Objective To explore the method for measurement of tritium in nuclear power plant liquid effluent purified by a mixed ion-exchange resin, to verify the feasibility of the method by experiments, and to provide technical support for the development of standard methods for the measurement of tritium in liquid effluent of nuclear power plants. Methods The purification effect of the mixed ion-exchange resin was determined by measuring the quenching factor, conductivity, and β-nuclide adsorption efficiency of the samples purified using the resin. A comparison was made between the ion-exchange resin method and the atmospheric distillation method for tritium determination. The precision and accuracy of the method were verified by calculating the relative standard deviation and the recovery in repeated measurement of samples with different activity concentrations and spiked samples. Results There were no significant differences in quenching factor, conductivity, and tritium activity concentration between the two methods. The adsorption efficiencies of EC20MB resin for common β-nuclides such as carbon, iron, nickel, strontium, yttrium, and cesium ranged from 99.28% to 99.88%. Repeated measurement of the same sample showed relative standard deviations of 5.2%-9.4% and recoveries of 86.8%-107%. Conclusion There were no significant differences between the results of the ion-exchange resin purification method and the atmospheric distillation method. The precision and accuracy of the method met the requirements of the ecological and environmental management authorities for monitoring tritium in liquid effluent from nuclear power plants. This method can be widely used in daily monitoring work.

Objective　To investigate the efficacy of combined use of apigenin and resveratrol in the treatment of non-alcoholic fatty liver disease (NAFLD). Methods　Fifty male C57BL/6 mice were randomly divided into a normal group (n=10) and a model group (n=40). The NAFLD model was established in the model group using carbon tetrachloride (CCl4) and a high-fat diet. After successful modeling, the model group was further divided into a model group, an apigenin group, a resveratrol group, and an apigenin and resveratrol combined group (combined administration group), with 10 mice in each group. The mice were administered once daily for four consecutive weeks. At the end of the administration, the mice in each group were weighed, the eyeballs were taken for blood samples, and the necks were dissected and sacrificed. The livers were dissected and weighed, and the liver index was calculated. The automatic biochemical analyzer was used to detect the serum biochemical indicators of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TG), and total cholesterol (TC) levels in mice. The ELISA method was used to detect the contents of superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GSH-Px) in mouse 10% liver tissue homogenate. HE staining was used to observe the pathological morphology of liver tissue in mice. Results Compared with the normal group, the liver index and serum biochemical ALT, AST, TG, TC levels in the model group were significantly increased (P<0.01), and the liver homogenate MDA was significantly increased (P<0.01), while the levels of SOD, CAT, GSH- Px were decreased significantly (P<0.01). There were a large number of fatty vacuoles and hepatic cord disorders in the liver tissue. Compared with the apigenin group and the resveratrol group, the liver index, and serum biochemical ALT, AST, TG and TC levels in the combined administration group decreased (P<0.05), and the liver homogenate MDA level decreased (P<0.05), and the levels of SOD, CAT and GSH-Px were increased (P<0.05). The number of fatty vacuoles in liver tissues were reduced, hepatic cord disorders were improved. Conclusions The combined administration of apigenin and resveratrol has a protective effect on NAFLD model mice, possibly through the reduction of hepatic enzymes and blood lipid levels, as well as enhanced antioxidant activity. The combination treatment shows better efficacy compared to the apigenin and resveratrol groups.

Intraspinal air is a rare complication of intraspinal anesthesia.Reported cases of intraspinal or intracranial air are mostly associated with the air insufflation resistance test,while those associated with the normal saline resistance test are rare.This article presents a case of intracranial air following intraspinal anesthesia performed using the normal saline resistance method.The patient was a 38-year-old female who underwent elective intraspinal anesthesia for 1 week without obvious cause of perianal swelling and pain.The procedure included incision and drainage of perianal abscess,excision of anal fistula with internal thread insertion,mixed hemorrhoid exfoliation and internal ligation,and electrocautery of anal papilloma.On the second postoperative day,she experienced headaches,dizziness,severe neck and back pain,along with numbness in the arms and inability to touch or move them.Resting in a supine position did not alleviate the symptoms.Head CT revealed scattered multiple air collections in the cranial cavity,with a total volume of approximately 3 mL.After a multidisciplinary consultation,symptomatic supportive treatment including bed rest,fluid supplementation,oxygen therapy,and anti-inflammatory and analgesic treatment was administered,leading to improvement and discharge.Follow-up at 6 months showed no discomfort.Currently,intracranial air is mostly associated with the air insufflation resistance test,while cases following the normal saline resistance method are rare,with unclear pathophysiological mechanisms,diagnosis,treatment,and prevention,necessitating further research.

Objective:To explore the relationship between relapse tendency and childhood maltreatment in methamphetamine-dependent youths,and the role of impulsivity and quality of life in the relationship.Methods:To-tally 287 methamphetamine-dependent youths(160 females,127 males)were selected in compulsory drug rehabili-tation centers.The Relapse Tendency Questionnaire(RTQ),Childhood Trauma Questionnaire-Short Form(CTQ-SF),Barrett Impulsivity Scale(BIS-11)and Quality of Life for Drug Addicts(QOL-DA)for Drug Addicts were used to conduct the survey.SPSS macro program PROCESS was used to test the mediating role.Results:The BIS-11 total scores acted as a partial mediator between the total scores of CTQ-SF and RTQ,with an effect value of 0.03(95％CI:0.01-0.05),the QOL-DA total scores acted as a full mediator between the total scores of CTQ-SF and RTQ,with an effect value of 0.05(95％CI:0.02-0.08),and the scores of BIS-11 and QOL-DA acted as chain mediators between total scores of CTQ-SF and RTQ,with an effect value of 0.01(95％CI:0.00-0.03).Conclusion:Childhood maltreatment,impulsivity,and quality of life may be associated with relapse tendencies in methamphetamine-dependent youths.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the effects and underlying mechanisms of microRNA (miR)-34a on isoflurane anesthesia-induced cognitive dysfunction in aged rats. Methods Forty rats at 20 months of age were randomly divided into control (Con) group, model group, miR-34a inhibitor group and miR-34a mimics group, with 10 rats in each group. Rats in the miR-34a inhibitor and miR-34a mimics groups received a tail vein injection of 100 nmoL/kg of the corresponding drug, while those in the Con and model groups received an equal volume of saline, once daily for 5 consecutive days. At the 6th day, all groups except the Con group underwent a single 6-hour isoflurane anesthesia to establish a postoperative cognitive dysfunction (POCD) model. Twelve hours after modeling, the Morris water maze test was used to assess the escape latency and time spent in the target quadrant. Immunofluorescence staining was performed to observe the positive expression rate of ionized calcium-binding adapter molecule 1 (Iba-1) in the hippocampal tissue. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to measure the relative expression levels of miR-34a, B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X-protein (Bax) mRNA in the hippocampal tissue. Enzyme-linked immunosorbent assay (ELISA) was conducted to detect serum levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), reactive oxygen species (ROS) and glutathione peroxidase (GSH-Px), as well as the content of glutamate (Glu), Ca²⁺ and N-methyl-D-aspartate receptor 2B (NMDAR2B) in the hippocampal tissue. Western blotting was used to determine the relative expression levels of calcium-calmodulin-dependent protein kinase Ⅱ (CaMKⅡ), phosphorylated CaMKⅡ (pCaMKⅡ), cyclophosphoadenosine effector-binding protein (CREB), and phosphorylated CREB (pCREB) in the hippocampal tissue. Results Compared with the Con group, the Model group exhibited significantly prolonged escape latency, elevated serum levels of IL-6 and IL-1β and ROS, as well as increased positive expression rate of Iba-1, relative expression levels of miR-34a and Bax mRNA, contents of Glu, Ca²⁺ and NMDAR2B in the hippocampal tissue; in contrast, the time spent in the target quadrant, serum GSH-Px levels, Bcl-2 mRNA relative expression levels, Bcl-2/Bax, as well as pCaMKⅡ/CaMKⅡ and pCREB/CREB in the hippocampal tissue were significantly reduced (P < 0.05). Downregulation of miR-34a expression shortened the escape latency and decreased serum levels of IL-6, IL-1β and ROS, as well as Iba-1 positive expression rate, relative expression levels of miR-34a and Bax mRNA, Glu, Ca²⁺ and NMDAR2B content in the hippocampal tissue (P < 0.05). It also extended the time spent in the target quadrant and increased serum GSH-Px levels, Bcl-2 mRNA expression levels, Bcl-2/Bax, as well as pCaMKⅡ/CaMKⅡ and pCREB/CREB in the hippocampal tissue (P < 0.05). Upregulation of miR-34a expression promoted abnormal activation of microglia, inflammation, oxidative stress and apoptosis, inhibited the activation of the CaMKⅡ/CREB signaling pathway, and exacerbated cognitive dysfunction in the model rats. Conclusion MiR-34a is highly expressed in POCD in aged rats. Inhibition of miR-34a expression can improve isoflurane anesthesia-induced cognitive dysfunction in aged rats by activating the CaMKⅡ/CREB signaling pathway.

Objective: To screen the differential expression profile of circular RNA (circRNA) in pancreatic cancer and analyze its potential function. Methods: Four pairs of pancreatic cancer tissues and corresponding adjacent pancreatic tissues were selected for high⁃throughput sequencing , and the differentially expressed circRNA was screened according to fold change > 2 and P < 0. 05. qRT⁃PCR was used to detect the expression of 5 randomly selected differentially expressed circRNA in 20 pairs of pancreatic cancer tissue samples. GO and KEGG enrichment analysis of differentially expressed circRNA was performed , and the top 50 circRNA⁃microRNA interaction network was constructed. The relationship between hsa_circ_0046523 and the clinicopathological features of pancreatic cancer was further analyzed , and the effects of hsa_circ_0046523 on the proliferation , migration and invasion of pancreatic cancer cells were observed by functional experiments. Results: A total of 17 182 circRNA were predicted by high⁃throughput sequencing , of which 302 circRNA were differentially expressed including 137 circRNA were upregulated and 165 circRNA were downregulated in pancreatic cancer tissues. The qRT⁃PCR results showed that the expression levels of hsa_circ_0046523 , hsa_circ_0004220 and hsa_circ_0000690 in pancreatic cancer tis⁃sues were significantly upregulated (P<0.05)，while the expression levels of hsa_ ir_0008676 and hisa _ circ_0004416 were significantly downregulated (P<0.05）.which was consistent with the sequencing results.GO analysis indicated that differentially expressed circRNA were mainly involved in substrate-dependent cell migration, protein kinase complex and cytoskeletal protein bindinig.KEGG pathway enrichment analysis showed that differentially expressed circRNA were mainly involved in protein digestion and absorption , ABC transporters , central carbon metabolism in cancer,and glycineserine and threonine metabolism pathways.The expression level of hsa_ circ_0046523 was closely correlated with tumor differentiation (P=0.002),T stage (P=0.006),lymph node metastasis (P=0.011) and TNM stage (P=0.001).Compared with HPDE6-C7 cells the expression of hsa_circ_0046523 significantly inc increased in pancreatic cancer SW1990, Mia PaCa-2BxPC-3 and Capan-2 ceIls (P<0.05). hsa_circ_ 0046523 knockdown significantly inhibited the proliferation, migration and invasion of pancreatic cancer Mia PaCa⁃2 BxPC⁃3 cells (P < 0. 05) . Conclusion There are characteristic differentially expressed circRNAs in pancreatic cancer tissues , and these differentially expressed circRNAs may be involved in the occurrence and development of pancreatic cancer.

Objective:To explore the characteristics of executive function and alterations in monoamine neurotransmitters in methamphetamine-dependent adolescents and to analyse the relationship between executive function and monoamine neurotransmitters.Methods:From January to March 2017, totally 50 female methamphetamine-dependent adolescents and 50 male methamphetamine-dependent adolescents were selected as the experimental group in two compulsory isolation drug rehabilitation centres in Sichuan Province, while normal adolescents (50 males and 50 females) matching the age and gender of the experimental group were recruited as the control group in a school.Executive function was tested by the N-back test, colour word interference test and Hanoita test, and serum levels of dopamine, 5-hydroxytryptamine, epinephrine and norepinephrine were measured using high-performance liquid chromatography with fluorescence detection.Statistical analysis was performed by SPSS 21.0 software.The t-test was used to compare the differences of executive function between the experimental group and control group, and Pearson correlation analysis was used to assess the correlation between executive functions and monoamine neurotransmitters in the experimental group. Results:The differences in the number of correct 0-back responses ((105.38±17.00) vs (114.05±5.29) ) and correct response time ((728.82±110.95) ms vs (652.24±89.88) ms), number of correct 2-back responses ((54.78±23.04) vs ( 74.01±12.01)) and correct response time ((585.74±245.35) ms vs (477.44±181.26) ms), the number of correct responses in the Stroop task ((29.68±7.19) vs (33.60±7.36)) and correct response time ((973.73±228.27) ms vs ( 916.11±98.54) ms), and the number of TOH movement steps ((99.42±32.83) vs (87.70±32.55)) were statistically significant in the experimental group compared to the control group(all P<0.05). In the experimental group, serum dopamine ((5.06±1.55) μg/mL vs (3.18±1.97) μg/mL), 5-hydroxytryptamine ((351.94±119.90) ng/mL vs (149.27±69.24) ng/mL), epinephrine ((555.66±225.55) ng/mL vs (129.20± 81.39) ng/mL), and norepinephrine ((3.63±0.96) ng/mL vs (2.03±0.64) ng/mL) were higher than those in the control group, all with statistically significant differences (all P<0.01). Correlation analysis of executive function with monoamine neurotransmitters showed that serum dopamine level in the experimental group was correlated significantly with the number of correct 0-back, 2-back responses, correct response time, and TOH movement steps ( r=-0.194, 0.170, -0.163, 0.198, 0.196, all P<0.05), 5-hydroxytryptamine level was negatively correlated with the number of correct 0-back, 2-back responses( r=-0.267, -0.375), and was positively correlated with correct response time ( r=0.243, 0.177). Adrenaline content was significantly correlated with the number of correct 0-back and 2-back responses, correct response time, and the number of correct Stroop test responses, correct response time ( r=-0.340, 0.212, -0.415, 0.170, -0.212, 0.178, all P<0.05). Norepinephrine level was correlated significantly with the number of correct 0-back responses, correct response times, correct 2-back responses, correct Stroop test responses, and TOH movement steps ( r=-0.245, 0.266, -0.291, -0.193, 0.226, all P<0.05). Conclusion:The executive function of methamphetamine-dependent adolescents is damaged to a certain extent and the content of monoamine neurotransmitter in serum is increased.There is a correlation between impairment in executive function and serum levels of monoamine neurotransmitters.

OBJECTIVE To explore the difference in th e mechanis m of baicalein and wogonin inhibiting the energy metabolism of hepatoma cells. METHODS Human hepatoma HepG 2 cells were divided into blank control group （without medicine），different dose groups of baicalein and wogonin （1.25，2.5，5，10 and 20 μmol/L）. The effects of baicalein and wogonin on the viability of HepG 2 cells were detected by MTT assay. HepG 2 cells were divided into blank control group （without medicine），baicalein group and wogonin group. After administration ，the concentration of ATP in cell was detected by enhanced ATP kit. The levels of cell glycolysis and mitochondrial energy metabolism were evaluated by glycolysis and mitochondrial pressure test kit ；the affinity of baicalein and wogonin with key enzymes of energy metabolism was predicted by molecular docking ，and the key enzymes of energy metabolism with high affinity were screened ；the expression of key enzymes of energy metabolism was detected by Western blot. RESULTS Within the dose range of 2.5-20 μmol/L，the half inhibitory concentrations of baicalein and wogonin were 12.84 and 24.09 μmol/L；baicalein 1.25 μmol/L and wogonin 2.5 μmol/L had no effect on cell viability ，so it was selected as the dosage for subsequent experiments. Compared with blank control group ，the concentration of ATP in HepG 2 cells decreased significantly in baicalein group and wogonin group （P＜0.05）；the inhibitory effects on basic acidification rate of HepG 2 cells in wogonin group were significantly stronger than those of baicalein group （P＜0.05），but there was no significant difference between them on the basic oxygen consumption rate （P＞0.05）；baicalein had strong binding to pyruvate kinase M 2 and mitochondrial enzyme complexes Ⅰ（CⅠ），C Ⅱ and C Ⅳ，while wogonin only had strong binding to pyruvate kinase M 2； wogonin could significantly down-regulate the protein expressions of hexokinase ，phosphofructokinase，pyruvate kinase M 2，CⅠ， C Ⅱ and C Ⅳ（P＜0.05），but there was no statistical significance in the effect of baicalein on the regulation of these enzymes （P＞ 0.05）. CONCLUSIONS Both baicalein and wogonin can inhibit the energy metabolism of hepatoma HepG 2 cells，but the mechanism is different ：the effect of baicalein is related to the activity of key enzymes ，while the effect of wogonin is related to the inhibition of the expression of key enzymes of energy metabolism.

Objective:To establish a new classification of lateral clavicle fractures and to evaluate its clinical value.Methods:The data of 67 patients with lateral clavicle fractures admitted from January 2016 to December 2020 were included. Thirty-seven cases were from Shanghai First People's Hospital, including 22 males and 15 females, with an average age of 49.1 years (22-78 years). Thirty cases were from the Second Upper Limb Ward of Tianjin Hospital of Tianjin, including 20 males and 10 females, with an average age of 47.6 years (19-76 years). The ligament injury was determined by measuring the coracoclavicular space on Zanca view X-ray and the distance between the fracture fragment on the inferior surface of the 3D-CT and the distal end of the clavicle. All patients were classified according to the new classification (based on the measurement on Zanca view X-ray and 3D-CT reconstruction, the relationship between the fracture and the coracoclavicular ligament footprint, coracoclavicular ligament injury, the injury of the acromioclavicular joint and the stability of the fracture), conservative treatment is preferable for stable fractures, and surgical treatment for unstable fractures. Three experienced orthopaedic surgeons and three radiologists independently observed the imaging data of 67 patients with distal clavicle fractures, determined the fracture type according to the new classification, and randomly reclassified after 4 weeks interval. Finally, 15 cases were randomly selected for internal control (2 junior orthopedic physicians), and the ICC value was used to assess the reliability. Results:The lateral clavicle fractures were divided into 5 types according to the Gongji classification. Type 1: isolated conical tubercle avulsion fracture, and the fracture line is located medial to the coracoid process; Type 2: complete involvement of the trapezoid & conical ligament at the clavicle insertion, and the fracture line extends to the middle of the clavicle, mean while the acromioclavicular joint is intact; Type 3: fracture fragments on the inferior surface involving the trapezoidal/conical ligament, respectively; Type 4: rupture of the conical ligament, and avulsion fracture of the trapezoid ligament; Type 5: conical ligament intact, and avulsion fracture of clavicle insertion of the trapezoid ligament. There were 18 cases of type 1, 4 cases of type 2, 8 cases of type 3, 32 cases of type 4, and 5 cases of type 5. The inter-observer and intra-observer agreement of all included cases was good (inter-group: first ICC=0.764, second ICC=0.778; intra-group: shoulder specialist ICC=0.782, radiologist ICC=0.750, internal control ICC=0.793). Types 1 and 2 fractures were fixed with anatomical plate and coracoid anchor. Type 3 and 4 fractures were fixed with clavicle hook plate and coracoid anchor. And type 5 underwent conservative treatment. At the last follow-up, all patients had no obvious shoulder joint instability and pain, and no internal fixation failure or fixation breakage was found. Conclusion:The Gongji classification has moderate reliability between observers and intra-observers, and the Gongji distal clavicle fracture classification has a good significance for evaluating the stability of the fracture and guiding the selection of the treatment.