Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.

Objective:To investigate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis combined with edaravone dexborneol at different timing in super elderly patients (aged≥85 years) with moderate to severe acute ischemic stroke (AIS).Methods:A prospective study was performed. Seventy-one super elderly patients with moderate to severe AIS treated with rt-PA intravenous thrombolysis combined with edaravone dexborneol from December 2020 to March 2023 in Department of Neurology, Affiliated Fourth Central Hospital of Nankai University were selected and randomly divided into early group ( n=35) and advanced group ( n=36); patients in the early group were given edaravone dexborneol immediately after rt-PA intravenous thrombolysis, and patients in the advanced group were given edaravone dexborneol 24 h after rt-PA intravenous thrombolysis. In addition, 31 patients with moderate to severe AIS received rt-PA intravenous thrombolysis only in Department of Neurology of the hospital from August 2018 to December 2020 were selected as control group. Differences in efficacy and safety indexes among the 3 groups were compared. Results:After 7 d of treatment, the improvement rate of neurological function in early group was significantly higher than that in control group and advanced group ( P<0.05). After 90 d of treatment, modified Rankin scale (mRS) scores in early group were statistically lower than those in control group and advanced group ( P<0.05); good prognosis rate in early group was statistically higher than that in control group and advanced group ( P<0.05). The incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage in early group were significantly lower than those in control group and advanced group ( P<0.05). After 30 and 90 d of treatment, the advanced group had significantly lower mortality than the control group, but significantly higher mortality than the early group ( P<0.05). Conclusion:Edaravone dexborneol immediately after rt-PA intravenous thrombolysis is the optimal timing for super elderly patients with moderate to severe AIS, which can improve the efficacy and safety.

Objective:To analyze the monitoring results of national brucellosis monitoring sites in Jinzhong City, Shanxi Province, and to provide a basis for scientific evaluation of prevention and control effects.Methods:From the "Disease Surveillance Information Report Management System", the surveillance results of national brucellosis surveillance sites (Pingyao County) in Jinzhong City from 2013 to 2021 were summarized and descriptive analysis was carried out.Results:From 2013 to 2021, a total of 996 cases of brucellosis were reported at the national brucellosis monitoring sites in Jinzhong City. A total of 3 538 serum samples were collected from key occupational groups, of which 161 were positive for brucellosis, with a positive rate of 4.55%. Among them, new cases accounted for 55.28% (89/161) and latent infections accounted for 21.74% (35/161). The annual serological test positive rate fluctuated between 1.19% and 20.55%. Except for 2014, the positive rate in all other years was less than 5.00%, and there was a statistically significant difference in positive rates between different years (χ 2 = 222.89, P < 0.001). The monitoring sites covered all townships within the jurisdiction (5 towns and 8 townships), and there was a statistically significant difference in positive rates among different townships (χ 2 = 26.45, P = 0.009). There was a statistically significant difference in positive rates among different occupations (χ 2 = 27.35, P < 0.001), with higher positive rates for veterinarians (5.41%, 2/37) and herders (4.76%, 29/609), respectively. There was a statistically significant difference in positive rates among different age groups (χ 2 = 42.97, P < 0.001), with a higher positive rate of 7.04% (104/1 477) in the 50 to 59 year old group. It can be seen from the scatter plot that the reported incidence rate did not increase linearly with the increase of serological positive rate. Conclusions:Except for 2014, the positive rate of serological tests for brucellosis at the national brucellosis monitoring sites in Jinzhong City, Shanxi Province has remained basically stable in other years. All townships in Pingyao County have an epidemic of brucellosis, and the 50 - 59 year old group and high-risk occupational groups are susceptible to it. The representatives of the monitoring results is not good, and it is recommended that the monitoring sites should strictly control the inclusion of the monitoring objects.

Objective:To translate the Pressure Ulcer Quality of Life Questionnaire (PU-QOL) into Chinese and test its reliability and validity.Methods:The PU-QOL was translated, back translated, cross-cultural debugged and pre-investigated to form the Chinese version of PU-QOL. From August 2020 to November 2021, 405 patients with PU in wound clinics of two third-class hospitals in north and south regions of China were conveniently selected as the research objects.Results:The Chinese version of PU-QOL had 74 items. The content validity of the items was 0.80 to 1.00 and the content validity of the scale level was 0.95. Exploratory factor analysis extracted 7 common factors and the cumulative variance contribution rate was 60.79%. Each problem area is moderately correlated with the 12-Item Short Form Survey (SF-12), and the correlation coefficient between each dimension (0.13-0.28) was less than the correlation coefficient between each dimension and the total score of the scale and the difference was statistically significant( P<0.01). The Cronbach′s α coefficient was 0.84 and the retest reliability was 0.92. Conclusions:The Chinese version of PU-QOL questionnaire was proved to be a good instrument with acceptable reliability and validity, which can be used as a tool for evaluating quality of life of patients with PU in China.

ObjectiveTo explore the prevalence rate and related risk factors of anxiety， depression and insomnia symptoms in close contacts of COVID-19 patients undergoing centralized quarantine and observation， so as to provide references for follow-up targeted psychological crisis intervention. MethodsFrom February 6 to 8， 2020， a total of 136 close contacts at designated quarantine sites in four districts and counties of Ya'an city were enrolled， and assessed using the general information questionnaire， Hospital Anxiety and Depression Scale （HAD） and Insomnia Severity Index （ISI）. ResultsA total of 26 quarantined individuals （19.12%） had various degrees of anxiety， depression or insomnia， including 16 cases （11.76%） with anxiety， 9 cases （6.62%） with depression and 16 cases （11.76%） with insomnia. Correlation analysis showed that HAD （A） score was positively correlated with HAD （D） score （r=0.642， P<0.01）. HAD （A） score was positively correlated with ISI score （r=0.590， P<0.01）. HAD （D） score was positively correlated with ISI score （r=0.329， P<0.01）. Multivariate Logistic regression analysis showed that the risk factor of anxiety was the first week of isolation （OR=3.290， P<0.05）， meantime， the risk factors of insomnia included the old age （OR=7.990， P<0.05） and the first week of isolation （OR=4.659， P<0.05）. ConclusionThe close contacts of COVID-19 infections undergoing centralized quarantine and observation in Ya’an have high prevalence rate of anxiety and insomnia， and the symptoms are most severe during the first week of quarantine.

Objective:To explore the status quo and influencing factors of caregivers' perception of nurses' empowerment behavior in children with type 1 diabetes mellitus (T1DM) , and to provide scientific basis for focusing on and efficiently empowering caregivers of children with T1DM.Methods:This study was a cross-sectional survey. A total of 360 children with T1DM who were admitted to 2 tertiary hospitals in Zhejiang Province from January 2019 to May 2020 were selected by the convenient sampling method. General information questionnaire, Patient Perceptions of Patient-Empowering Nurse Behaviors Scale (PPPNBS) and General Self-Efficacy Scale (GSES) were used to investigate and analyze the influencing factors. A total of 360 questionnaires were issued and 347 valid questionnaires were recovered, with an effective response rate of 96.4%.Results:The PPPNBS score of caregivers of 347 children with T1DM was (185.85±50.05) . Multiple linear regression analysis showed that the course of the disease, the age of the caregiver, the education background of caregivers and self-efficacy sense were influencing factors of perception of empowerment behavior of caregivers of children with T1DM ( P<0.05) . Conclusions:The perception of caregivers of T1DM children with nurses' empowerment behavior is at a moderate level. The course of the disease, age of caregivers, the education background of caregivers and self-efficacy are the influencing factors in perception of caregivers' empowerment behaviors of T1DM children. Medical staff should formulate targeted intervention measures based on the influencing factors of the perception of empowerment behaviors to improve the perception of nurses' empowerment behaviors by caregivers of patients.

Objective:To compare positional and volumetric differences between the gross target volumes (GTV) delineated on three-dimensional CT (3D-CT) referencing 18F-FDG PET/CT and the GTV on the deformed image derived from 3D-CT and 18F-FDG PET/CT for primary thoracic esophageal cancer (EC). Methods:Seventy-two patients underwent chemoradiotherapy were enrolled. All the patients sequentially underwent 18F-FDG PET/CT scans for diagnosis and 3D-CT scans for simulation. The GTV 3D was delineated on 3D-CT without referencing 18F-FDG PET/CT. The GTV PET-ref was delineated on 3D-CT referencing 18F-FDG PET/CT. The GTV PET-regwas delineated on the deformed image derived from 3D-CT and 18F-FDG PET/CT by MIM deformable registration software. The differences in position, volume, length, conformity index (CI), and degree of inclusion (DI) of target volumes were compared, respectively. Results:The median volume of GTV 3D, GTV PET-ref, GTV PET-reg were 44.90, 40.36 and 41.15 cm 3, respectively. There was no statistical difference between the volumes of any two targets. The mean lengths of GTV 3D, GTV PET-ref, GTV PET-reg were 8.54, 9.29 and 8.38 cm, respectively. The length of GTV PET-ref was longer than that of GTV 3D ( t=2.134, P<0.05). The median DIs of GTV PET-ref, GTV PET-regin GTV 3D were 0.86, 0.82( Z=-2.741, P<0.05), and that of GTV 3D in GTV PET-ref, GTV PET-reg were 0.87, 0.84 ( Z=-1.429, P<0.05). The median CIs of GTV 3D in GTV PET-ref and GTV PET-reg were 0.72, 0.68 ( Z=2.756, P<0.05), and the difference was significant. The CIs of GTV 3D and GTV PET-ref, GTV 3D and GTV PET-reg, GTV PET-ref and GTV PET-reg had significant negative correlation with the distance of target centers. Conclusions:There was no significant difference between GTV contoured on three-dimensional CT (3D-CT) referencing 18F-FDG PET/CT and the GTV on the deformed image derived from 3D-CT and 18F-FDG PET/CT either in volume size or in spatial position. Therefore, it is recommended that radiation oncologists can refer to the recent diagnostic PET/CT when delineating the gross target volume for primary thoracic esophageal cancer.

Objective To detect the efficiency of the newly developed PLGA/IO MPs in tracking tendon stem cells (TSCs) by magnetic resonance (MR) and photoacoustic (PA) imaging . Methods Both PLAG/IO MPs and TSCs were prepared and acquired according to the previous study ,and TSCs were incubated with PLGA/IO MPs for labeling .TSCs were collected for MR and PA imaging ,prussian blue staining was performed ,and the iron concentration of labeled TSCs was determined using inductively coupled plasma optical emission spectrometry ( ICP-OES ) at 3 ,7 ,14 ,21 and 28 days after labeling respectively . The rotator cuff injury model was built on the right side of SD rats by surgery and the labeled TSCs were implanted instantly . Dual-modal MR/PA imaging was performed to observe the implanted labeled TSCs at day 3 ,7 ,14 ,21 and 28 after implantation respectively . Results Along with the increase of labeling time ,both MR and PA signal of labeled TSCs decreased gradually ,and the amount of intracellular Fe loading was gradually decreased . At day 28 ,the difference of Fe concentration per cell between labeled TSCs and non-labeled TSCs was not significant (1 .45 pg Fe/cell vs 1 .17 pg Fe/cell , P ＞0 .05) . MR and PA imaging allowed a long-term tracking of labeled TSCs for 21 and 7 days respectively in the rat rotator cuff injury model . Conclusions PLGA/IO MPs are able to label TSCs for up to 21 days ,and dual-modal MR/PA imaging could be used to track the labeled TSCs in the rat rotator cuff injury model .

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are confirmed to be expressed in bladder interstitial Cajal-like cells (ICC-LCs), but little is known about their possible role in cystitis-associated bladder dysfunction. The present study aimed to determine the functional role of HCN channels in regulating bladder function under inflammatory conditions. Sixty female wild-type C57BL/6J mice and sixty female HCN1-knockout mice were randomly assigned to experimental and control groups, respectively. Cyclophosphamide (CYP)-induced cystitis models were successfully established in these mice. CYP treatment significantly enhanced HCN channel protein expression and I(h) density and significantly altered bladder HCN1 channel regulatory proteins. Carbachol (CCH) and forskolin (FSK) exerted significant effects on bladder ICC-LC [Ca²⁺]i in CYP-treated wild-type (WT) mice, and HCN1 channel ablation significantly decreased the effects of CCH and FSK on bladder ICC-LC [Ca²⁺]i in both naive and CYP-treated mice. CYP treatment significantly potentiated the spontaneous contractions and CCH (0.001-10 µM)-induced phasic contractions of detrusor strips, and HCN1 channel deletion significantly abated such effects. Finally, we demonstrated that the development of CYP-induced bladder overactivity was reversed in HCN1 -/- mice. Taken together, our results suggest that CYP-induced enhancements of HCN1 channel expression and function in bladder ICC-LCs are essential for cystitis-associated bladder hyperactivity development, indicating that the HCN1 channel may be a novel therapeutic target for managing bladder hyperactivity.
Animals ; Carbachol ; Colforsin ; Cyclophosphamide ; Cystitis ; Female ; Humans ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels* ; Mice* ; Telocytes* ; Up-Regulation* ; Urinary Bladder*

The four properties theory of traditional Chinese medicine (TCM) is an important basis for the guidance of TCM clinical medication.However,TCM modernization has produced a large number of active substances with unknown medicine properties.Therefore,it is urgent to build a new drug development system guided with TCM four properties theory.From the view of that four properties of TCM must have their material basis,and based on the known knowledge on TCM four properties,this paper proposed strategies of new drug research by cloning TCM partial components based on theTCM model of standard level property. A certain number of representative standard level property TCM drugs were selected to conduct system separation for the establishment of aTCM model of standard level property with the proportion and content of each separated component as a reference.The standard model was used as a boundary.Contents and proportions of the experimental TCM separation components deviated from thisstandard model were classified as hot or cold properties.From cloning of the partial components of TCM with hot or cold property medicine,the quality standards of partial components of experimental TCM were also studied,in order to investigate their corrective actions and mechanisms.The TCM partial components were expected to form a new TCM drug with the four properties theory of TCM as guidance.