Ferritin is widely present in various organisms and is responsible for storing excess iron to maintain iron balance in vivo.Due to its inherent targeting ability,natural cavity structure,reversible self-assembly,high biocompatibility,and easy modification,ferritin is considered to be an ideal delivery system,which is widely used in many fields.This review summarizes the biological characteristics,functionalization,drug loading strategies,research progress and application prospects of ferritin-based nanocarrier systems in biomedical fields,such as drug delivery,biocatalysis,photodynamic therapy,medical imaging and vaccine research,aiming to provide some reference for related biomedical research based on ferritin delivery systems.

Objective:To analyze the influential factors of blurred vision after general anesthesia.Methods:The clinical data of 997 patients who underwent elective general anesthesia at The No. 1 People's Hospital of Pinghu from September 2022 to May 2023 were retrospectively analyzed. The data collected included age, sex, body mass index, American Society of Anesthesiologists classification, history of hypertension, history of diabetes, operation duration (specifically whether it exceeded 3 hours), surgical position (whether the patient was in the supine position), operating room temperature, use of penehyclidine hydrochloride, use of muscle relaxant antagonists, use of atropine, blood pressure (specifically whether it was ≥ 30% of the baseline value), fluid input, blood loss, and use of pneumoperitoneum. Collinearity diagnosis and univariate logistic regression analysis were conducted to select factors with statistical significance. Subsequently, multivariate logistic regression analysis was performed.Results:Univariate and multivariate logistic regression analyses showed that age > 65 years ( OR = 1.47, 95% CI: 1.01-2.15, P = 0.043), surgical position (non-supine position) ( OR = 1.54, 95% CI: 1.06-2.25, P = 0.025), operation time exceeding 3 hours ( OR = 1.76, 95% CI: 1.05-2.94, P = 0.031), and the use of penehyclidine hydrochloride ( OR = 4.91, 95% CI: 3.35-7.21, P < 0.001) were identified as factors contributing to postoperative blurred vision in patients undergoing general anesthesia. Conclusion:Factors contributing to postoperative blurred vision in patients undergoing general anesthesia include age > 65 years, the use of penehyclidine hydrochloride during surgery, operation time exceeding 3 hours, and non-supine surgical position. Clinically, it is essential to implement early and effective preoperative education, enhance intraoperative nursing quality, and optimize preoperative medication for general anesthesia to reduce the incidence of blurred vision after surgery.

Objective To investigate the value of tranexamic acid combined with aspirin,low molecular weight heparin calcium in regulating inflammatory mediators and TEG in blood management of Total knee arthroplast(TKA).Methods 120 elderly patients with TKA in our hospital from January 2020 to October 2022 were randomly divided into group A(n=60)and group B(n=60).They were given tranexamic acid+aspirin and tranexamic acid+low molecular weight heparin calcium,respectively,for 2 weeks.Perioperative indexes,complications[lower limb deep vein thrombosis(DVT),intermuscular vein thrombosis(MCVT),incision infection],blood transfusion rate,adverse reactions(gastrointestinal discomfort,subcutaneous ecchymosis),TEG parameters[coagulation reaction time(R),blood coagulation time(K),maximum amplitude(MA),coagulation angle(α)],inflammatory mediators[soluble CD40 ligand(sCD40L),Toll-like receptor 4(TLR4),tumor necrosis factor(TNF-α)],vascular endothelial injury factors[soluble thromboregulatory protein(sTM),vascular endothelial cell growth factor(VEGF),E-selectin]were compared between the two groups.Results There was no significant difference in the 24 h postoperative drainage volume,latent blood loss,total blood loss,intraoperative blood loss,Hb and HCT levels 72 h after surgery between the two groups(P＞0.05).There was no statistically significant difference in TEG parameters between the two groups,at different time points,and between groups at different time points(P＞0.05);The serum levels of TLR4,sCD40L and TNF-α in group A were lower than those in group B 2 weeks after surgery(P＜0.05).The levels of plasma sTM and serum VEGF and E-selectin in group A were lower than those in group B 2 weeks after surgery(P＜0.05).There was no significant difference in the incidence of deep vein thrombosis(DVT),intermuscular vein thrombosis(MCVT),incision infection and blood transfusion rate between group A and group B(P＞0.05).There was no significant difference in the total incidence of adverse reactions between group A and group B(P＞0.05).Conclusion Compared with the combination of low molecular weight heparin calcium,the combination of tranexamic acid and aspirin can protect vascular endothelium and inhibit inflammatory response.However,both can maintain the patient's coagulation function and avoid massive blood loss or thrombosis.There is no significant difference in safety and effectiveness.

Purpose To explore the application value of clinical-ultrasound parameter model in secondary hyperparathyroidism(SHPT).Materials and Methods A total of 86 patients(134 lesions)with renal insufficiency who underwent maintenance hemodialysis in the First Affiliated Hospital of Shihezi University from October 2020 to August 2022 were included and divided into group 1 according to the level of parathyroid hormone(iPTH)(iPTH＜300 pg/ml),group 2(iPTH 300-800 pg/ml)and group 3(iPTH≥800 pg/ml),all patients underwent gray-scale parathyroid ultrasound and acoustic palpation tissue quantitative imaging examinations.The characteristics of glandular gray-scale ultrasound and virtual touch tissue imaging quantification parameters between different groups,combined with relevant clinical indicators,established a clinical-ultrasound parameter model,used multiple linear regression to analyze the correlation between the model and iPTH,explored the independent risk factors of iPTH,and evaluated this model to evaluate SHPT the value of.Results There were significant differences in dialysis age,phosphorus,alkaline phosphatase,serum creatinine,corrected calcium and phosphorus product,lesion size,number,echo,shear wave velocity(SWV)max,SWVcen,and SWVmean among the three groups(F/x2/H=6.396-53.524,all P＜0.05).Dialysis age,phosphorus,alkaline phosphatase,and SWVratio were independent influencing factors of iPTH level(β=0.514,0.422,0.226,-0.368,all P＜0.005).The area under the curve,sensitivity,specificity and accuracy of the model for diagnosing SHPT and predicting surgical treatment with iPTH levels of 300 pg/ml and 800 pg/ml were 0.967,95.00％,100.00％,97.73％and 0.824,77.42％,71.43％and 90.00％,respectively.Conclusion Dialysis age,phosphorus,alkaline phosphatase and SWVratio are independent influencing factors of iPTH level,and the clinical-ultrasound parameter model is of great value in accurately assessing the severity of SHPT.

Uncommon epidermal growth factor receptor (EGFR) mutations account for 10%-20% of all EGFR mutations in non-small-cell lung cancer (NSCLC). The uncommon EGFR-mutated NSCLC is associated with poor clinical outcomes and generally achieved unsatisfactory effects to the current therapies using standard EGFR-tyrosine kinase inhibitors (TKIs), including afatinib and osimertinib. Therefore, it is necessary to develop more novel EGFR-TKIs to treat uncommon EGFR-mutated NSCLC. Aumolertinib is a third-generation EGFR-TKI approved in China for treating advanced NSCLC with common EGFR mutations. However, it remains unclear whether aumolertinib is effective in uncommon EGFR-mutated NSCLC. In this work, the in vitro anticancer activity of aumolertinib was investigated in engineered Ba/F3 cells and patient-derived cells bearing diverse uncommon EGFR mutations. Aumolertinib was shown to be more potent in inhibiting the viability of various uncommon EGFR-mutated cell lines than those with wild-type EGFR. And in vivo, aumolertinib could also significantly inhibit tumor growth in two mouse allograft models (V769-D770insASV and L861Q mutations) and a patient-derived xenografts model (H773-V774insNPH mutation). Importantly, aumolertinib exerts responses against tumors in advanced NSCLC patients with uncommon EGFR mutations. These results suggest that aumolertinib has the potential as a promising therapeutic candidate for the treatment of uncommon EGFR-mutated NSCLC.

BACKGROUND: Although newly formed constructs of feasible pressure-preadjusted bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) showed biomechanical flexibility and superior capacity for cartilage regeneration, it is still not very clear how BMSCs and seed cells feel mechanical stimuli and convert them into biological signals, and the difference in signal transduction underlying mechanical and chemical cues is also unclear. METHODS: To determine whether mechanical stimulation (hydrostatic pressure) and chemical cues (platelet-rich fibrin, PRF) activate canonical or noncanonical Wnt signaling in BMSCs, BMSCs cocultured with PRF were subjected to hydrostatic pressure loading, and the activation of the Wnt signaling molecules and expression of cartilage-associated proteins and genes were determined by western blotting and polymerase chain reaction (PCR). Inhibitors of canonical or noncanonical Wnt signaling, XVX-939 or L690,330, were adopted to investigate the role of Wnt signaling molecules in mechanically promoted chondrogenic differentiation of BMSCs. RESULTS: Hydrostatic pressure of 120 kPa activated both Wnt/b-catenin signaling and Wnt/Ca2+ signaling, with the the maximum promotion effect at 60 min. PRF exerted no synergistic effect on Wnt/b-catenin signaling activation. However, the growth factors released by PRF might reverse the promotion effects of pressure on Wnt/Ca2+ signaling. Real-time PCR and Western blotting results showed that pressure could activate the expression of Col-II, Sox9, and aggrecan in BMSCs cocultured with PRF. Blocking experiment found a positive role of Wnt/b-catenin signaling, and a negative role of Wnt/ Ca2+ signaling in chondrogenic differentiation of the BMSCs. Mutual inhibition exists between canonical and noncanonical Wnt signaling in BMSCs under pressure. CONCLUSION Wnt signaling participates in the pressure-promoted chondrogenesis of the BMSCs co-cultured with PRF, with canonical and noncanonical pathways playing distinct roles during the process.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

Objective To explore the application effect of dynamic case scenario simulation in emergency ability training of new nurses in Department of Neurosurgery.Methods A total of 28 nurses newly recruited in 2015 and 2016 to Department of Neurosurgery, Huai'an First People's Hospital, Nanjing Medical University were selected. According to time of joining the department, the 15 nurses recruited in 2015 were selected as control group, and the 13 nurses enrolled in 2016 as observation group. Nurses in the control group were trained by stages, i.e. technique training after theory training. On the basis of above mentioned training stages, nurses in the observation group were trained in simulated scenario, with 1 dynamic case added to each training stage. Emergency management ability, self evaluation of the nurses and patients' satisfaction after the training were compared between the two groups.Results After the training, scores of ability in disease observation, emergency cooperation and first-aid operation of new nurses in observation group were (27.41±1.32), (29.59±1.06) and (38.55±1.58), all higher than those in the control group (t=7.24, 12.26, 10.07;P<0.01). It was shown in results of self-evaluation that, ability to link theory with reality, to arouse subjective initiative and participation of nurses in the observation group were higher than those in the control group (P<0.05). Satisfaction of patients towards nurses in the observation group was 96.15%, higher than 86.00% in the control group (χ2=8.524,P<0.01).Conclusions Trained with method of dynamic case scenario simulation, emergency response ability of new nurses can be improved rapidly in a short time. Also, patients are more satisfied with the nursing. This training management method is worth promoting.

Objective On patients with mechanical ventilation spontaneous breathing trial (SBT) success, out of breath machine smoothly pulled out after endotracheal intubation for active airway moist sequential therapy of clinical new method and new technology. Methods Between January 2013 and May 2014 respiratory endotracheal intubation implementation of mechanical ventilation with intensive medicine successful withdraw machine pulled out of 135 patients with tracheal intubation, they were divided into group A(68 cases) and group B(67 cases) by random digits table method. The patients in group A were treated with buoy type oxygen device, group B with active airway moist heat treatment unit. The breathing rate, PaO2, SpO2, heart rate, Clinical Pulmonary Infection Score(CPIS) were measured after 72 h of pull out endotracheal intubation in two groups. Sputum viscosity was evaluated by Airway Secretions Score before pull out endotracheal intubation and after 24, 48, 72 h of pull out endotracheal intubation in two groups. Results There were no significant differences between two groups in gender, age, clinical diagnosis, mechanical ventilation time, acute physiology and chronic health evaluation systemⅡrating etc (P>0.05). The breathing rate, heart rate and CPIS score respectively (20.94 ± 0.89), (80.79±4.67) times/min and (7.13 ± 2.54) points after 72 h of pull out endotracheal intubation in group B, and (24.12 ± 0.97), (86.32 ± 5.12) times/min and (8.79±3.56) points in group A, and there were significant differences(t=5.113, 7.298, 5.597, all P<0.01). PaO2, SpO2 were (93.24±1.96) mmHg(1 mmHg=0.133 kPa), 0.973 2±0.014 8 in group B, and (87.35±2.32) mmHg, 0.937 8±0.013 2 in group A, and there were significant differences(t=9.279, 4.548, all P<0.01). There was no significant difference in sputum viscosity before pull out endotracheal intubation between two groups (P>0.05). After 24, 48 and 72 h of pull out endotracheal intubation, group B of patients with sputum viscosity was suitable in group A (Z=-2.684,-2.870,-2.771, all P < 0.01). Conclusions Mechanical ventilation in patients with ventilator buoy type oxygen device for the pull out after endotracheal intubation success does not favor the sputum drainage, improve patients with dyspnea and hypoxemia is not obvious. By positive airway plus temperature humidity to sequential therapy is helpful to correct hypoxemia, improve the patients' respiratory function, reduce the breathing difficulties, reduce sputum viscosity, promote the airway drainage unblocked, shortening the time of lung infection.