Objective To investigate the impact of ropivacaine on apoptosis of lippolysaccharide(LPS)-induced ulcerative colitis cell line NCM-460 and on activity of nucleotide oligomerization domain(NOD)-like receptor protein-3(NLRP3)inflammatome.Methods Human colon epithelial cell line NCM-460 was cultured in vitro and divided into control group(no intervention),model group(10 μg/mL LPS treatment),low/medium/high concentration ropivacaine group(10 μg/mL LPS and 0.5,1,1.5 mmol/L ropivacaine co-treatment,respectiv-oly).Cell viability was determined by cell counting kit 8(CCK-8)and the appropriate concentration was selected.The cells were then divided into control group,model group,ropivacaine group(10 μg/mL LPS and 1.5 mmol/L ropivacaine treatment)and ropivacaine+inhibitor group(10 μg/mL LPS,1.5 mmol/L ropiva-caine and 1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment),inhibitor group(10 μg/mL LPS+1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment)and ropivacaine+activator group(10 μg/mL LPS,1.5 mmol/L ropivacaine and 1 μmol/L NF-κB pathway activator Prostratin),all groups were treated for 24 h.The level of IL-6,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay(ELISA).The proliferation rate was detected by EdU incorporation.Hoechst 33258 staining microscopy was used to detect the apoptosis rate.Level of cyclinD1,caspase-3,NLRP3 and NF-κB pathway-related proteins were detected by Western blot.Results Compared with the control group,the cell viability of the model group was significantly decreased and the cell viability of high-concentration experimental group was increased after adding ropivacaine(P＜0.05).So,1.5 mmol/L ropivacaine was selected for the follow-up experiment.Compared with the control group,the concentration of inflammatory cytokines IL-6,IL-8,TNF-α,apoptosis rate and the protein expression of caspase-3,NLRP3 and phosphorylated p-NF-κB in model group were all significantly increased(P＜0.05),while the proliferation rate and cycilnD1 protein expression were decreased(P＜0.05).Com-pared with model group,the concentrations of IL-6,IL-8,TNF-α,apoptosis rate and the expression of caspase-3,NLRP3 and p-NF-κB protein in ropivacaine group and inhibitor group were significantly decreased(P＜0.05),while the proliferation and cycilnD1 protein expression were increased(P＜0.05).Compared with ropivacaine group,the trend of the above indexes in ropivacaine+inhibitor group was more significant(P＜0.05),and the trend of these indexes in ropivacaine+agonist group was significantly reversed(P＜0.05).Conclusions Ropivacaine can inhibit the activation of NLRP3 inflammasome and block the signal transduction of NF-κB pathway,further inhibit LPS-induced apoptosis of NCM-460 cells and promote proliferation.

AIM:This study aimed to investigate the effects of sinomenine hydrochloride(SIN)on the ultra-structure of renal tissue and the expression of interferon gene-stimulating factor in db/db mice.METHODS:Sixteen 12-week-old male db/db mice were randomly divided into two groups:a model group and a sinomenine hydrochloride(SIN)group,each consisting of 8 mice.An additional 8 wild-type(WT)mice served as the normal control group.The sinome-nine hydrochloride group was administered the treatment for 8 weeks,followed by a 20-week observation period,while the normal and model groups received an equal volume of saline via gavage.Weekly measurements were taken for body weight and fasting blood glucose.Serum creatinine(SCr)and blood urea nitrogen(BUN)levels were assessed,and 24-hour uri-nary microalbumin(ALB)levels,as well as serum inflammatory cytokines interleukin-1β(IL-1β),IL-6 and tumor necro-sis factor-α(TNF-α),were determined using ELISA.Pathological changes in renal tissue were evaluated through hema-toxylin-eosin(HE)staining,while ultrastructural alterations were examined using transmission electron microscopy.Im-munohistochemistry and Western blotting were employed to assess STING protein expression in renal tissue,and STING mRNA expression was quantified via RT-qPCR.RESULTS:Compared to the normal group,the model group exhibited significant increases in BUN,ALB,and SCr levels(P<0.01),alongside elevated inflammatory markers IL-1β,IL-6,and TNF-α(P<0.01).Notable pathological changes included leukocyte wall thickening in capillaries,inflammatory cell infiltration,increased mesangial matrix,disorganized and linear alignment of podocytes,and thickening of the basement membrane.Moreover,STING protein and mRNA expression levels were significantly elevated(P<0.01).In contrast,the sinomenine hydrochloride group demonstrated significantly reduced levels of renal function markers(BUN,ALB and SCr)compared to the model group(P<0.01),as well as decreased concentrations of inflammatory factors IL-1β,IL-6,and TNF-α(P<0.01).Improvements in renal histopathology included decreased leukocyte wall thickening,reduced inflam-matory cell presence,diminished mesangial matrix,and a significant reduction in foot process fusion,alongside thinner basement membranes.Both STING protein and mRNA expression levels were also significantly lower(P<0.01).CON-CLUSION:Sinomenine hydrochloride effectively mitigates renal tissue injury,improves ultrastructural alterations,and inhibits inflammatory responses in db/db mice.Its mechanism of action appears closely linked to the downregulation of STING protein and mRNA expression.

Objective To investigate the differences in the influencing factors for acute necrotizing pancreatitis (ANP) and infectious pancreatic necrosis (IPN) between Eastern and Western countries, and to provide a theoretical basis for the prediction and prevention of ANP. Methods Databases including PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles on the influencing factors for ANP and IPN published up to January 21, 2021, and a Meta-analysis was performed. Results A total of 59 studies were included, with 22 studies from Eastern countries and 37 studies from Western countries.The Meta-analysis showed that in Eastern countries, male sex (odds ratio[ OR ]=1.51, 95% confidence interval[ CI ]: 1.18-1.91, P < 0.01), C-reactive protein (CRP)(standardized mean difference[ SMD ]=1.39, 95% CI : 1.06-1.71, P < 0.01), D-dimer ( SMD =0.44, 95% CI : 0.07-0.81, P =0.02), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE-Ⅱ) score (mean difference[ MD ]=3.51, 95% CI : 1.38-5.64, P < 0.01), alcoholic etiology ( OR =3.57, 95% CI : 2.68-4.75, P < 0.01), and biliary etiology ( OR =0.60, 95% CI : 0.46-0.77, P < 0.01) were the influencing factors for ANP, and in Western countries, male sex ( OR =1.63, 95% CI : 1.30-2.05, P < 0.01), CRP ( SMD =2.09, 95% CI : 1.12-3.05, P < 0.01), APACHE-Ⅱ score ( MD =4.28, 95% CI : 2.73-5.83, P < 0.01), Ranson score ( MD =2.99, 95% CI : 2.50-3.47, P < 0.01), and organ failure ( OR =10.87, 95% CI : 2.62-45.04, P < 0.01) were the influencing factors for ANP.In Eastern countries, age ( MD =2.16, 95% CI : 0.43-3.89, P =0.01), body mass index (BMI)( MD =1.74, 95% CI : 1.23-2.25, P < 0.01), albumin level ( SMD =-0.43, 95% CI : -0.75 to-0.12, P < 0.01), CRP ( SMD =0.58, 95% CI : 0.04-1.11, P =0.03), procalcitonin ( SMD =0.80, 95% CI : 0.56-1.04, P < 0.01), D-dimer ( MD =0.23, 95% CI : 0.15-0.31, P < 0.01), APACHE-Ⅱ score ( MD =2.47, 95% CI : 0.73-4.22, P < 0.01), Ranson score ( MD =1.60, 95% CI : 1.46-1.73, P < 0.01), and extent of necrosis ≥30%( OR =2.52, 95% CI : 1.26-5.06, P < 0.01) were the influencing factors for IPN, while in Western countries, age ( MD =4.07, 95% CI : 1.82-6.31, P < 0.01), APACHE-Ⅱ score ( MD =3.28, 95% CI : 1.39-5.17, P < 0.01), Ranson score ( MD =2.18, 95% CI : 1.75-2.62, P < 0.01), SIRS score ( OR =3.88, 95% CI : 1.58-9.51, P < 0.01), alcoholic etiology ( OR =0.61, 95% CI : 0.42-0.87, P < 0.01), and organ failure ( OR =3.63, 95% CI : 1.11-11.92, P =0.03) were the influencing factors for IPN. Conclusion Current evidence shows that biliary etiology and alcoholic etiology are unique influencing factors for ANP in the Eastern population, while Ranson score is a unique influencing factor in the Western population.BMI and extent of necrosis ≥30% are unique influencing factors for IPN in the Eastern population, while alcoholic etiology is a unique influencing factor in the Western population.

Objective:To evaluate and summarize the best evidence of exercise management of cancer-related fatigue in cancer patients.Methods:Evidence-based questions were identified using the PIPOST model to determine retrieval strategies and inclusion and exclusion criteria. According to the "6S" evidence model, the clinical decision-making, best clinical practice, guidelines, systematic review and expert consensus on the exercise management of cancer-related fatigue in cancer patients were searched in UpToDate, British Medical Journal Best Practice, Joanna Briggs Institute Evidence-based Health Care Center Database, Cochrane Library, National Institute for Health and Clinical Excellence, National Comprehensive Cancer Network, Guidelines International Network, Canadian Medical Association: Clinical Practice Guidelines, PubMed, Web of Science, Embase, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc and professional association platform. The retrieval time limit was from the establishment of the database to January 31, 2022. Three researchers evaluated the quality of the literature and collated, evaluated and integrated the evidence.Results:A total of 20 articles were included, including 1 clinical decision-making, 4 guidelines, 2 evidence summaries, 10 systematic reviews, and 3 expert consensus. A total of 25 best evidences were summarized from 8 aspects, namely, safety and effectiveness of exercise, exercise timing, exercise evaluation, exercise principle, exercise mode, exercise intensity and duration, exercise compliance and exercise risk management.Conclusions:The best evidence on the exercise management of cancer-related fatigue in cancer patients provides evidence-based evidence support and reference opinions for clinical standardized exercise. It is suggested that medical and nursing staff should select the best evidence according to the specific clinical situation and individual differences of patients in the process of evidence transformation, and formulate a personalized exercise management plan to alleviate the cancer-related fatigue of patients.

Objective: To investigate the prevalence of postmenopausal osteoporosis (PMOP) and analyze its influencing factors among women at ages of 50 to 59 years in Dali Bai Autonomous Prefecture, Yunnan Province, so as to provide insights into the prevention of PMOP among menopausal women. Methods: Bai Ethnic menopausal women at ages of 50 to 59 years who received healthy examination at the Center of Healthy Examination, Dali Prefecture People's Hospital from June 2017 to May 2021 were selected as the study subjects, and subjects' demographic characteristics, living habits, history of diseases, family history of osteoporosis and history of parturition were collected using self-designed questionnaires. The height, body weight and bone density were measured, and fasting blood glucose, vitamin D3, blood lipids and liver functions were detected. The factors affecting the development of PMOP were identified using a multivariable logistic regression model. Results: Totally 2 000 questionnaires were allocated, and 1 584 valid questionnaires were recovered, with an effective recovery rate of 79.20%. The respondents had a mean age of ( 56.22±2.61 ) years, and mean body mass index ( BMI ) of ( 24.62±2.35 ) kg/m2. There were 497 respondents ( 31.38% ) with a family history of osteoporosis, and the prevalence of PMOP was 20.64%. Multivariable logistic regression analysis identified age ( OR=1.135, 95%CI: 1.074-1.196 ), age of menarche ( OR=1.138, 95%CI: 1.059-1.217 ), duration of menopause (OR=1.425, 95%CI: 1.228-1.622), number of parturition ( >2, OR=5.036, 95%CI: 2.972-7.101 ), smoking ( OR=2.594, 95%CI: 1.767- 3.421 ), alcohol consumption ( OR=2.051, 95%CI: 1.503-2.598 ), family history of osteoporosis ( OR=2.540, 95%CI: 1.769-3.311 ), hypertension ( OR=1.492, 95%CI: 1.406-1.578 ), diabetes ( OR=1.774, 95%CI: 1.581-1.967 ), total cholesterol ( OR=1.483, 95%CI: 1.251-1.716 ), triacylglycerol ( OR=1.801, 95%CI: 1.576-2.026 ), low-density lipoprotein cholesterol ( OR=1.614, 95%CI: 1.498-1.731 ), fasting blood glucose ( OR=1.192, 95%CI: 1.077-1.307 ), BMI ( OR=0.934, 95%CI: 0.862-0.993 ), outdoor activity ( ≥1 time/week, OR: 0.413-0.549, 95%CI: 0.329-0.637 ), age of menopause ( OR=0.909, 95%CI: 0.841-0.977 ), daily intake of calcium ( ≥600 mg, OR: 0.493-0.644, 95%CI: 0.389-0.786 ), vitamin D3 level ( ≥20 ng/mL, OR: 0.604-0.719, 95%CI: 0.523-0.853 ) and high-density lipoprotein cholesterol ( OR=0.658, 95%CI: 0.550-0.767 ) as factors affecting the development of PMOP. Conclusions The prevalence of PMOP in Dali Bai Autonomous Prefecture is similar to the nationwide level in China, and old age, smoking, alcohol consumption, a family history of osteoporosis and high blood lipid levels may increase the risk of PMOP.

Escherichia coli biofilm is a complex membrane aggregation produced by the adhesion and secretion of extracellular polymeric substances by E. coli cells aggregated on specific media. Pathogenic E. coli will evade the immune system and the impact of various harmful factors in the environment after the formation of biofilm, causing sustained and even fatal damage to the host. Cyclic diguanosine monophosphate (c-di-GMP) is a second messenger ubiquitous in bacteria and plays a crucial role in regulating biofilm formation. This paper reviewed the recent studies about the role of c-di-GMP in the movement, adhesion, and EPS production mechanism of E. coli during biofilm formation, aiming to provide a basis for inhibiting E. coli biofilm from the perspective of c-di-GMP.
Bacterial Proteins/genetics* ; Biofilms ; Cyclic GMP/analogs & derivatives* ; Escherichia coli/metabolism* ; Escherichia coli Proteins/metabolism* ; Gene Expression Regulation, Bacterial

This paper reviews the research status of the training and certification of extracorporeal membrane oxygenation nurses at home and abroad and their job competencies, and analyzes its limitations, so as to provide a reference for the training of extracorporeal membrane oxygenation nurses in my country.

Objective:To explore the differences of the diagnostic performance between the most recent 2018 version of liver imaging reporting and data system (LI-RADS v2018) and 2017 version (LI-RADS v2017) based on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI to diagnose hepatocellular carcinoma (HCC) in high-risk patients.Methods:The clinical data and imaging findings of 237 patients in high-risk of HCC who underwent Gd-EOB-DTPA enhanced MRI and obtained postoperative or biopsy pathological results within one month from June 2016 to December 2019 in Tianjin Third Central Hospital were collected retrospectively. A total of 282 observations were obtained as study objects. Two independent radiologists blindly reviewed the preoperative MRI of all patients. The observations were categorized according to LI-RADS v2018 and v2017 respectively. The inter-observer agreement of the categorization between the two radiologists was tested by kappa analysis. With the LR-5 and LR-4+5 as the diagnosis of HCC, the sensitivity, specificity, accuracy, and Youden index of the LI-RADS v2017 and LI-RADS v2018 were evaluated with postoperative histopathological results as references. The McNemar test was used to compare the diagnostic performance between the two versions.Results:The two physicians had good consistency in the categorization of observations, with kappa values between 0.536 and 0.793. Using LR-5 as the criterion for HCC diagnosis, the Youden index (0.687) of LI-RADS v2018 was higher than that of v2017 (0.612). The sensitivity [80.6% (166/206)] and accuracy [82.6% (233/282)] were both higher than those of LI-RADS v2017 [70.4% (145/206) and 75.9%(214/282)] (χ2=19.048, 14.087, both P<0.001). The specificity was slightly lower [88.2%(67/76) and 90.8%(69/76), respectively], but there was no statistical difference (χ2=0.500, P=0.500). With LR-4+5 as the diagnosis of HCC, the diagnostic performance of the two versions was the same. The sensitivity [91.3% (188/206)] and accuracy [87.6% (247/282)] were higher, and the specificity [77.6% (59/76)] were lower than the LR-5 standard of LI-RADS v2018 (χ2=20.045, P<0.001; χ2=5.633, P=0.018; χ2=16.056, P<0.001), and the Youden index (0.689) was also higher than the LR-5 standard of LI-RADS v2018. Conclusions:Based on Gd-EOB-DTPA enhanced MRI, the LI-RADS v2018 has higher sensitivity and accuracy in diagnosing HCC than v2017. Correct use can provide more objective diagnostic evidence for the clinic.