Objective To explore the application of quantitative EEG(QEEG)trends in the assessment of the state of brain function in patients with severe stenosis of the internal carotid artery and its predictive value for the risk of acute occlusion in the short term.Methods The clinical and imaging data of a case of severe left internal carotid stenosis were retrospectively analyzed,and QEEG trends were used for evaluating the state of brain function.Results It showed that rhythmicity spectrogram,amplitude-integrated EEG,fast Fourier transformation spectrogram and fast Fourier transform power spectrum in QEEG trends could quickly and visually display theta activity and amplitude at the side of severe internal carotid artery stenosis continued to increase compared with the healthy side hemisphere.Acute occlusion of the left internal carotid artery and large artery atherosclerotic cerebral infarction occurred in the patient after 3 days.Conclusion As a supplement to neuroimaging examination,QEEG trends may be helpful for rapidly diagnosing brain function damage in the early stage of patients with severe internal carotid artery stenosis who are under the ischemic attack state,and even have potential predictive values for patients with acute occlusion in the short term.

Objective To verify the mental health status and methods to regulate emotion as well as identify the associated factors among Northwest University students during the lockdown period of the COVID-19 outbreak in Xi'an.Methods A questionnaire survey using the random sampling was conducted among the college students in Xi'an,using Self-Control Scale(SCS),Perceived Social Support Scale(PSSS),the Depression-Anxiety-Stress Scale Lite(DASS-21),and Self-Rating Scale of Sleep(SRSS).Results A total of 512 valid questionnaires for college students were collected.The statistical results showed that during the lockdown period after the COVID-19 epidemic outbreak in Xi'an,there were gender and discipline differences in self-control and understanding of social support among college students.That is,compared with boys,girls were more likely to receive social support(P=0.031),friend support(P=0.008),and other support(P=0.029).Compared to liberal arts majors,college students majoring in science and engineering were more likely to engage in self-control,especially in healthy habits(P=0.001),moderate entertainment(P=0.002),and impulse control(P=0.001).However,there was no significant difference in the influence of students'age or whether they came from rural or urban areas on their self-control and understanding of social support abilities.The statistical results also found that the age of college students was significantly correlated with their level of stress and sleep status.Their self-control ability and ability to comprehend social support also had correlation with their mental health status and sleep status during the lockdown period of the epidemic.Conclusion College students were prone to have negative emotions and sleep disorders during the lockdown period of sudden epidemic,which were more common in senior grades,male college students,and liberal arts majors.Active self-control and seeking social support can effectively moderate negative emotions and sleep disturbances.

Objective : To investigate the expression and mechanism of long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and microRNA 181 a ( miR 181 a ) in a myocardial cell oxidative stress model. Methods : The expression of MALAT1 and miR 181 a in peripheral blood of 30 patients with acute myocardial infarction ( AMI group) and 30 healthy controls ( Normal group) was detected by qRT PCR. Pearson correlation analysis was performed to determine the correlation between MALAT1 and miR 181 a in AMI . The binding sites between MALAT1 and miR-181a were predicted using the lncBase online prediction database and validated by dual luciferase reporter assay. An oxidative stress model of myocardial cells was established by hydro gen peroxide (H2O2 ) treatment in AC16 human myocardial cell line . siRNA targeting MALAT1 ( si-MALAT) and negative control siRNA ( si-NC) were transfected into AC16 cells , and the cells were divided into H2O2 treatment (H2O2 ) group , H2 O2 + si NC group , and H2O2 + si-MALAT group . Cell proliferation activity was detected by CCK-8 assay , cell apoptosis was assessed by TUNEL assay , and the expression levels of cleaved caspase-3 , Bcl-2 associated X protein (Bax ) , and B cell lymphoma-2 ( Bcl-2) were determined by Western blot. Results : Compared to the Normal group , the expression of MALAT1 was upregulated and the expression of miR-181a was down regulated in the AMI group (P < 0.05) , and there was a negative correlation between MALAT1 and miR-181a expression. The lncBase online prediction database and dual-luciferase reporter assay results had proven that MAL AT1 could target and regulate the expression of miR 181 a. Compared to the H2O2 group, the H2O2 + si MALAT group showed increased cell viability (P < 0.05) , decreased TUNEL positive rate (P < 0.05) , decreased expres sion levels of cleaved caspase-3 and Bax (P < 0.05) , and increased expression level of Bcl-2 (P < 0.05) , while the H2O2 + si NC group showed no significant changes (P > 0.05) . Conclusion LncRNA MALAT1 expression is elevated in AMI patients , which could promote oxidative stress induced myocardial cell damage through targeted inhibition of miR-181a.

Quantum dots are an emerging semiconductor nanocrystalline material with optical and electronic properties. Quantum dots in the environment are transmitted into human body mainly via digestive system. Quantum dots in the workplace are transmitted into human body via various pathways such as the respiratory tract and mucocutaneous surface. They cross the blood brain barrier to affect the nervous system, eventually leading to irreversible damage. Quantum dots have more complex biological toxicity than ordinary nanomaterials and metal ions, due to their core-shell structure and surface modifiers. The physicochemical properties of quantum dots, such as particle size, surface modification, and charge, greatly influence their neurotoxic effects. Quantum dots can induce oxidative stress and inflammatory responses, causing neuronal damage and functional impairment, thereby affecting learning, memory, and synaptic plasticity. Its mechanisms may be the modulation of signaling pathways such as the mitogen-activated protein kinase/extracellular signal regulated kinase pathway. In the future, the neurotoxicity of different types of quantum dots should be systematically analyzed, and multi-omics methods should be used to elucidate the mechanism of quantum dots on neuronal damage to improve the safety of workers exposed to quantum dots.

Objective To investigate the knowledge,attitude and practice of nurses from hospitals in Tibet Autonomous Region on the use of peripheral venous needle and analyze the influencing factors.Methods Utilizing a convenience sampling approach,we conducted a survey from November to December 2023 involving 1 319 nurses from 62 hospitals across 7 cities(regions)of Tibet Autonomous Region.Custom-made electronic questionnaires were utilized.Results A total of 1 320 questionnaires were collected,of which 1 319 were valid,with an effective response rate of 99.92％.The scores of nurses'knowledge,attitude and practice were 46.24±13.68,79.75±10.30,and 60.38±14.15,respectively.808(61.26％)nurses had received relevant training experience.The results of multiple linear regression analysis showed that the influencing factors of nurses'knowledge of peripheral venous indwelling needle included whether they had received training experience,ethnicity,education background,professional title,department and hospital region(P＜0.05).Training experience,ethnicity,educational background,profession title and hospital region were the influence factors of nurses'attitude of venous indwelling needle(P＜0.05).Whether they had received training,ethnicity,education background,department and hospital region were the influencing factors of nurses'practice of peripheral venous indwelling needle(P＜0.05).Conclusion Nurses from hospitals in Tibet Autonomous Region have a good attitude towards using venous indwelling needle.However,the knowledge level is not ideal and the practice is still needed to be improved.Nursing managers should implement targeted training and enrich the training form and content,so as to meet the needs of nurses and to improve the quality of intravenous therapy in the Tibet Autonomous Region.

Objectives:To develop and validate predictive models for esophageal squamous cell carcinoma (ESCC) using circulating cell-free DNA (cfDNA) terminal motif analysis. The goal was to improve the non-invasive detection of early-stage ESCC and its precancerous lesions.Methods:Between August 2021 and November 2022, we prospectively collected plasma samples from 448 individuals at the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences for cfDNA extraction, library construction, and sequencing. We analyzed 201 cases of ESCC, 46 high-grade intraepithelial neoplasia (HGIN), 46 low-grade intraepithelial neoplasia (LGIN), 176 benign esophageal lesions, and 29 healthy controls. Participants, including ESCC patients and control subjects, were randomly assigned to a training set ( n=284) and a validation set ( n=122). The training cohort underwent z-score normalization of cfDNA terminal motif matrices and a selection of distinctive features differentiated ESCC cases from controls. The random forest classifier, Motif-1 (M1), was then developed through principal component analysis, ten-fold cross-validation, and recursive feature elimination. M1's efficacy was then validated in the validation and precancerous lesion sets. Subsequently, individuals with precancerous lesions were included in the dataset and participants were randomly allocated to newly formed training ( n=243), validation ( n=105), and test ( n=150) cohorts. Using the same procedure as M1, we trained the Motif-2 (M2) random forest model with the training cohort. The M2 model's accuracy was then confirmed in the validation cohort to establish the optimal threshold and further tested by performing validation in the test cohort. Results:We developed two cfDNA terminal motif-based predictive models for ESCC and associated precancerous conditions. The first model, M1, achieved a sensitivity of 90.0%, a specificity of 77.4%, and an area under the curve (AUC) of 0.884 in the validation cohort. For LGIN, HGIN, and T1aN0 stage ESCC, M1's sensitivities were 76.1%, 80.4%, and 91.2% respectively. Notably, the sensitivity for jointly predicting HGIN and T1aN0 ESCC reached 85.0%. Both the predictive accuracy and sensitivity increased in line with the cancer's progression ( P＜0.001). The second model, M2, exhibited a sensitivity of 87.5%, a specificity of 77.4%, and an AUC of 0.857 in the test cohort. M2's sensitivities for detecting precancerous lesions and ESCC were 80.0% and 89.7%, respectively, and it showed a combined sensitivity of 89.4% for HGIN and T1aN0 stage ESCC. Conclusions:Two predictive models based on cfDNA terminal motif analysis for ESCC and its precancerous lesions are developed. They both show high sensitivity and specificity in identifying ESCC and its precancerous stages, indicating its potential for early ESCC detection.

Objective:To evaluate the incidence of arrhythmias and electrocardiographic (ECG) characteristics in cancer patients treated with immune checkpoint inhibitors (ICIs).Methods:This was a cohort study conducted in the Fourth Hospital of Hebei Medical University. Cancer patients initiating ICIs treatments from November 2020 to September 2022 were included in this study. Baseline 12-leads ECG before ICIs initiation and post-treatment ECG were analyzed. An abnormal ECG was defined as the presence of any of the following changes: sinus arrhythmias, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia, premature contractions, conduction disorder, and ST-T changes.Results:A total of 87 patients were enrolled, aged 63 (57, 68) years, with 66 (75.9%) males. And 44.8% (39/87) of patients presented with at least one confirmed cardiovascular disease or cardiovascular risk factor at baseline. The incidence of abnormal ECG increased from 31.0% (27/87) at baseline to 65.5% (57/87) after receiving (5.0±2.7) cycles of ICIs treatment ( P<0.001). The incidence of sinus arrhythmias was significantly increased after ICIs treatment (23.0% (20/87) vs. 9.2% (8/87), P=0.023), of which only the incidence of sinus tachycardia was significantly increased (11.5% (10/87) vs. 2.3% (2/87), P=0.039). There was also a significantly increased incidence of ST-T changes after ICIs treatment (31.0% (27/87) vs. 17.2% (15/87), P=0.012), which mainly attributed to the T wave changes (29.9% (26/87) vs. 13.8% (12/87), P=0.001). The incidence of premature contractions was also significantly increased after ICIs treatment (9.2% (8/87) vs. 0, P=0.008). Additionally, compared with baseline, the P wave axis was significantly increased after ICIs treatment ((56.94±21.01)° vs. (52.00±22.69)°, P=0.043). After ICIs treatment, the heart rate was significantly increased ((79.07±15.37) beats/min vs. (75.64±13.37) beats/min, P=0.029). Sokolow-Lyon index ((2.21±0.81)mV vs. (2.33±0.75)mV, P=0.138), QTc interval ((431.44±36.04)ms vs. (428.00±30.05)ms, P=0.415) all showed signs of change after treatment, but did not reach the traditional significant level. Conclusions:The incidence of abnormal ECG is significantly increased after ICIs treatment, especially for sinus tachycardia, premature contractions and T wave changes; the P wave axis and heart rate is also significantly increased after treatment. It is important to perform regular ECG monitoring in patients receiving ICIs treatment.

Objectives:To develop and validate predictive models for esophageal squamous cell carcinoma (ESCC) using circulating cell-free DNA (cfDNA) terminal motif analysis. The goal was to improve the non-invasive detection of early-stage ESCC and its precancerous lesions.Methods:Between August 2021 and November 2022, we prospectively collected plasma samples from 448 individuals at the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences for cfDNA extraction, library construction, and sequencing. We analyzed 201 cases of ESCC, 46 high-grade intraepithelial neoplasia (HGIN), 46 low-grade intraepithelial neoplasia (LGIN), 176 benign esophageal lesions, and 29 healthy controls. Participants, including ESCC patients and control subjects, were randomly assigned to a training set ( n=284) and a validation set ( n=122). The training cohort underwent z-score normalization of cfDNA terminal motif matrices and a selection of distinctive features differentiated ESCC cases from controls. The random forest classifier, Motif-1 (M1), was then developed through principal component analysis, ten-fold cross-validation, and recursive feature elimination. M1's efficacy was then validated in the validation and precancerous lesion sets. Subsequently, individuals with precancerous lesions were included in the dataset and participants were randomly allocated to newly formed training ( n=243), validation ( n=105), and test ( n=150) cohorts. Using the same procedure as M1, we trained the Motif-2 (M2) random forest model with the training cohort. The M2 model's accuracy was then confirmed in the validation cohort to establish the optimal threshold and further tested by performing validation in the test cohort. Results:We developed two cfDNA terminal motif-based predictive models for ESCC and associated precancerous conditions. The first model, M1, achieved a sensitivity of 90.0%, a specificity of 77.4%, and an area under the curve (AUC) of 0.884 in the validation cohort. For LGIN, HGIN, and T1aN0 stage ESCC, M1's sensitivities were 76.1%, 80.4%, and 91.2% respectively. Notably, the sensitivity for jointly predicting HGIN and T1aN0 ESCC reached 85.0%. Both the predictive accuracy and sensitivity increased in line with the cancer's progression ( P＜0.001). The second model, M2, exhibited a sensitivity of 87.5%, a specificity of 77.4%, and an AUC of 0.857 in the test cohort. M2's sensitivities for detecting precancerous lesions and ESCC were 80.0% and 89.7%, respectively, and it showed a combined sensitivity of 89.4% for HGIN and T1aN0 stage ESCC. Conclusions:Two predictive models based on cfDNA terminal motif analysis for ESCC and its precancerous lesions are developed. They both show high sensitivity and specificity in identifying ESCC and its precancerous stages, indicating its potential for early ESCC detection.

Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.

Objective To explore the association between peripheral retinal defocus and myopia in adolescents.Methods This study encompassed 192 adolescents(192 right eyes),aged between eight and fifteen years,who sought treatment at Ineye Hospital of Chengdu University of TCM from October 2022 to April 2023.Based on the spherical equiva-lent(SE),the patients were divided into three groups:Emmetropia(E),low myopia(LM),and moderate myopia(MM),with each group comprising 64 patients(64 right eyes).After mydriatic refraction,the SE values were documen-ted.Ocular biological parameters,including axial length(AL),central corneal thickness(CCT),lens thickness(LT),and keratometry values(K1,K2),were obtained using IOL Master 900.Multispectral refraction topography was employed to measure the retinal defocus:positive values indicated hyperopic defocus,while negative ones represented myopic defocus.With the macular fovea as the center,the total retinal defocus value was recorded as TRDV.The ring partition(eccentrici-ty)was divided into 0°-10°、＞10°-20°、＞20°-30°、＞30°-40°、＞40°-53°,which was recorded as RDV-0°-10°,RDV-10°-20°,RDV-20°-30°,RDV-30°-40°,and RDV-40°-53°,respectively;the quadrants were recorded as RDV-Superior(RDV-S),RDV-Inferior(RDV-I),RDV-Temporal(RDV-T)and RDV-Nasal(RDV-N),respectively.The variance of RDV across different ranges was analyzed using One-Way ANOVA and non-parametric tests.The associations between SE,AL and RDV were examined using Spearman and Pearson correlation analyses.Results The RDV-20°-30°,RDV-30°-40° and RDV-40°-53° of Groups E,LM and MM all exhibited hyperopic defocus.Statistically significant differences were identi-fied in TRDV,RDV-10°-20°,RDV-20°-30°,RDV-30°-40°,RDV-40°-53°,RDV-S,RDV-T and RDV-N among the three groups(all P＜0.05).TRDV,RDV-20°-30°,RDV-30°-40°,RDV-40°-53°,RDV-S,RDV-T,and RDV-N were found to be negatively correlated with SE while positively correlated with AL(all P＜0.05).RDV-0°-10° and RDV-I were uncorrelated with both SE and AL(all P＞0.05);RDV-10°-20° was positively correlated with AL(P=0.012)while uncorrelated with SE(P=0.233).Conclusion Peripheral retinal hyperopic defocus tends to advance with escalating eccentricity and my-opia.Peripheral retinal defocus is asymmetrical.Peripheral(10°-53°),superior,nasal and temporal retinal defocus may be closely related to the development of myopia.