To review the randomized controlled trials (RCTs) at home and abroad on digital intelligence (DI)-driven rehabilitation in patients of neuromuscular disease, compare the effects of DI-driven rehabilitation with traditional rehabilitation, summarize the special needs and challenges faced by patients in rehabilitation of rare neuromuscular diseases, and provide evidence for the development and quality improvement of rehabilitation for rare neuromuscular diseases.

To provide references to and give suggestions to the development and optimiza-tion of Digital Intelligence (DI) technology in management of non-hospitalized patients by systematical review the application of digital technology in non-hospital settings.

ObjectiveTo observe the clinical efficacy of modified Yigongsan combined with multi-enzyme tablets and bifidobacterium triple live powder on infantile anorexia with spleen-stomach Qi deficiency syndrome. MethodA total of 112 infantile patients anorexia with spleen-stomach Qi deficiency syndrome treated at Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were enrolled and divided into a control group and an observation group， with 56 cases in each group， according to a random number table. Children in the control group were treated with multi-enzyme tablets and Bifidobacterium triple live powder， while those in the observation group were treated with modified Yigongsan in addition to the treatment in the control group. During the study， one case dropped out in the control group and two cases dropped out in the observation group. The clinical efficacy of the two groups of children was compared， including changes in traditional Chinese medicine （TCM） syndrome scores （main symptoms， secondary symptoms， tongue， and pulse）， time to restore normal food intake， and increase in body weight. Changes in calcium， iron， zinc levels， hemoglobin， and albumin levels before and after treatment， as well as changes in gastrointestinal hormones such as gastrin and motilin， vasoactive intestinal peptide， somatostatin， neuropeptide Y， orexin， and leptin， were observed. The occurrence of adverse reactions in the two groups of children during the study was also recorded. ResultThe total effective rate of children in the control group after treatment was 85.19% （46/54）， while that in the observation group was 98.15% （53/54） （χ² =5.939， P<0.05）. Compared with the control group， the time for food intake to return to normal in the observation group was shorter， and the increase in body weight was greater （P<0.05）. Compared with the results before treatment， the TCM syndrome scores （main symptoms， secondary symptoms， tongue， and pulse） in both groups of children significantly decreased， while the levels of calcium， iron， zinc， hemoglobin， albumin， gastrin， motilin， neuropeptide Y， and orexin increased， and the levels of vasoactive intestinal peptide， somatostatin， and leptin decreased （P< 0.01）. Compared with the control group after treatment， the improvement in the above indicators in the observation group was more significant （P<0.01）. The incidence of adverse reactions in the two groups of children during the treatment period was similar， and the difference was not statistically significant. ConclusionModified Yigongsan combined with multi-enzyme tablets and Bifidobacterium triple live powder is highly effective in treating infantile anorexia （spleen-stomach Qi deficiency syndrome）. After treatment， symptoms of the children were improved，appetite and food intake increased， gastrointestinal function was improved， body weight increased， and adverse reactions were few， indicating that the treatment was safe and reliable.

Objective:The evidence on the use of bedside ultrasound to assess muscle mass in critically ill adults was retrieved and screened, and the best evidence was summarized.Methods:A computer search was conducted for relevant literature on ultrasound measurement of muscle mass in critically ill adults in domestic and foreign databases such as BMJ Best Clinical Practice, UpToDate, PubMed, CNKI, and guide website and professional association website. The search time limit was from the establishment of the database to August 30, 2023. Literature quality was evaluated by four researchers trained in systematic evidence-based courses according to literature type.Results:A total of 15 literatures were included, including 2 guideline, 4 expert consensus, 5 systematic reviews and 4 randomized controlled studies. A total of 22 pieces of evidence were summarized, including 6 aspects: position and patient preparation, feasibility of implementation by nursing staff, selection of probe and matters needing attention, muscle positioning, evaluation of muscle structure by ultrasound and the guiding significance of ultrasound evaluation of muscle mass.Conclusions:The best evidence summary of bedside ultrasound assessment of muscle mass in critically ill adults summarized in this study is scientific and systematic, and provides evidence-based basis for establishing standardized ultrasound assessment procedures in clinic.

To sort out the requirements for enhancing the capacity and informatization construction of CDC laboratories in the context of high-quality development of disease prevention and control. To investigate and analyze the current situation, problems faced and development needs for laboratory informatization construction of disease prevention and control institutions in Shanghai, so as to provide an evidence for putting forward targeted suggestions. In addition, it will provide ideas for comprehensively improving the informatization construction of laboratories in disease prevention and control institutions and constructing a smart and accurate modern disease prevention and control system under the new context.

Polysorbate is a commonly used non-ionic surfactant in the development of therapeutic antibodies. In recent years, polysorbate has attracted industry attention due to its ability to induce the production of insoluble particles in therapeutic antibody solutions. This article offers a comprehensive synopsis of polysorbate’s role in therapeutic antibody development and associated risks of insoluble particle formation, including its intrinsic mass, interacting material, and degradation. Subsequently, the merits of employing chromatography to supervise polysorbate quality are underscored. Finally, based on current research, a solution to this type of insoluble particle and the existing challenges are proposed, providing reference for the application prospects of polysorbate in therapeutic antibodies.

Objective:To explore the influence of fentanyl on sorafenib sensitivity in the treatment of hepatocellular carcinoma (HCC) pain.Methods:Adopting a prospective research method, all laboratory tests were conducted in the Central Laboratory of Xinhua Hospital, Dalian University from August 2021 to August 2023. CCK-8 method, clone formation assay and cell counting under light microscope were used to detect cell proliferation of the human liver cancer cell line HepG2. LysoTracker, monodansyl cadaverine and transmission electron microscopy (TEM) were used to detect the levels of autophagy in fentanyl-induced HCC cells. The level of reactive oxygen species was measured using the fluorescent dye, 2′, 7′-dichlorodihydrofluorescein diacetate (DCFH-DA). Protein immunoblotting test was applied to detect the protein level of upstream protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway. The effects of the antitumor efficacy of fentanyl combined with sorafenib were evaluated by the HCC tumor-forming experiment in nude mice. Fifteen female BALB/c nude mice (6-week-old) were divided into control group, sorafenib group and sorafenib + fentanyl group by random digits table method with 5 mice each. The nude mice in three groups were subcutaneously injected at left axilla HepG2 cells (4 ×10 6). The nude mice in control group, sorafenib group and sorafenib + fentanyl group were respectively treated with injection of 1 ml of 0.9% sodium chloride, oral sorafenib with 20 mg/kg, oral sorafenib with 20 mg/kg combined with intravenous injection fentanyl with 0.05 mg/kg every other day for 3 consecutive weeks. The tumor volume was measured at the 4th、8th、12th、16th、20th and 24th day. The nude mice were sacrificed after tumors formed and the tumor tissues were collected and weighed. The tumor tissue was checked by the immunohistochemical staining assay. Results:The CCK-8 and clone formation assay results showed that fentanyl reduced the antitumor effect of sorafenib in HCC. Fentanyl upregulated the expression of autophagy-related proteins Beclin-1 and LC3, and immunofluorescence and transmission electron microscopy showed that fentanyl could increase the levels of autophagy in HCC cells. DCFH-DA staining showed that fentanyl increased reactive oxygen species production, and Protein immunoblotting test result showed that fentanyl reduced the levels of phosphorylated protein kinase B (p-Akt) and phosphorylated mammalian target of rapamycin (p-mTOR). The autophagy inhibitor 3-methyladenine (3-MA) could block the protective autophagy induced by fentanyl, and then reduce the adverse effects of fentanyl on sorafenib. There was no statistical difference in tumor volume at 4th, 8th and 12th day among three groups ( P>0.05); the tumor volume 16th, 20th and 24th and weight in fentanyl + sorafenib group and sorafenib group were significantly lower than those in control group: (275.00 ± 11.58) and (174.00 ± 91.42) mm 3 (307.40 ± 81.39) mm 3, (701.00 ± 105.08) and (563.60 ± 89.59) mm 3 vs. (855.20 ± 68.71) mm 3, (971.60 ± 79.87) and (691.80 ± 11.17) mm 3 vs. (1 177.20 ± 105.79) mm 3, (705.00 ± 35.50) and (540.20 ± 80.76) mg vs. (1 118.40 ± 76.81) mg, the indexes in sorafenib group were significantly lower than those in fentanyl + sorafenib group, and there were statistical differences ( P<0.05). The immunohistochemical staining assay result showed that Ki67 and LC3 positive cells (brown cells) in fentanyl + sorafenib group were significantly more than those in sorafenib group. Conclusions:Fentanyl reduces the suppressive effect of sorafenib on HCC tumor growth by inducing protective autophagy, which could be weakened by adding autophagy inhibitors.

Objective To investigate the effect of silk fibroin hydrogel loaded with developmental endothelial locus-1(Del-1)nanoparticles on the healing of chronic skin wounds in mice.Methods The back skin of BALB/c mice(6-8 weeks old)was pressed with a magnet for 12 h and then relaxed for 12 h,for 4 consecutive days to establish a chronic pressure ulcer wound.After infliction,the mice were randomly divided into 3 groups(n=8),and the skin wounds were treated with PBS,silk fibroin hydrogel or Del-1 nanoparticles/silk fibroin hydrogel.The wound healing was recorded with camera to calculate the wound healing rate.In 9 d after treatment,HE and Masson staining were used to observe the wound healing,and immunofluorescence staining for CD 14 and TNF-α was used to compare the appearance frequency of skin macrophages and the expression of inflammatory factors.After Tert-butyl peroxide(TBHP)was used to stimulate mouse macrophage RAW 264.7 cells and mouse vascular endothelial C166 cells,C166 cells were transfected with lentival vector to overexpress Del-1.Crystal violet staining was used to observe the migration of macrophages.RT-qPCR was used to detect the expression of inflammatory factor IL-6.Results The wound healing was significantly faster in the Del-1 nanoparticles/silk fibroin hydrogel group than the silk fibroin hydrogel group and the PBS group(P＜0.01).The expression levels of TNF-α and CD14 in the wound surface were lower(P＜0.01),but collagen deposition and tissue repair were better in the Del-1 nanoparticles/silk fibroin hydrogel group than the silk fibroin hydrogel group and the PBS group(P＜0.01).In vitro experiments,macrophages migrated to endothelial cells stimulated by TBHP,but the migration rate of macrophages was significantly lower in the Del-1 overexpression group(P＜0.01).RT-qPCR confirmed that Del-1 inhibited the transcription of IL-6(P＜0.01).Conclusion Del-1 nanoparticles/silk fibroin hydrogel can significantly accelerate the healing of skin wounds,and its mechanism may be through promoting the regression of inflammation and tissue repair.

Unplanned readmission is one of the adverse outcomes of patients after left ventricular assist device implantation,which seriously affects the prognosis of patients.This article reviews the incidence,causes,influencing factors and intervention measures of unplanned readmission of patients after left ventricular assist device implantation,in order to improve the attention of nursing staff,early identify high-risk groups of unplanned readmission of patients after left ventricular assist device implantation and provide references for formulating personalized intervention measures.

Multi-photon microscopy has been used for skin tissue imaging based on the principle that endogenous fluorescent components in specific skin tissues or exogenous fluorescence-labeled substances could emit fluorescence under different excitation wavelengths of near-infrared lasers. It is an effective imaging technique for the auxiliary diagnosis of skin neoplasms, inflammatory skin diseases, wound healing and skin aging, with the advantages of in vivo, non-invasive and accurate three-dimensional skin imaging. This review summarizes the application of and progress in multi-photon microscopy in clinical practice in dermatology.