height， weight， creatinine clearance rate （CCR）， glomerular filtration rate （GFR）， alanine transaminase （ALT）， hemoglobin （HGB）， white blood cell count and neutrophils （P＜0.05）. There were significant differences in age， CRE and other 14 indexes among different PDC groups （P＜0.05 or P＜0.01）. Age and underlying diseases had significant effects on vancomycin PDC （P＜0.05 or P＜0.01）. CCR， direct bilirubin （DBil）， β2-MG， UA， HGB and height （standardized coefficients were －0.371， 0.367， 0.169， 0.232， －0.140， －0.132； P＜0.05） were independent predictors of vancomycin PDC. The F value of the regression equation was 34.858 （P＜0.05）， the R2 was 0.610， and the adjusted R2 was 0.592. CONCLUSIONS The vancomycin PDC of patients in high-altitude regions is affected by multiple factors such as renal function， liver function and hematological indexes. CCR， HGB and height could be used to predict vancomycin PDC negatively， while DBil， β2-MG and UA could be used to predict vancomycin PDC positively. The variables of the established prediction model could explain 59.2% of the variation of vancomycin PDC.

Meropenem （MEM） is one of the important drugs for the treatment of severe infections， but the standard dose is often difficult to achieve an effective therapeutic concentration target. This article reviews the related studies on the population pharmacokinetics of MEM in patients with severe infection. It is found that the apparent volume of distribution （Vd） and clearance rate are the most important factors affecting the dose adjustment， and the factors affecting Vd include serum albumin， age， overall weight， shock status， and chest/abdomen/cerebrospinal fluid drainage. The main factors affecting the clearance rate were renal function， renal replacement therapy treatment mode and combination therapy. For adult patients with severe infections in China， MEM is recommended to be administered in an individualized manner based on glomerular filtration rate， with a dosage range of 500 to 1 500 mg given every 4 to 6 hours， and prolonged infusion is preferred. When the minimum inhibitory concentration （MIC） of the pathogenic bacteria reaches 64 mg/L， therapeutic drug monitoring is required. For therapeutic efficacy， it is essential to ensure that the trough concentration remains above the MIC； to prevent drug resistance， it should be maintained above 4×MIC. Regarding safety， it is recommended that the upper limit of the trough concentration be 32 mg/L， and blood sampling for monitoring can be conducted as early as after 1 to 2 doses of administration.

Background and purpose:Colorectal cancer(CRC)is one of the major malignant tumors threatening human health worldwide,with long-term high incidence and mortality rate.Potassium channel modulatory factor 1(KCMF1)is a member of the E3 ubiquitin ligase family.It binds to target proteins through the RING domain and participates in the regulation of a variety of biological processes in vivo.However,the function of KCMF1 in CRC remains unclear.This study aimed to investigate the expression level of E3 ubiquitin ligase KCMF1 in colorectal tumor,and to explore the effects of KCMF1 on the proliferation of CRC cells and its underlying molecular mechanism.Methods:The The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases were used to analyze the expression level of KCMF1 in CRC tissues and adjacent tissues and the association between the KCMF1 expression and the prognosis of CRC patients.Furthermore,immunohistochemical staining was performed to detect the protein level of KCMF1 in 90 paired human CRC tissues and adjacent non-tumor tissues.Lentiviral shRNA delivery system was employed to specifically target the KCMF1 gene(shKCMF1)in HCT116 and HCT15 CRC cell lines.The effects of KCMF1 knockdown on cell proliferation,apoptosis and cell cycle distribution were assessed by methyl thiazoyl terazolium(MTT)assay,colony formation assay,Western blot and flow cytometry.Changes in the transcriptional profile in HCT116 cells upon KCMF1 knockdown were identified by RNA sequencing(RNA-Seq),and the affected signaling pathways were evaluated by bioinformatics analysis.Real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR),Western blot,luciferase reporter assay and cell immunofluorescence assay were utilized to validate the alteration of the affected signaling pathway.Results:The TCGA and GTEx databases and IHC results showed that the mRNA and protein expression levels of KCMF1 in CRC tissues were significantly upregulated compared with adjacent tissues(P＜0.01).KCMF1 expression level was negatively correlated with the survival time of patients with CRC(P＜0.01),and was positively associated with CRC clinical stage(P＜0.05).Compared with control cells,KCMF1 knockdown significantly inhibited the proliferation of HCT116 and HCT15 cells(P＜0.001),induced cell apoptosis(P＜0.001),and led to cell cycle arrest in G1 phase(P＜0.01).RNA-Seq analysis showed that KCMF1 was involved in the regulation of several signaling pathways,including nuclear factor-κB(NF-κB)signaling pathway.KCMF1 knockdown reduced the transcription levels of the target genes of NF-κB signaling pathway,including BCL-XL,XIAP and CIAP(P＜0.05),and suppressed the expression of phosphorylated p65 and nuclear translocation of p65(P＜0.01).Meanwhile,the activity of NF-κB reporter was reduced in tumor cells upon KCMF1 knockdown(P＜0.01).Conclusion:The expression of KCMF1 is significantly upregulated in human CRC tissues and positively associated with advanced clinical stage and poor prognosis.KCMF1 may promote the proliferation of CRC cells by activating the NF-κB signaling pathway.KCMF1 may be a potential new therapeutic target for CRC.

Objective:To investigate the self-defect sensation and its influencing factors in patients scheduled for photodynamic therapy for port wine stains.Methods:A total of 183 patients scheduled for photodynamic therapy for port wine stains in our hospital were selected and investigated by online questionnaire. The data of the respondents were collected by means of online filling in the questionnaire star using the General Data Survey Scale and the Defect Perception Scale (FIS) at admission.Results:The total score of self-defect in 183 patients with bright red nevus treated by photodynamic therapy was higher than that of the domestic norm. Age ( t=4.19), place of residence ( F=14.90), co-resident ( F=3.21), education level ( F=4.39), marital status ( F=2.47), income level ( F=9.51) and occupation ( F=5.82) had significantly related with the level of self-deficiency of patients ( P<0.05). The results of multiple linear regression analysis indicated that residence and income level were the main factors affecting patients′ sense of self-deficiency ( F=4.96, P<0.05). Conclusions:The overall self-defect sense of 183 patients with port wine stains treated with photodynamic therapy in this survey is more serious, their own comprehensive conditions and family structure will affect the self-defect sense of patients with port wine stains. We should pay special attention to the mental health of patients from municipal cities and low-income levels, timely carry out clinical nursing education and psychological guidance, jointly improve the compliance and cooperation of patients with treatment, and promote the rapid recovery of patients.

Parkin, an E3 ubiquitin ligase, plays a role in maintaining mitochondrial homeostasis through targeting damaged mitochondria for mitophagy. Accumulating evidence suggests that the acetylation modification of the key mitophagy machinery influences mitophagy level, but the underlying mechanism is poorly understood. Here, our study demonstrated that inhibition of histone deacetylase (HDAC) by treatment of HDACis activates mitophagy through mediating Parkin acetylation, leading to inhibition of cervical cancer cell proliferation. Bioinformatics analysis shows that Parkin expression is inversely correlated with HDAC2 expression in human cervical cancer, indicating the low acetylation level of Parkin. Using mass spectrometry, Parkin is identified to interact with two upstream molecules, acetylase acetyl-CoA acetyltransferase 1 (ACAT1) and deacetylase HDAC2. Under treatment of suberoylanilide hydroxamic acid (SAHA), Parkin is acetylated at lysine residues 129, 220 and 349, located in different domains of Parkin protein. In in vitro experiments, combined mutation of Parkin largely attenuate the interaction of Parkin with PTEN induced putative kinase 1 (PINK1) and the function of Parkin in mitophagy induction and tumor suppression. In tumor xenografts, the expression of mutant Parkin impairs the tumor suppressive effect of Parkin and decreases the anticancer activity of SAHA. Our results reveal an acetylation-dependent regulatory mechanism governing Parkin in mitophagy and cervical carcinogenesis, which offers a new mitophagy modulation strategy for cancer therapy.

Objective: To analyze the current situation and research update on campus air quality in China, and to provide reference for effective campus environment improvement. Methods: The documents of China national knowledge internet (CNKI) from 1980 to 2020 were extracted and the key words related to campus air quality were analyzed by CiteSpace software. Microorganisms, formaldehyde and benzene were selected, data of 200 literatures were classified and sorted out in different functional areas. Results: Studies on campus air quality in China has been increasing gradually since 2004, especially focusing on indoor air, PM 2.5 and benzene series. The primary microorganism in the air environment of Chinese campuses was bacteria with the concentration of 2 309.31 cfu/m 3 . The ranking of the overall load of bacteria in air of different functional areas was consistent with that of microorganisms: living service area > landscape leisure area > public transport area > scientific research and teaching area > administrative office area > sports activity area. The average value of microbial indicators in indoor air of computer room, office area and campus living areas were more likely exceed the standard. The formaldehyde concentration in the computer room and reading room was high. The health of students exposed to formaldehyde and benzene on campus evaluated by using the evaluation model of the U.S. Environmental Protection Agency proved out to be in the safe range. Conclusion The concentrations of microorganisms, formaldehyde and benzene in campus environment mostly meet the requirements. Further measures need to be taken to reduce microbial concentration and strengthen formaldehyde monitoring and pollution source management in computer room and reading room.

Objective:To translate Pediatric Quality of Life Inventory TM 3.2 Diabetes Module (PedsQL TM 3.2-DM) for children and adolescents into Chinese and analyze the reliability and validity of it. Methods:Following the principle of Brislin translation, the source scale was translated by 2 supervisor nurses with master's degrees and the scale was back translated by 2 nursing experts with overseas study experience. The semantic adjustment of the scale was carried out by pre-surveys. By the convenient sampling method, a total of 175 children and adolescents with diabetes who were treated in Department of Endocrinology and Department of Pediatrics in ClassⅢ Grade A hospitals in Yantai and Qingdao from March to August 2019 were investigated and 175 effective scales were finally included to analyze the reliability and validity of the revised scale in children and adolescents with diabetes.Results:The Chinese version of PedsQL TM 3.2-DM had 33 items in total, including 4 dimensions such as disease-related symptoms, treatment compliance, disease-caused worry and communication. The Cronbach's α coefficient of Chinese version of PedsQL TM 3.2-DM was 0.927 and that of 4 dimensions were respectively 0.885, 0.910, 0.828 and 0.798. After assessment by panel of experts, the content validity index of Chinese version of PedsQL TM 3.2-DM was 0.97 and the content validity index of every item was from 0.80 to 1.00. A total of 4 common factors were extracted by exploratory factor analysis and the cumulative variance contribution rate was 59.539%. In addition, the factor loading of each item on its common factor was over 0.4. Conclusions:The Chinese version of PedsQL TM 3.2-DM has good reliability and validity, which can be used as a simple tool for self-assessment of quality of life in children aged from 8 to 19 years with diabetes.

OBJECTIVE: To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [Df], slow diffusion coefficient [Ds], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. MATERIALS AND METHODS: A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30–69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. RESULTS: Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, Ds, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except Df and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). CONCLUSION: Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.
Carcinoma, Renal Cell ; Diffusion ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; ROC Curve

Objective To apply the individualized health education by the form of one-day ward to nursing of patients with pregnancy-induced hypertension so as to reduce the blood pressure (BP), anxiety, depression and the incidence of caesarean section.Methods A total of 194 patients with pregnancy-induced hypertension were randomly divided into observation group and control group with 97 patients in each group. Patients in the control group received routine inspection and health education in out-patient clinic. On the basis of nursing in the control group, patients in the observation group adopted individualized health education by the form of one-day ward. And then, the BP, mastery of health related knowledge, the anxiety, depression, mode of delivery, self-efficacy and satisfaction with nursing of patients between two groups were observed when they were admitted to groups and before discharge.Results After the intervention, the systolic pressure and the diastolic pressure [(122.5±9.0) mmHg and (83.4±7.8)mmHg]of patients in the observation group was lower than those [(136.3±10.7) mmHg and (95.1±8.3)mmHg]in the control group with significant differences (t=4.083, 3.769;P<0.001). After the intervention, the scores of anxiety and depression of patients in the observation group were lower than those in the control group; the mastery of health related knowledge and the self-efficacy of patients in the observation group were higher than those in the control group; the incidence of caesarean section in the observation group was lower than that in the control group; the satisfaction with nursing in the observation group was higher than that in the control group; there were all statistically significant differences in them between two groups (P<0.05).Conclusions The individualized health education by the form of one-day ward can significantly reduce the BP, anxiety, depression and the incidence of caesarean section, and improve the self-efficacy and satisfaction with nursing among patients with pregnancy-induced hypertension.

This article was aimed to assess the effectiveness and safety of Y in-Dan Xin-Nao-Tong (YDXNT) Cap-sule combined with routine modern therapies for treatment of type-2 diabetes mellitus (T2MD) complicated with coronary heart disease (CHD). Databases including CBMDisc, CMAC, CNKI, VIP, Wanfang Data, PubMed, EMbase, and Web of Science were electronically searched from inception to December 2013. Randomized controlled trials (RCTs) on YDXNT capsule combined with routine modern therapies for treatment of T2MD complicated with CHD were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, ex-tracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1.0 software. The results showed that a total of 9 RCTs with 667 T2MD with CHD cases were included. The results of meta-analysis indicated that the total effective rate of YDXNT capsule combined with routine modern therapies was significant higher than the routine treatment for T2MD complicated with CHD treatment with statistical significance (OR = 4.01, 95%CI [2.37-6.79], P< 0.000 01). It showed that YDXNT capsule combined with routine modern therapies can control angina pectoris. Due to limitation of included data, controlling of the duration of angina pectoris, the attack frequency of angina pectoris, and fasting blood glucose, may be better than the routine treatment group with significant differences. YDXNT capsule can improve hemorheology indices and reduce high condensation state among CHD with T2DM patients in order to relieve angina pectoris. It was concluded that on the basis of current clinical evidences, YDXNT capsule had better treatment effect than the routine treatment group in the treatment of CHD with T2DM. However, the results have certain limitations. It still required double-blind multi-center RCTs with high quality, large samples for further verification.