BACKGROUND:Small diameter artificial vessels are urgently needed to treat coronary artery and peripheral artery diseases in clinical practice.At present,vascular tissue engineering has become the main method for preparing small diameter artificial vessels.Selecting suitable biomaterials and cell sources is the key factor for successful construction of small diameter tissue engineered vessels. OBJECTIVE:To observe the effect of four kinds of electrospinning membrane materials on proliferation,adhesion and differentiation of bone marrow mesenchymal stem cells into vascular smooth muscle cells. METHODS:Bone marrow mesenchymal stem cells were isolated and extracted from SD rats.The bone marrow mesenchymal stem cells were inoculated separately on polycaprolactone(PCL),polycaprolactone-hyaluronic acid(PCL-HA),polycaprolactone-silk-filament proteins(PCL-SF),and polycaprolactone-gelatin(PCL-GEL)electrospinning membrane materials.After 1,3,and 7 days of culture,the cell arrangement on the material was observed under scanning electron microscope.The proliferation and adhesion of the material were observed by phalloidin staining.The mRNA expressions of CD90,Meflin,and transforming growth factor β were detected by qRT-PCR.After 7 days of induced differentiation into vascular smooth muscle cells,the mRNA expression ofɑ-smooth muscle actin on the material was detected by qRT-PCR. RESULTS AND CONCLUSION:(1)Bone marrow mesenchymal stem cells were arranged along the fibers of the four kinds of electrospinning membranes under scanning electron microscopy.(2)Phalloidin staining showed the regular distribution of bone marrow mesenchymal stem cells on the four kinds of electrospinning membranes and parallel distribution along the fiber direction.Moreover,PCL-HA,PCL-SF,and PCL-GEL electrospinning membranes were more conducive to the proliferation and adhesion of bone marrow mesenchymal stem cells than PCL electrospinning membranes.Compared with PCL-HA and PCL-GEL electrospinning membranes,PCL-SF electrospinning membranes were more conducive to the proliferation and adhesion of bone marrow mesenchymal stem cells.(3)qRT-PCR showed that the four kinds of electrospun membrane materials could maintain the mRNA expression of CD90 and Meflin in bone marrow mesenchymal stem cells,but there was no significant difference between groups(P>0.05).The mRNA expression of transforming growth factor β in PCL-HA,PCL-SF,and PCL-GEL groups was higher than that in PCL group on days 1 and 7(P<0.05),and the mRNA expression of transforming growth factor β in PCL-SF group was higher than that in the other three groups on days 3 and 7(P<0.05).The mRNA expression of transforming growth factor β in PCL-HA group was higher than that in PCL-GEL group on day 7(P<0.05).(4)qRT-PCR showed that the mRNA expression of ɑ-smooth muscle actin in PCL-SF group was higher than that in the other three groups(P<0.05),and that in PCL-HA group was higher than that in PCL group(P<0.05).(5)The results indicate that compared with PCL,PCL-HA and PCL-GEL electrospinning membranes,PCL-SF electrospinning membranes combined with bone marrow mesenchymal stem cells are more suitable for the preparation of small diameter tissue engineered vessels.

Objective To analyze the current status and frontier trends of research on the application of cognitive-motor dual task training(CMDT)in stroke. Methods Relevant literatures on the application of CMDT in stroke were retrieved from CNKI,Wanfang data,VIP,SinoMed and Web of Science Core Collection from inception to October 11,2023,and was analyzed with CiteSpace 6.2R4. Results A total of 285 articles were included with 124 in Chinese and 161 in English.The annual number of publications showed a general upward trend.United States,Canada,Netherlands,China and United Kingdom were the lead-ing countries in terms of output in English.The scholar with the most publications in Chinese was Zheng Jiejiao,and the Department of Rehabilitation Medicine in Huadong Hospital of Fudan University was the leading institu-tion for Chinese publications.Vrije University Amsterdam was the leading institution for English publications.The most frequent Chinese keywords were gait,falls,balance,cognition and postural control.The most frequent English keywords were dual-task,walking,gait,balance and cognitive-motor interference.Bursting keywords from the past two years included gait training,cognitive tasks,balance ability and cognitive-motor interference. Conclusion The researches on the application of CMDT in stroke are on the rise,with hotspots including gait training,cognitive tasks and cognitive-motor interference.The mechanisms of CMDT and the development of optimal CMDT rehabilitation protocols for stroke may be researched more in the future.

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids

Objective:To form the expert consensus on screening and evaluation of dysphagia with oral cancer patients (abbreviated as Consensus) , so as to standardize the relevant contents of screening and evaluation of dysphagia in the whole cycle of oral cancer. Methods:By referring to domestic and foreign literature related to dysphagia, combining with the specialty characteristics of oral cancer and the clinical experience of experts, a preliminary consensus was formed through in-depth interviews with experts. A total of 21 experts were selected for three rounds of expert letter consultation and expert meeting, the corresponding items were sorted out, analyzed and modified based on expert opinions, and the Consensus was finally formed. Results:The effective recovery rates of the three rounds of correspondence were 100.00% (21/21) , the expert authority coefficient was 0.91, the variation coefficient of each item was 0.04-0.20, and Kendall's harmony coefficient was 0.05 ( P<0.05) . The final consensus included four aspects, such as the effect of oral cancer on swallowing, the clinical manifestations of dysphagia, the basic procedures of screening and evaluation and the prevention and treatment of complications during evaluation. Conclusions:This Consensus is scientific and practical, which can provide clinical guidance for the screening and evaluation of dysphagia in the whole cycle of oral cancer.

Objective To establish the standard paths of creative expression cognitive intervention program for Chinese older adults with mild cognitive impairment(MCI).Methods Thirty MCI older adults received creative expression cognitive program twice per week for six weeks.The action research process was implemented through plan,action,observation and reflection to constantly modify and improve the paths.The Montreal cognitive assessment scale(MoCA),daily living activity scale(ADL),self-made creative story-telling therapy activity observation table and feedback form were used to evaluate the effects of program.Results The standard paths of the creative expression cognitive intervention program for Chinese older adults with MCI were established through the action research method.There were no significant differences in MoCA and ADL before and after intervention(P＞0.05).The attending intention,attention,expression ability,communication skills,participant levels,enjoyment had been significantly improved through this program (P＜0.05).Patients believed that the creative storytelling was able to stimulate their creativity and expression ability,help them attain more social support and trust,thus they would be more willing to involve and cooperate in developing group activities.Conclusion The creative expression cognitive intervention activity is an effective and feasible non-pharmacological treatment for Chinese older adults with MCI.It provides an economical,convenient,easy to implement,and higher participatory nursing suitable technology for elderly service industry.

Objective: To explore the changes and signiifcance of serum level of salusins in patients with essential hypertension (EH), obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS complicated hypertension.
Methods: Our research included 4 groups: EH+OSAHS group,n=50, EH group,n=60, OSAHS group,n=35 and Control group,n=31 healthy subjects. Blood pressure, AHI index, body weight, height and routine biochemical examination were conducted and recorded in all subjects, serum levels of salusin-α and salusin-β were detected by ELISA, the relationship between each variable and OSAHS complicated hypertension was studied by multivariate Logistic regression analysis.
Results:①Serum levels of salusin-α were reduced accordingly as in Control group (7.438±1.626) pg/ml, in OSAHS group (6.186±1.200) pg/ml, in EH group (5.938±1.287) pg/ml and in EH+OSAHS group (5.299±1.398) pg/ml; for difference between OSAHS group and EH group,P>0.05 and for differences between other groups, allP<0.01.②Serumlevels of salusin-βwere decreased accordingly as in Control group (10.575±1.791) pg/ml, in OSAHS group (10.279±0.530) pg/ml, in EHgroup (9.698±0.344) pg/ml and in EH+OSAHS group (9.070±0.586) pg/ml; for differences between OSAHS group and Control group, EH group, bothP>0.05 and fordifferences between other groups, allP<0.05.③Multivariate Logistic regression analysis showed that serum level of salusin-α was independently and negatively related to OSAHS complicated hypertension (OR=-0.736,P<0.05); serum level of salusin-β was independently and negatively related to OSAHS complicated hypertension (r=-0.731,P<0.05).
Conclusion: Low serum levels of salusin-α and salusin-β were related to OSAHS complicated hypertension.

Objective To investigate the effects of Wuling Powder on insulin resistance of C57BL/6J mice induced by high lipid diet, and discuss the mechanism. Methods C57BL/6J mice were randomly divided into six groups:normal group, model group, rosiglitazone group, Wuling Powder in low, middle, and high dose groups, 10 mice per group. Besides the normal group, other five groups were fed with high fat and sugar diet, with a purpose to establish insulin resistance model. Normal group and model group were given pure water. Rosiglitazone group received a gavage with rosiglitazone of 0.75 mg/kg. Wuling Power low, middle, and high groups received gavage with Wuling Power of 1.23, 3.69, 11.07 g/kg, respectively, the does volume was 0.2 mL/10 g, once a day. The weight and abdominal girth were detected every week. At the end of the sixth week, mice were given 12-hour fasting, and their eyeball were taken for blood. The body weight, length, and fat in abdomen and both kidneys were detected. Paraffin section was made with HE staining. FPG and FINS of each group were detected. ISI and IRI were calculated, and TC and TG were detected. Results Compared with the model group, Wuling Powder can significantly reduce the body weight and abdominal girth of mice (P<0.01, P<0.001), improve liver fatty degeneration, lower the FPG, FINS, TCH, TG, IRI, and increase the ISI in mice (P<0.05, P<0.01). Conclusions Wuling Powder has the effect of preventing insulin resistance of C57BL/6J mice induced by high lipid diet.

Objective To observe the effects of standardized treatment to pregnancy and perinatal outcome of children gestational diabetes (GDM).Methods Forty-five cases of GDM glycemic control satisfied patients and 36 cases of GDM glycemic control dissatisfied patients were enrolled in this study who in the General Hospital of Jizhong Energy Feng Feng Group hospital from January 2010 to October 2012,and 50 cases of the same period of hospitalization single fetal blood sugar normal pregnant women were randomly selected as control group.Pregnancy outcome and perinatal outcome of three groups were analyzed and compared.Results (1) Pregnancy outcome of three groups:the incidence of concurrent gestational hypertension (27.8％),polyhydramnios(22.2％),premature delivery (16.7％),cesarean section rate (80.5％) and puerperalism (13.9％) in GDM glycemic control dissatisfied patients were higher than those of GDM glycemic control satisfied patients (8.9％,6.7％,2.2％,55.6％,2.2％) and control group (6.0％,4.0％,2.0％,46.0％,2.0％),and the differences were statistically significant (P＜ 0.05).(2) Perinatal outcome of three groups:the incidence of huge child (27.8％),neonatal hypoglycemia (41.7％),neonatal asphyxia rate (22.2％) of GDM glycemic control dissatisfied patients were higher than those of GDM glycemic control satisfied patients (4.4％,17.8％,6.7％) and control group (6.0％,2.0％,4.0％),and the differences were statistically significant (P＜0.05).Conclusion Gestational diabetes increases the incidence of infant and maternal complications,early diagnosis,standardized diagnosis and treatment can reduce infant and maternal complications,improve pregnancy outcomes.

Objective To know about the level and influencing factors of transcultural self-efficacy of clinical registered nurse ( RN ) in level three class A hospitals. Methods transcultural self-efficacy tool ( TSET) was carried on the investigation of 950 nurses in Shanghai 6 level three class A hospitals. Results The total score of TSET in the nursing staffs in level three class A hospitals was (594. 96 ± 139. 424), and the 3 dimension scores from high to low were emotional (211. 21 ± 60. 882), practice (200. 12 ± 50. 087), cognitive (183. 63 ± 47. 688) points. Step-wise multiple linear regression showed learning humanities courses or not, religious belief, departments, English level and education background were the main influencing factors of TSET. Conclusions In Shanghai level three class A hospitals, the total score of TSET was favorable, and cognitive dimension was poor compared with others, so nursing administrator should make out transculture nursing training course, encourage nurses to improve education and English level, arrange further study and learning exchange on time, and enhance clinical nurse′s transcultural nursing ability.

BACKGROUNDHigh-frequency oscillatory ventilation (HFOV) allows for small tidal volumes at mean airway pressures (mPaw) above that of conventional mechanical ventilation (CMV), but the effect of HFOV on hemodynamics, oxygen metabolism, and tissue perfusion in acute respiratory distress syndrome (ARDS) remains unclear. We investigated the effects of HFOV and CMV in sheep models with ARDS.

METHODSAfter inducing ARDS by repeated lavage, twelve adult sheep were randomly divided into a HFOV or CMV group. After stabilization, standard lung recruitments (40 cmH2O × 40 seconds) were performed. The optimal mPaw or positive end-expiratory pressure was obtained by lung recruitment and decremental positive end-expiratory pressure titration. The animals were then ventilated for 4 hours. The hemodynamics, tissue perfusion (superior mesenteric artery blood flow, pHi, and Pg-aCO2), oxygen metabolism and respiratory mechanics were examined at baseline before saline lavage, in the ARDS model, after model stabilization, and during hourly mechanical ventilation for up to 4 hours. A two-way repeated measures analysis of variance was applied to evaluate differences between the groups.

RESULTSThe titrated mPaw was higher and the tidal volumes lower in the HFOV group than the positive end-expiratory pressure in the CMV group. There was no significant difference in hemodynamic parameters between the HFOV and CMV groups. There was no difference in the mean alveolar pressure between the two groups. After lung recruitment, both groups showed an improvement in the oxygenation, oxygen delivery, and DO2. Lactate levels increased in both groups after inducing the ARDS model. Compared with the CMV group, the superior mesenteric artery blood flow and pHi were significantly higher in the HFOV group, but the Pg-aCO2 decreased in the HFOV group.

CONCLUSIONCompared with CMV, HFOV with optimal mPaw has no significant side effect on hemodynamics or oxygen metabolism, and increases gastric tissue blood perfusion.

Animals ; Disease Models, Animal ; Hemodynamics ; physiology ; High-Frequency Ventilation ; methods ; Male ; Oxygen ; metabolism ; Positive-Pressure Respiration ; methods ; Respiration, Artificial ; methods ; Respiratory Distress Syndrome, Adult ; metabolism ; therapy ; Sheep