Objective To systematically retrieve,evaluate and integrate the best evidences on the early fluid resuscitation management in the patients with acute pancreatitis(AP)at home and abroad to provide ref-erence for clinical decision.Methods The related evidences on the early fluid resuscitation management in the AP patients were retrieved by computer from the databases of BMJ Best Practice,Up To Date,JBI,National Institute for Health and Care Excellence,Registered Nurses Association of Ontario,Guideline International Network,Scottish Intercollegiate Guidelines Network,International Association of Pancreatology,American Pancreatic Association,American College of Gastroenterology,Yimaitong,Cochrane Library,PubMed,Em-bass,CINAHL,The Web of Science,CNKI,Wanfang databases.The retrieval time limit was from the data-base establishment to March 20,2022.The literatures types included thematic evidence summarization,guide-lines,evidence summaries,systematic reviews and expert consensus.The researchers conducted the literature quality evaluation.The literatures meeting the standard conducted the evidence extraction.Results A total of 13 arti-cles were included,including 3 special subject evidence summary,4 guidelines,2 evidence summary,2 systematic evalu-ation and 2 expert consensus.A total of 16 pieces of best evidence were integrated,involving 4 aspects of organization management,evaluation and monitoring,fluid infusion strategy and health education.Conclusion It is recommended to use the target-oriented therapy for early fluid resuscitation management,and perform the fluid resuscitation immediate-ly after diagnosis,according to the patient's underlying disease,disease changes and monitoring indicators,implement precise early fluid resuscitation in order to reverse pancreatic microcirculation disorder,increase tissue perfusion and improve the patient's prognosis.

Proprotein convertase subtilisin/kexin type 9(PCSK9)is a protein that is synthesized and secreted from hepato-cytes.It can reduce low-density lipoprotein(LDL)uptake by promoting degradation of LDL receptor(LDLR)on the surface of hepatocyte.Since application of PCSK9 inhibitors become more common,researchers have found that PCSK9 can regulate ather-osclerosis development,platelet activation and thrombosis,inflammation,and glycolipid metabolism.PCSK9 is also the main in-ducements of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Therefore,this article reviews the research progress of mechanism of PCSK9 in ISR after PCI,and makes a preliminary prospect on the application of PCSK9 as a therapeu-tic target in coronary atherosclerotic heart disease.

Atherosclerosis(As)is the pathological basis of various vascular diseases,which affects the function of important organs.Recent studies have found that N6-methyladenosine(m6A)modification plays a vital role in As.This paper summarizes the regulatory effects of m6A modification on vascular endothelial cell(VEC)injury,vascular smooth muscle cell(VSMC)transformation,macrophage(M?)differentiation,foam cell(FC)formation,pyroptosis,and lipid regulation,and summarizes the regulation function of some m6 A regulatory proteins in As.

Mycotoxins are secondary metabolites produced by pathogenic fungi.They often contaminate various crops,and are detrimental to human and animal health.Mycotoxins have a variety of toxic effects,such as neurotoxicity,hepatotoxicity,immunotox-icity,teratogenicity,and carcinogenicity.However,the mechanism of immunotoxicity is still unclear.Dendritic cells(DCs),as the most potent antigen presenting cells,play a vital role in initiating innate and adaptive immune responses.Previous studies have found that mycotoxins can affect the endocytosis of DCs,the ability to stimulate T cell activation,the secretion of cytokines and chemokines.Thus,this review is aim to summarize the effects of mycotoxins on DCs-mediated immune responses,which may provide reference for researches to clarify the immunotoxicity mechanism of mycotoxins.

Objective To investigate the influencing factors of unplanned rehospitalization within one year after surgery among adult renal transplant recipients. Methods The clinical data of 299 recipients who underwent renal transplant surgery in the Department of Organ Transplantation of the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were retrospectively analyzed. The recipients were divided into unplanned rehospitalization group and non-rehospitalization group based on whether they experienced unplanned rehospitalization within one year after surgery. Univariate analysis and binary Logistic regression analysis were performed to explore the influencing factors of unplanned rehospitalization within one year after renal transplantation. Results Among the 299 recipients, 102 experienced unplanned rehospitalization, with an incidence rate of 34.11%. Univariate analysis revealedstatistically significant differences were noted between the two groups in terms of gender, occupational status, preoperative underlying disease, rejection reactions, nosocomial infections, immunosuppressive medication regimens, serum creatinine, cystatin C, serum phosphorus, serum potassium, and initial hospitalization duration (P < 0.05). Binary Logistic regression analysis showed that having ≥3 kinds of preoperative underlying disease (OR=2.122, 95%CI, 1.198 to 3.759) and experiencing rejection reactions (OR=3.162, 95%CI, 1.217 to 8.218) were independent risk factors for unplanned rehospitalization within one year after renal transplantation (P < 0.05). Conclusion The rate of unplanned rehospitalization within one year after surgery is relatively high among adult renal transplant recipients. Having ≥3 preoperative underlying disease and experiencing rejection reactions are independent risk factors for unplanned rehospitalization within one year after surgery. Transplantation healthcare teams can develop corresponding strategies targeting these risk factors to reduce the rate of unplanned rehospitalization and alleviate the burden of disease.

Objective:To explore the value of apparent diffusion coefficient (ADC) and renal volume in assessing fetal kidney development and disease.Methods:From January 2016 to October 2020, 84 fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) were identified with MRI (CAKUT group), and 97 fetuses with no significant abnormalities on MRI or postnatal follow-up (control group) from the Obstetrics and Gynecology Hospital of Fudan University were enrolled and analyzed retrospectively. ADC value and renal volume were measured to compare the two groups, and the relationship was analyzed between these two parameters in the control group with gestational age, location (left or right kidney), and fetal gender. Two independent or paired sample t-tests, and linear correlation analyses, were adopted for the statistical analysis. Results:(1) There were 84 pregnant women in the CAKUT group, including a twin pregnancy, with an average age of (29±4) years old, ranging from 21 to 39 years old. The gestational age at MRI was (26±4) weeks with a range of 21-34 weeks. Of the 85 fetuses, 52 were male (61.2%), and 33 were female (38.8%). The polycystic dysplastic kidney was found in 32 cases (37.6%), hydronephrosis in 29 cases (34.1%), and an isolated kidney in 24 cases (28.2%). There were 97 singleton pregnancies in the control group, including 45 (46.4%) male and 52 (53.6%) female fetuses. The average maternal age was (30±5) years old, with a range of 19-41 years old, and the gestational week at MRI was (27±4) weeks, with a range of 21-34 weeks. (2) In the control group, the mean ADC value and renal volume were (1.255±0.112)×10 －3 mm2/s and (4 747±2 479) mm 3, which were negatively ( R 2=0.30, P<0.01) and positively correlated ( R 2=0.80, P<0.01) with the gestational age, respectively. There was no significant difference between ADC value and renal volume between different fetal gender in the control group. (3) The ADC value and the renal volume of fetuses with polycystic dysplastic kidney [(1.720±0.200) ×10 －3 mm2/s and (8 154±8 337) mm 3] were higher than those in the control group ( t=－13.11 and－3.08, P<0.001 and P=0.004). Compared with the control group, ADC of fetuses with hydronephrosis [(1.333±0.171) ×10 －3 mm2/s] was higher ( t=－3.90, P<0.001); and the renal volume [(7 201±4 460) mm 3] was larger but without statistical significance. The fetuses with an isolated kidney had an increasing trend in renal volume [(5 239±4 244) mm 3] and a decreasing trend in the ADC value [(1.239±0.125) ×10 －3 mm2/s] when compared with the normal fetuses, but neither difference was significant. Conclusions:In normal fetuses, the ADC value decreases, and the renal volume increases with the gestational age. Fetuses with CAKUT may have a larger kidney than normal.

Objective: To investigate the clinical effect of percutaneous curved vertebroplasty in the treatment of thoracolum-bar osteoporotic vertebral compression fractures (OVCFs). Methods: All of 85 patients with single thoracolumbar vertebral OVCFs who met the admission criteria from January 2017 to July 2018 were divided into three groups according to the random dig-its table method. They were treated with percutaneous curved vertebroplasty, routine unipedicular PVP and routine bipedicular PVP respectively. There were 25 patients in the percutaneous curved vertebroplasty group, 6 males and 19 females; aged 56-80 years, with an average age of 70.6±9.7 years. Fracture vertebral body distribution: T₁₀ 2 cases, T₁₁ 4 cases, T₁₂ 3 cases, L₁ 9 cases, L₂ 3 cases, L₃ 1 case, L₄ 1 case and L₅ 2 cases. There were 32 patients in the routine unipedicular PVP group, 6 males and 26 fe-males; aged 58-75 years, with an average age of 69.5±9.3 years. Fracture vertebral body distribution: T₁₀ 2 cases, T₁₁ 4 cases, T₁₂ 5 cases, L₁ 11 cases, L₂ 6 cases, L₃ 1 case, L₄ 1 case and L₅ 2 cases. There were 28 patients in the routine bipedicular PVP group, 5 males and 23 females; aged 59-81 years, with an average age of 69.8±8.8 years. Fracture vertebral body distribution: T₁₀ 2 cases, T₁₁ 4 cases, T₁₂ 4 cases, L₁ 10 cases, L₂ 4 cases, L₃ 1 case, L₄ 1 case and L₅ 2 cases. The operation time, injected cement volume, in-traoperative blood loss were recorded and analyzed. Preoperative, postoperative 1 week and 3 months visual analogue scale scores and oswestry disability index were adopted to value the clinical improvements. Preoperative, postoperative 1 week and 3 months relative vertebral height and kyphosis correction, and the cement leakage rate were measured and analyzed. Results: There was no significant difference in the data of gender, age, VAS scores, ODI and distribution of fracture vertebrae among the three groups (P>0.05), and the baseline data was comparable. The average VAS score in the percutaneous curved vertebroplasty group was 2.3±0.5 at 1 week after surgery, that of the routine unipedicular PVP group was 2.4±0.4 and that of the routine bipe-dicular PVP group was 2.4±0.4; the average ODI in the percutaneous curved vertebroplasty group was 19.8%±3.9%, that of the routine unipedicular PVP group was 20.0%±4.1% and that of the routine bipedicular PVP group was 19.9%±3.8%; they were lower than the preoperative data, which were statistically significant (P<0.001). The average relative vertebral height in the percutaneous curved vertebroplasty group was 48.99%±9.23% at 3 months after surgery, that of the routine unipedicular PVP group was 47.11%±10.12% and that of the routine bipedicular PVP group was 46.71%±11.16%; the average kyphosis cor-rection in the percutaneous curved vertebroplasty group was 6.21%±1.94%, that of the routine unipedicular PVP group was 5.22%±2.07% and that of the routine bipedicular PVP group was 5.97%±2.09%; there was 1 cement leakage case in the per-cutaneous curved vertebroplasty group; those of the routine unipedicular PVP group were 4 cases and those of the routine bipe-dicular PVP group were 6 cases; there was no significant difference among the three groups (P>0.05). Operation time 39.10±2.00 min vs 38.70±1.70 min, injected cement volume 3.60±0.11 ml vs 3.50±0.13 ml and blood loss 5.10±0.30 ml vs 5.00±0.40 ml of the percutaneous curved vertebroplasty group and the routine unipedicular PVP group were less than those of the routine bipedicular PVP group, which were statistically significant (P<0.05). Conclution Percutaneous curved vertebroplasty could achieve satisfactory clinical outcomes for OVCFs, with advantages of less operation time, less blood loss, limited X-ray expo-sure, less injected cement volume, and more balanced augmentation for stabilization of the affected vertebrae and total verte-bral column.

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.

Pharmaceutical care thinking is organic combination of the pharmaceutical and clinical thinking. Shang Han Lun contains very rich connotation of the clinical pharmacy, embodies the patient-centered and immediate intervention clinical pharmaceutical service concept in the progress of the diseases. This article sorted out and concluded pharmaceutical care thinking from the aspects of condition assessment and medication selection, medicine taking methods and notes after medication, which provided theoretical supports for the development of clinical pharmacy of TCM.