Objective To analyze the evaluation indicators of pre-hospital first aid for adult patients with acute severe trauma to provide the evidence-based basis for the initiation of "zero channel" in first aid work.Methods The literatures such as expert consensus,clinical research,guideline and systematic review were retrieved from PubMed,Medline,Embase,Cochrane Central Register of Controlled Trials,and China Knowledge Network by computer.The retrieval time was from January 2013 to November 2023.After screen-ing the literatures according to the standard,the quality evaluation and evidence grading were conducted by a-dopting different tools.Results A total of 8 literatures were included,including 4 clinical studies,2 expert consensus and 2 systematic reviews.Finally,10 evidence-based evidences for the initiation of "zero channel" in adult patients with acute severe trauma were summarized.Conclusion This study summarizes the relevant in-dicators of "zero channel" initiation in the adult patients with acute severe trauma,which is helpful for clinical medical staff to start the first aid "zero channel" in time and increase the success rate of rescue.

Objective:To explore the characteristics of SLCO1B1/ SLCO1B3 gene variants among children with Rotor syndrome (RS). Methods:Four children who were admitted to the Department of Hepatology of Hunan Children′s Hospital between January 2019 and January 2022 were selected as the study subjects. Trio-whole exome sequencing was carried out for the four families, and gel electrophoresis was used to verify an insertional variant of long-interspersed element-1 (LINE-1).Results:Genetic testing has identified three variants of the SLCO1B1 gene, including c. 1738C>T (p.R580*), c. 757C>T (p.R253*) and c. 1622A>C (p.Q541P), and two variants of the SLCO1B3 gene, including c. 481+ 22insLINE-1 and c. 1747+ 1G>A among the children. Three of them were found to harbor homozygous variants of the SLCO1B1/ SLCO1B3 genes, and one has harbored compound heterozygous variants. Sanger sequencing confirmed the existence of all variants, and gel electrophoresis has confirmed the existence of the LINE-1 insertional variant of about 6 kb within intron 6 of the SLCO1B3 gene in all children. Conclusion:The pathogenesis of the RS among the four children may be attributed to the variants of the SLCO1B1/ SLCO1B3 genes. The LINE-1 insertion variant of the SLCO1B3 gene may be common among Chinese RS patients.

Objective:To explore the latent classes of recurrence risk perception in ischemic stroke patients and their relationship with health behaviors.Methods:Convenience sampling was used to select 312 patients with ischemic stroke from two ClassⅢ Grade A hospitals of Guangzhou from December 2022 to June 2023 as the research subject. Before discharge, the General Information Questionnaire, Recurrence Risk Perception Scale for Patients with Stroke, and Health Behavior Scale for Stroke Patients were used for investigation. One month later, the Health Behavior Scale for Stroke Patients was used for follow-up. Latent class analysis and multiple Logistic regression analysis were used to explore the latent classes of recurrence risk perception and their influencing factors, while multiple linear regression was used to analyze the relationship between latent classes of recurrence risk perception and health behavior at 1-month follow-up.Results:A total of 312 questionnaires were distributed, and 302 valid questionnaires were collected, with an effective response rate of 96.79%. One month later, 261 study subjects completed follow-up. The recurrence risk perception in ischemic stroke patients were divided into four classes of overall low perceived accuracy, light consequence-heavy disease-moderate perceived accuracy, heavy self-care-light diet-upper moderate perceived accuracy, and overall high perceived accuracy. Age, educational level, place of residence and monthly average income were influencing factors for different latent classes ( P<0.05). Compared with patients with overall low perceived accuracy, patients with heavy self-care-light diet-upper moderate perceived accuracy, as well as those with overall high perceived accuracy, showed better health behavior after discharge, with a statistically significant difference ( P<0.05) . Conclusions:Medical and nursing staff should provide targeted nursing interventions based on the common characteristics and individual differences of different classes of patients, helping patients correctly perceive the recurrence risk, improve health behavior, and prevent stroke recurrence.

Objective To search,evaluate and summarize the relevant evidence of management on xerostomia and thirst of maintenance hemodialysis(MHD)patients,and provide the evidence for clinical medical staff to relieve the symptoms of xerostomia and thirst in MHD patients.Methods We search guideline websites such as the BMJ Best Practice,UpToDate,NICE,GIN,NGC,CMA Infobase,Medlive,and databases such as Cochrane Library,JBI,PubMed,Embase,CINAHL,CNKI,Wanfang,VIP,SinoMed related to interventions on xerostomia and thirst of MHD patients.The literature types include guidelines,expert consensuses,clinical decisions,best practice,evidence summaries,systematic reviews,randomized controlled trials.The search period is from January 1,2013 to September 30,2023.Results A total 12 pieces of the literature were included,including 3 systematic reviews and 9 randomized controlled trials.A total of 19 pieces of evidence were summarized in 6 aspects,including evaluation,basic interventions,oral local interventions,auricular acupressure,dialysis scheme,Chinese herbal medicine combined with acupoint therapy and Chinese herbal medicine therapy.Conclusion Blood purification medical staff should comprehensively consider MHD patients and specific clinical situations,and make interventions to relieve the symptoms of xerostomia and thirst of MHD patients,relieve their physical and mental pain and improve their quality of life.

Objective:To investigate the therapeutic mechanism of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating mild amnestic cognitive impairment (aMCI).Methods:Twenty-five patients with aMCI were randomly divided into an observation group of 13 and a control group of 12. The observation group was given 10-Hz rTMS over the left dorsolateral prefrontal cortex at 80% of the motor threshold-400 pulses a day, 5 times a week for 4 consecutive weeks. The control group received sham stimulation on the same schedule. Before and after the experiment, both groups were evaluated using the Montreal cognitive assessment (MoCA) and received fMRI scans.Results:After the intervention, the average MoCA score of the observation group had improved significantly more compared with that of the control group and compared with before the intervention. According to the fMRI results, regional homogeneity in the right middle frontal gyrus of the observation group had increased significantly, while that of the control group both there and in the left precuneus had decreased significantly.Conclusions:High-frequency rTMS can effectively improve the cognitive function of patients with aMCI and synchronize neuron activity in cognition-related brain regions.

Objective:To explore the effect of the Six Sigma management in reducing the pre-examination and triage error rate of emergency acute abdominal diseases.Methods:Data of 367 misdiagnosed patients in Emergency Department of Shanxi Bethune Hospital from January to June 2018 were collected. Six Sigma management method was applied to the management of emergency acute abdomen triage. After analyzing the causes of errors, improvement measures were formulated and implemented.A total of 118 patients who were triaged from September 2018 to February 2019 were taken as the intervention group to evaluate the effect.Results:After the implementation of Six Sigma management, the errors of acute abdomen diagnosis were significantly reduced from 9.92%(367/3 698) to 2.80%(118/4 219), and there was a significant difference before and after the implementation ( χ2 value was 174.082, P < 0.05). Conclusions:The application of Six Sigma management method can effectively reduce the misdiagnosis rate of emergency acute abdomen triage and realize standardized management of acute abdomen triage, which has the value of popularization and application.

OBJECTIVE： To study the difference of the contents of copper， lead， cadmium， mercury and arsenic in the single decoction and combined decoction of Huangqi jianzhong decoction （containing Astragali radix， Cinnamomi ramulus， Paeoniae radix alba， prepared Glycyrrhiza uralensis， Zingiberis rhizoma recens， Jujubae fructus）， and to provide reference for safe use of TCM in clinic. METHODS： Samples of medicinal materials， single decoction and combined decoction were prepared from different medicinal materials； the contents of copper， lead， cadmium， mercury and arsenic in various samples were determined by atomic absorption spectrophotometry， which were compared with the limits of copper （＜20 mg/kg）， lead （＜5 mg/kg）， cadmium （＜0.3 mg/kg）， mercury （＜0.2 mg/kg） and arsenic （＜2 mg/kg） content stated in 2015 edition of Chinese Pharmacopeia and Green Trade Standards of Importing Exporting Medicinal Plants Preparations. The difference of 5 elements contents were compared between single decoction and combined decoction. RESULTS： Among the 6 medicinal materials， the cadmium content of Cinnamomi ramulus and Zingiberis rhizoma recens exceeded the standard， 0.32， 0.74 mg/kg， respectively （copper， lead， mercury and arsenic all met the requirements）， and the 5 elements content of other medicinal materials all met the requirements； the contents of copper， lead， cadmium， mercury and arsenic in the single and combined decoction meet the requirements； compared with the medicinal materials， the contents of copper， lead， cadmium， mercury and arsenic in the single decoction were lower （P＜0.01）； compared with mixture of single decoction， the contents of copper and mercury in combined decoction were lower （P＜0.01）， while the contents of lead， cadmium and arsenic in the decoction were higher （P＜0.01）. CONCLUSIONS： For Huangqi jianzhong decoction， combined decoction can reduce the dissolution of copper and mercury， and increase the dissolution of lead， cadmium and arsenic. The possible reason is that the interaction of various components in the co-decoction process changes the solubility of copper， lead， cadmium， mercury and arsenic.

Phenol-soluble modulins (PSMs) are a novel family of small amphipathic, alpha-heli-cal peptides with strong surfactant-like properties. PSMs have multiple roles in staphylococcal pathogenesis and are considered as important virulence-associated factors. They may cause lysis of many eukaryotic cells, such as human neutrophils,erythrocytes and dendritic cells;induce the expression of pro-inflammatory cyto-kines;facilitate the structuring and detachment of biofilms;influence the expression of other genes. This re-view summarizes the classification,structure,regulatory effect on gene expression and biological function of PSMs. The potential avenues to target PSMs for drug development against staphylococcal infections are also evaluated in this paper.

Objective: To observe effects of exogenous high mobility group protein box 1 (HMGB1) on angiogenesis in ischemic zone of early scald wounds of rats. Methods: Thirty-six Sprague-Dawley rats were divided into HMGB1 group and simple scald (SS) group according to the random number table, with 18 rats in each group. Comb-like copper mould was placed on the back of rats for 20 s after being immersed in 100 ℃ hot water for 3 to 5 min to make three ischemic zones of wound. Immediately after scald, rats in HMGB1 group were subcutaneously injected with 0.4 μg HMGB1 and 0.1 mL phosphate buffer solution (PBS), and rats in SS group were subcutaneously injected with 0.1 mL PBS from boarders of ischemic zone of scald wound. At post scald hour (PSH) 24, 48, and 72, 6 rats in each group were collected. Protein expressions of vascular endothelial growth factor (VEGF) in ischemic zone of wound at PSH 24, 48, and 72 and protein expressions of CD31 in ischemic zone of wound at PSH 48 and 72 were detected by immunohistochemistry. The number of microvessel in CD31 immunohistochemical sections of ischemic zone of wound at PSH 48 and 72 was calculated after observing by the microscope. The mRNA expressions of VEGF and CD31 in ischemic zone of wound were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction at PSH 24, 48, and 72. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PSH 24, 48, and 72, protein expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=7.496, 4.437, 5.402, P<0.05 or P<0.01). At PSH 48 and 72, protein expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were 0.038 8±0.007 9 and 0.057 7±0.001 2 respectively, significantly higher than 0.013 4±0.004 9 and 0.030 3±0.004 0 of rats in SS group (t=10.257, 15.055, P<0.01). (2) At PSH 48 and 72, the number of microvessel in ischemic zone of wound of rats in HMGB1 group was obviously more than that of rats in SS group (t=3.536, 4.000, P<0.05). (3) At PSH 24, 48, and 72, mRNA expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.406, 3.821, 3.356, P<0.05). At PSH 24 and 48, mRNA expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.113, 3.466, P<0.05). At PSH 72, mRNA expressions of CD31 in ischemic zone of wound of rats in 2 groups were close (t=0.010, P>0.05). Conclusions Exogenous HMGB1 can promote angiogenesis in ischemic zone of early scald wounds of rats by increasing expressions of VEGF and CD31.

BACKGROUND: We previously showed that the expression of follistatin-like protein 1 (FSTL1) was significantly down-regulated in metastatic clear-cell renal cell carcinoma (ccRCC). In this study, we aimed to characterize the role of FSTL1 in the development of ccRCC. METHODS: The effects of FSTL1 on cell activity and cell cycle were investigated in ccRCC cell lines with altered FSTL1 expression. Gene expression microarray assays were performed to identify the major signaling pathways affected by FSTL1 knockdown. The expression of FSTL1 in ccRCC and its effect on postoperative prognosis were estimated in a cohort with 89 patients. RESULTS: FSTL1 knockdown promoted anchorage-independent growth, migration, invasion, and cell cycle of ccRCC cell lines, whereas FSTL1 overexpression attenuated cell migration. FSTL1 knockdown up-regulated nuclear factor-κB (NF-κB) and hypoxia-inducible factor (HIF) signaling pathways, increased epithelial-to-mesenchymal transition, up-regulated interleukin-6 expression, and promoted tumor necrosis factor-α-induced degradation of NF-κB inhibitor (IκBα) in ccRCC cell lines. FSTL1 immunostaining was selectively positive in epithelial cytoplasm in the loop of Henle, and positive rate of FSTL1 was significantly lower in ccRCC tissues than in adjacent renal tissues (P < 0.001). The multivariate Cox regression analysis showed that the intratumoral FSTL1 expression conferred a favorable independent prognosis with a hazard ratio of 0.325 (95% confidence interval 0.118-0.894). HIF-2α expression was negatively correlated with FSTL1 expression in ccRCC specimens (r = - 0.229, P = 0.044). Intratumoral expression of HIF-2α, rather than HIF-1α, significantly predicted an unfavorable prognosis in ccRCC (log-rank, P = 0.038). CONCLUSIONS FSTL1 plays a tumor suppression role possibly via repressing the NF-κB and HIF-2α signaling pathways. To increase FSTL1 expression might be a candidate therapeutic strategy for metastatic ccRCC.
Adult ; Aged ; Aged, 80 and over ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Carcinoma, Renal Cell ; genetics ; pathology ; Cell Line, Tumor ; Cell Movement ; genetics ; Disease-Free Survival ; Epithelial-Mesenchymal Transition ; genetics ; Female ; Follistatin-Related Proteins ; genetics ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; Male ; Middle Aged ; NF-kappa B ; genetics ; Neoplasm Metastasis ; Signal Transduction ; genetics ; Tumor Suppressor Proteins ; genetics