Objective:To establish the rat cardiac arrest model in high-altitude hypobaric hypoxia environment, and to explore the effect of the treatment time in the hypobaric oxygen chamber on the reproduction of high-altitude rat cardiac arrest model.Methods:SPF grade healthy male Sprague-Dawley (SD) rats were used as observation subjects. The experiment was conducted in two different altitude areas. The rats from the Plateau Branch of Institute of Cardiopulmonary and Cerebral Resuscitation of Sun Yat-sen University (Xining, Qinghai) were weighed and numbered, and they were placed in a hypobaric oxygen chamber (simulated altitude of 3 000 meters, speed of ascent and descent of 15 m/min, temperature of 20 ℃, cabin pressure of 69.5 kPa, cabin oxygen pressure of 14.5 kPa). After 30 days of feeding, the rats were obtained according to random number table method, and the cardiac arrest model was established by asphyxia method as the 30-day hypobaric hypoxia group. After 60 days of feeding, rats were randomly selected again, and the cardiac arrest model was established as the 60-day hypobaric hypoxia group. Thirty rats were randomly selected from the Institute of Cardiopulmonary Cerebral Resuscitation at Sun Yat-sen University (Guangzhou, Guangdong) by the same method, and the cardiac arrest model was established as the plain control group. The differences in the body weight of rat modeling precursors and the induction time of asphyxia during the modeling process among different groups were compared.Results:Finally, cardiac arrest model was established in 16 rats in the 30-day hypobaric hypoxia group and in 22 rats in the 60-day hypobaric hypoxia group. There was no significant difference in the body weight of rats before modeling among the plain control group, 30-day hypobaric hypoxia group and 60-day hypobaric hypoxia group [g: 429.00 (389.25, 440.75), 440.00 (415.50, 486.25), 440.00 (400.00, 452.50), all P > 0.05]. The asphyxia induction time of rats in the 60-day hypobaric hypoxia group was significantly longer than that in the 30-day hypobaric hypoxia group (s: 294.59±75.39 vs. 234.31±93.86, P < 0.01), even about 1.4 times of the plain control group (s: 294.59±75.39 vs. 208.73±30.88, P < 0.01). There was no significant difference in the asphyxia induction time between the 30-day hypobaric hypoxia group and the plain control group ( P > 0.05). Conclusion:Rats treated in a hypobaric oxygen chamber for 60 days are more suitable for the preparation of high-altitude cardiac arrest model, and are also consistent with the oxygen reserve and hypoxia tolerance of high-altitude rats.

Objective To evaluate the acceptability and effectiveness of different doses of midazolam oral solution in sedating infants during echocardiographic studies.Methods Two hundred and fourty patients aged 1 to 3 years who underwent echocardiographic study in sedation in our hospital were enrolled in this study.After recording the baseline data of all infants,they were randomly divided into four groups:0.3 mg·kg-1 midazolam oral solution group(M1 group),0.5 mg·kg-1 midazolam oral solution group(M2 group),0.7 mg·kg-1 midazolam oral solution group(M3 group)and 0.5 mL·kg-1 10%chloral hydrate administrated rectally group(C group),60 case per group,and the sedation was performed in the corresponding method of each group.The 5-point facial hedonic and Ramsay scales were used to evaluate acceptability and effectiveness in sedation.The onset time and duration time of sedation were recorded.Results Compared with the C group,the 5-point facial hedonic scale scores in M1,M2,and M3 groups increased during sedation(F=17.50,P<0.017).The onset time of sedation in the M1 and M2 groups was longer than that in the C group(P<0.017),and the duration time of sedation in the M1 and M2 groups was shorter than that in the C group(P<0.017).There was no significant difference in the onset time(P=0.85)and duration time(P=0.50)of sedation between the M3 and C groups.The onset time of sedation in the M1and M2groups was longer than that in the M3 group(P<0.017),and the duration time of sedation in the M1 and M2 groups were shorter than that in the M3 group(P<0.017).Conclusions The acceptability of infants with midazolam oral solution sedation under echocardiographic study was better than that of 10%chloral hydrate administrated rectally.There were fewer adverse reactions with the midazolam oral solution.The 0.7 mg·kg-1 midazolam oral solution had a rapid onset of sedation and definite effect.

Objective To investigate the knowledge,attitude and practice(KAP)of medical staff and parents of children on the risk of using traditional Chinese patent medicine,analyze the similarities and differences between the two groups of people in their knowledge of traditional Chinese patent medicine,medication attitudes and medication behaviors,and analyze the influencing factors of traditional Chinese patent medicine medication risk from the perspective of"doctor-patient",so as to better guide clinical work.Methods From July to November 2023,the medical staff of Children's Hospital Affiliated to the Capital Institute of Pediatrics(hereinafter referred to as"our hospital")and other hospitals,as well as the parents of children who had visited our hospital and taken traditional Chinese patent medicine were taken as the subjects of the survey.The questionnaires were distributed and collected by Questionnarie Stars to analyze the KAP scores of medical staff and parents of children on the risk of children using traditional Chinese patent medicine,and the factors influencing the scores of KAP of taking traditional Chinese patent medicine were analyzed using Logistic regression analysis.And Spearman correlation analysis was used to explore the correlation among knowledge,attitude and practice.Results A total of 339 valid questionnaires(the effective recovery rate of 98.83%)were collected from the medical staff version of the questionnaire.The medical staff with excellent knowledge,attitude and practice scores accounted for 16.22%,7.08%and 83.19%,respectively.A total of 336 valid questionnaires(the effective recovery rate of 98.82%)were collected from the parents'version.The parents of the children with excellent knowledge,attitude and practice scores accounted for 25.87%,3.57%and 30.65%,respectively.Logistic regression analysis showed that different hospital locations and educational levels were important influencing factors for the KAP of medical personnel,while the age,education level,work status,occupation,and monthly income of parents were important influencing factors for their KAP(P<0.05).The Spearman correlation analysis results showed a significant positive correlation among medication knowledge,attitude,and behavior(P<0.01).Conclusion Medical staff and parents of children need to further improve their knowledge and attitude towards the use of traditional Chinese patent medicine.Parents need to pay special attention to standardizing drug use practice,so as to reduce the risk of children using traditional Chinese patent medicine.Physicians and pharmacists can carry out appropriate traditional Chinese patent medicine knowledge popularization and science popularization for parents of children combined with the results of this study.

Objective: To observe the efficacy of electroacupuncture (EA) in treating dry eye syndromes (DES) and its regulatory effects on patient's quality of life (QOL), anxiety, and depression.Methods: By following a randomized controlled study design, eligible DES patients were allocated to an EA group (EAG) or an acupuncture group (AG). Patients in the AG were intervened by acupuncture alone, while in the EAG, electrical stimulation was applied to Cuanzhu (BL2) and Taiyang (EX-HN5) in addition to the same treatment in the AG. Changes in clinical manifestations, ocular surface disease index (OSDI), Schirmer tear test-1 (STT-1), tear-film break-up time (TF-BUT), cornea fluorescein staining (CFS), and corneal sensitivity (CS) were observed, as well as changes in the short-form 36-item health survey (SF-36) and hospital anxiety and depression scale (HADS) scores. Results: The scores of clinical symptoms, OSDI, and CFS decreased significantly in both EAG and AG when compared with the baseline values (P<0.05), respectively, while the TF-BUT and CS increased significantly (P<0.05), and the tear secretion of patients in the EAG increased (P<0.05). Compared with those before treatment, the scores of physical role functioning, general health perception, emotional role functioning, and mental health of patients in both EAG and AG showed significant increases after treatment (P<0.05), together with a marked decrease in the score of anxiety (P<0.05). Compared with the AG, the EAG obtained a more significant increase in STT-1 (P<0.05).Conclusion: DES patients respond well to both EA and acupuncture treatments, manifested by prolonged TF-BUT and improvement of CS. Meanwhile, the two approaches can improve QOL and reduce anxiety. Furthermore, EA appears more effective in increasing tear secretion than acupuncture alone.

Objective:To develop an age-appropriate and disease-specific social adaptation measurement tool for adolescents infected with HIV in the context of Chinese culture, and to test its reliability and validity.Methods:Through literature review and consultation with 8 experts, this study constructed the conceptual framework of social adaptation of adolescents infected with HIV and formulated the dimensions and items of the scale. The convenient sampling method was adopted, and questionnaires were distributed online and offline at Beijing Ditan Hospital, Xuzhou Center for Disease Control and Prevention and Yunnan Provincial Infectious Disease Hospital from October 2020 to February 2021 for questionnaire validity testing. A preliminary age-specific and disease-adaptable Social Adaptation Scale for HIV Infected Adolescents was prepared using methods such as project analysis and reliability and validity testing.Results:The scale consisted of 3 dimensions of cognition, emotion and will, 5 variables, and a total of 23 items. The Cronbach's α coefficient of the scale was 0.856, and the split reliability was 0.836. The item-level content validity index ( I- CVI) of the scale was 0.750-1.000, the scale-level content validity index ( S- CVI) was 0.940, and the scale score and subjective well-being scale score were positivelycorrelated ( P<0.05) . Factor analysis extracted 5 common factors, and the cumulative explanatory variable was 61.156%. Conclusions:The scale has good reliability, validity and feasibility, which can be used as an evaluation tool for social adjustment of HIV-infected adolescents in China.

Objective:To observe the glycemic profiles and emotion management in diabetic patients after the outbreak of novel coronavirus disease 2019(COVID-19).Methods:A questionnaire survey was used to observe the blood glucose levels and metabolic indexes before and after the outbreak of COVID-19, and to detect emotion ratings after the outbreak of COVID-19. The aim of the study is to present the effects of the COVID-19 on glycemic and emotional management in diabetic patients.Results:A total of 136 patients were included in this survey. The average age of the patients was 62.5 years old, and the average duration of diabetes was 10.1 years. Glycemic profiles(fasting blood glucose, 2 h postprandial blood glucose, HbA 1C), lipid profiles(triglycerides, low-density lipoprotein cholesterol), and body weight were not significantly different before and after the outbreak of COVID-19( P>0.05). According to emotional scales(scores of anxiety, depression, and sleep-related scales), 76.5% diabetic patients did not develop anxiety symptoms, 61.0%~69.9% diabetic patients did not have depressive symptoms and 52.0% diabetic patients did not have sleep disorder. 19.9% diabetic patients had mild anxiety symptoms, 25.7%~30.9% diabetic patients presented mild depression symptoms and 28.3% diabetic patients had mild sleep disorders. 2.9% diabetic patients had moderate anxiety, 2.2%~8.1% diabetic patients had moderate depression and 14.2% diabetic patients had moderate sleep disorder. Only a very small part of patients presented severe emotional symptoms including 0.7% patients with anxiety symptoms(GAD-7 15 points and above), 2.2% patients with depressive symptoms(PHQ9 and PHQ15 15 points and above)and 5.6% patients with sleep symptoms(PSQI 15 points and above). Compared with asymptomatic patients, neither patients with mild and moderate/severe depression and sleep disorder showed significant difference in HbA 1C, nor did patients with moderate/ severe anxiety symptoms. However, patients with mild anxiety symptoms showed significant lower HbA 1C than asymptomatic patients. Conclusion:After the outbreak of COVID-19, there was an increasing trend in blood glucose, but there was no statistical difference. Body weight, lipids profiles were not different in diabetic patients, either. Most of diabetic patients had mild symptoms of anxiety, depression and sleep disorders. Very few patients presented moderate to severe symptoms of anxiety, depression and sleep disorders.

Objective: To evaluate the feasibility of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI MRI) in the evaluation of tumor vascular normalization in a mouse model of colorectal cancer induced by recombinant human endostatin (rhES). Methods: The CT26 colorectal cancer xenograft model of BALB/c mice were established and divided into rhES group and control group, with 20 mice in each group. The mice of rhES group were intravenously injected with rhES 5 mg·kg^-1·d^-1 once daily for 12 days, while the mice of the control group were intravenously injected with the same volume of 0.9% saline. 5 mice of rhES group and control group were randomly selected to perform IVIM-DWI MRI as following times: before treatment and four, eight, twelve days after treatment. The parameters of IVIM-DWI were recorded, including true diffusion coefficient(D), pseudo-diffusion coefficient (D^*) and perfusion fraction (f). Meanwhile, microvessel density (MVD), pericyte coverage and tumor perfusion in tumor tissues were detected by immunofluorescence, respectively. Results: The tumor volumes of control group and rhES group before treatment were (154.42±24.65) mm³ and (174.24±28.27)mm^3, respectively, without statistically significant difference (P=0.440). From day 2 to day 12 after treatment, the tumor volume of rhES group was significantly smaller than that of control group (all P<0.05). There were no statistical significances of D value between the rhES group and control group before and after treatment (all P>0.05). The D^* values of the rhES group were (10.940±2.834)×10^-3mm²/s and (12.940±2.801)×10^-3mm²/s in day 4 and 8 after treatment respectively, significantly higher than (6.980±1.554)×10^-3mm²/s and (7.898±1.603)×10^-3mm²/s of control group (P<0.05). Moreover, compared with control group, the D^* value of rhES group was significantly lower in day 12 (6.848±1.460)×10^-3mm²/s vs (9.950±2.596)×10^-3mm²/s, (P<0.05). The f value of rhES group in day 8 was (0.226±0.021)%, significantly higher than (0.178±0.016)% of control group (P<0.01). The MVD of rhES group was significantly lower than that of control group (P<0.05), while the pericyte coverage and tumor perfusion of rhES group were significantly higher than those of control group in day 4 and 8 after treatment (all P<0.05). In addition, we found D^* value of IVIM-DWI in rhES group was significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.354, r=0.555, r=0.559, all P<0.05). Meanwhile, the f value in rhES group was also significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.391, r=0.538, r=0.315, all P<0.05). Conclusions IVIM-DWI MRI can effectively evaluate the vascular normalization in rhES-induced CT26 colorectal tumor.The parameters D^* and f are closely related to intratumorally microvessel density, pericyte coverage and perfusion, which can effectively monitor the occurrence of tumor vascular normalization time.

Objective: To investigate the therapeutic effect of dendritic cell-induced killer cells (DC-CIK) combined with 5-fluorouracil (5-FU) and loaded with CD133+ HT-29 cell lysate or RNA on mice bearing colon cancer HT-29 cell transplanted tumor, and to explore the underlying mechanism. Methods: Colon cancer xenograft model was established in BALB /c nude mice by using human colon cancer HT-29 cells at logarithmic growth phase; Antigen-free DC-CIK, 5-FU+DC-CIK, R+DC-CIK (loaded with total RNA of CD133+ cells), L+DC-CIK (loaded with CD133+ cell lysate), 5-FU and normal saline were respectively injected into transplanted mice, and the treatment efficacies on the growth of transplanted tumor in each group after three treatment cycles were observed, and the tumor growth curve was drawn. The nude mice were sacrificed by cervical dislocation and the tumor volume and body weight were measured. qPCR was used to detect the expression of AKT mRNA in transplanted tumor tissue, and WB was used to detect the expression of phosphorylated AKT protein. Results: After treatment, the body mass of nude mice in R+DC-CIK group, L+DC-CIK group and 5-FU+DC-CIK group increased steadily, while the body mass of nude mice in DC-CIK group and 5-FU group decreased gradually; the tumor growth speed of nude mice in R+DC-CIK group, 5-FU+DC-CIK group and L+DC-CIK group was significantly slower than that of the control group (P<0.05). Compared with 5-FU and DC-CIK alone, the combined treatment with loaded lysate/RNA had more sig nificant effect on mRNA and protein expressions of AKT(P<0.05). Conclusion: The effect of DC-CIKwithdifferentloadingoritscombinationwith5-FUisbetterthanthatofchemotherapy alone. One of the mechanisms is related to the down-regulation ofAKT level.

Objective To explore the clinical application and effect of fibular head compound soft tissue flap transplantation on precision repairing of compound tissue defect at limb joints assisted by 3-Dimensional contrast printing technology.Methods From March,2014 to September,2017,9 patients with bone and soft tissue defect at limb joints were selected.In which,2 were distal radius bone defect with joint capsule and ligament defect,2 were lower segment tibia bone and soft tissue defect,2 were femur under section of the bone and soft tissue defect,2 were medial malleolus bone and ligament defect,and 1 was external ankle ligament and bone defect.Using 3-Dimensional printing to conduct bilateral mirror-image contrast prior to the operation,morphology of bone defect at limb joints was acquired.Based on the texture printed out,corresponding fibular head compound blocks with blood vessels were removed from the donor site and transplanted to the recipient site before anastomosing the blood vessels and restoring the blood flow.The regular post-operative followed-up was performed.Results The 9 transplanted tissue blocks survived.The donor sites and the recipient sites were healed.The followed-up for restoration of limb function was from 9 to 35 (average,17.5) months.The ankle function was assessed according Kofoed scale,resulted in 2 excellent and 1 good;The wrist function was assessed according Mayo scale,resulted in 1 excellent and 1 good.The medial malleolus bone defect and criteria bone defect were healed at 6 months.The patients were satisfied with the efficacy.Conclusion The application of 3-Dimensional contrast printing of fibular head compound tissue flap transplantation in repairing compound tissue defects at limb joints can reduce damage to the donor site,realizing precise repairing on limb tissue defect,and make good function restoration.

Objective To evaluate the feasibility of intravoxel incoherent motion diffusion?weighted magnetic resonance imaging (IVIM?DWI MRI) in the evaluation of tumor vascular normalization in a mouse model of colorectal cancer induced by recombinant human endostatin (rhES).Methods The CT26 colorectal cancer xenograft model of BALB／c mice were established and divided into rhES group and control group, with 20 mice in each group.The mice of rhES group were intravenously injected with rhES 5 mg·kg－1·d－1 once daily for 12 days, while the mice of the control group were intravenously injected with the same volume of 0.9%saline. 5 mice of rhES group and control group were randomly selected to perform IVIM?DWI MRI as following times: before treatment and four, eight, twelve days after treatment. The parameters of IVIM?DWI were recorded, including true diffusion coefficient( D), pseudo?diffusion coefficient ( D?) and perfusion fraction ( f).Meanwhile, microvessel density ( MVD), pericyte coverage and tumor perfusion in tumor tissues were detected by immunofluorescence, respectively. Results The tumor volumes of control group and rhES group before treatment were (154.42 ± 24.65) mm3 and (174.24 ± 28.27) mm3, respectively, without statistically significant difference ( P＝0.440). From day 2 to day 12 after treatment, the tumor volume of rhES group was significantly smaller than that of control group ( all P＜0.05).There were no statistical significances of D value between the rhES group and control group before and after treatment ( all P＞0.05).The D? values of the rhES group were (10.940±2.834)×10－3mm2／s and (12.940±2.801)×10－3 mm2／s in day 4 and 8 after treatment respectively, significantly higher than (6.980±1.554)×10－3mm2／s and (7.898±1.603)×10－3mm2／s of control group (P＜0.05). Moreover, compared with control group, the D?value of rhES group was significantly lower in day 12 (6.848±1.460)×10－3mm2／s vs (9.950±2.596)×10－3 mm2／s, (P＜0.05). The f value of rhES group in day 8 was (0.226± 0.021)%, significantly higher than (0.178±0.016)% of control group (P＜0.01). The MVD of rhES group was significantly lower than that of control group (P＜0.05), while the pericyte coverage and tumor perfusion of rhES group were significantly higher than those of control group in day 4 and 8 after treatment ( all P＜0.05).In addition, we found D?value of IVIM?DWI in rhES group was significantly related with MVD, pericyte coverage and tumor perfusion ( r＝－0.354, r＝0.555, r＝0.559, all P＜0.05). Meanwhile, the f value in rhES group was also significantly related with MVD, pericyte coverage and tumor perfusion ( r＝－0.391, r＝0.538, r＝0.315, all P＜0.05). Conclusions IVIM?DWI MRI can effectively evaluate the vascular normalization in rhES?induced CT26 colorectal tumor.The parameters D? and f are closely related to intratumorally microvessel density, pericyte coverage and perfusion, which can effectively monitor the occurrence of tumor vascular normalization time.[Subject words] Colorectal neoplasms; Intravoxel incoherent motion; Diffusion magnetic resonance imaging; Vascular normalization; Recombinant human endostatin; Angiogenesis