【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P<0.01), and when stored at 22℃, the decay rate of factor Ⅷ was slower; 2) When stored at 4℃, the content of factor V was 41.19, 41.31(0.29%), 40.52(-1.64%), 40.27(-2.23%), 39.05(-5.19%) and 36.99(-10.21%) IU/ bag, respectively; Stored at 22℃, the factor V content was 41.19, 41.71(1.25%), 42.54(3.28%), 41.94(1.80%), 39.21(-4.80%) and 35.64(-13.48%) IU/ bag, respectively. Comparison of storage results between the two groups showed that the content of factor V was statistically significant(P<0.05) and significantly significant(P<0.01) at 4℃48 h and 22℃48 h, respectively, and the decay rate of factor V was faster when stored at 22℃; 3) When stored at 4℃, the Fbg content was 268.86, 268.17(-0.26%), 262.46(-2.38%), 270.50(0.61%), 267.52(-0.50%) and 261.92(-2.58%) mg/ bag, respectively; Stored at 22℃, the Fbg content was 268.86, 265.86(-1.12%), 264.12(-1.77%), 265.89(-1.11%), 266.04(-1.05%) and 261.04(-2.91%) mg/ bag, respectively. There was no statistical significance between the 2 groups and the original 0 h content in each time period(P>0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

BACKGROUND: This study aims to clarify the mechanism underlying dental pulp cells-extracellular vesicles (DPC–EVs) carrying runt-related transcription factor 3 (RUNX3) in mediating odontogenic differentiation of dental pulp stem cells (DPSCs) with the involvement of miR-30a-5p-regulated NOTCH1. METHODS: Extracellular vesicles (EVs) were isolated from human DPSCs, and identified using transmission electron microscopy, and nanoparticle tracking analysis. PBS, EVs, or EV inhibitor GW4869 was added to DPSCs for co-culture, whilst odontogenic differentiation was assessed in terms of ratio of mineralized nodules and expression odontoblast differentiation markers. Dual luciferase reporter gene assay and chromatin immunoprecipitation for binding relation among RUNX3, miR-30a-5p and NOTCH1were employed to evaluate their roles in odontogenic differentiation was determined.Animal experiment was established to confirm the effect of DPC-EVs-loaded RUNX3 on dental pulp. RESULTS: In vitro finding demonstrated that EVs delivered RUNX3 to DPSCs, thereby activated miR-30a-5p expression and inhibited NOTCH1 expression, which was reversed by addition of GW4869. RUNX3 upregulation promoted miR-30a-5p while miR-30a-5p targeted and inhibited NOTCH1. Silencing of RUNX3 in EVs decreased expression of those differentiation markers, downregulated miR-30a-5p and upregulated NOTCH1. CONCLUSION DPSC-EVs can carry RUNX3 to the DPSCs, promote the transcription of miR-30a-5p, and then inhibit the expression of NOTCH1, and finally promote the odontogenic differentiation of DPSCs.

Objective To analyze the effect of nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model in patients with functional dyspepsia, in order to improve their psychological state and gastrointestinal motility, and provide reference for clinical nursing. Methods A total of 160 functional dyspepsia patients admitted to the First Affiliated Hospital of Xinxiang Medical College from December 2022 to June 2023 were chosen as the study subjects. They were randomly divided into control group and observation group, using a random number table method, with 80 cases in each group. Patients in control group were given routine nursing intervention, and patients in the observation group were treated nursing intervention based on IMB model. The psychological state, gastrointestinal motility andquality of life of the two groups were compared before and after intezrvention. Results After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in two groups were decreased, and the observation group was lower than that in the control group (P < 0.05). After intervention, the levels of gastrointestinal hormone nitric oxide (NO), serum motilin (MTL) andserum gastrin (GAS) in two groups were improved, and the levels of all indexes in the observation group were better than those in the control group (P < 0.05). After intervention, gastrointestinal quality of life index (GIQLI) of two groups was improved, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). Conclusion Nursing interventions based on the IMB model are beneficial for alleviating anxiety and depression in patients with functional dyspepsia, effectively enhancing gastrointestinal motility and vitality, and improving their quality of life.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Objective:To explore the reliability and validity of the International Classification of Functioning, Disability and Health′s 17-item Rehabilitation Set (ICF-RS-17) when used to evaluate multidisciplinary inpatients.Methods:A total of 359 inpatients in the departments of rehabilitation, orthopedics, neurology, and neurosurgery of three hospitals in Jiangsu province were assessed with the ICF-RS-17 at admission and at discharge, and the internal consistency of the tool was calculated. Inter-rater and intra-rater reliability were quantified using interclass correlation coefficients (ICCs). Structural validity was analyzed using factor analysis.Results:The tool′s Cronbach′s α was 0.945. The overall inter-rater ICC was 0.946 with the ICCs of all of the items except b280 sensation of pain within the range from 0.630 to 0.948. The overall intra-rater ICCs ranged from 0.471 to 0.947. The factor analysis found three factors with eigenvalues greater than 1, accounting for 74% of the variation, without double-loaded items. The three influential factors were exercise ability, sleep perception communication ability and self-care ability.Conclusion:The ICF-RS-17 has good internal consistency, inter-rater and intra-rater reliability and structural validity in the evaluation of multidisciplinary inpatients.

This paper reports the diagnosis and treatment of a case of lymphocytic hypophysitis in pregnancy complicated by intrahepatic cholestasis of pregnancy. The 32-year-old patient had regular menstrual cycles and conceived naturally. Around 24 weeks of gestation, she developed a headache without abnormalities in the visual field. Skin itching occurred at 32 weeks of gestation, but her headache was significantly relieved. By 33 +1 weeks of pregnancy, the patient experienced elevated total bile acid, transaminase, and hypoglycemia, leading to a diagnosis of intrahepatic cholestasis of gestation (mild). Subsequently, at 33 +6 weeks of gestation, her total bile acid increased substantially, and the disease progressed rapidly into intrahepatic cholestasis of pregnancy (severe). As a result, an emergency cesarean section was performed to terminate the pregnancy. The Apgar score of the newborn was five points at one minute and ten points at five minutes. Following the surgery, the patient showed no lactation and had symptoms such as nausea, vomiting, fatigue, and refractory hyponatremia. Blood hormone measurement showed hypopituitarism. An enhanced intracranial MRI showed pituitary enlargement and uniform enhancement. Consequently, the clinical diagnosis was lymphocytic hypophysitis. Treatment with glucocorticoids effectively alleviated the symptoms. Menstruation resumed after more than one month of delivery. The intracranial MRI in postpartum reexamination after six months of delivery revealed a disappearance of the lesion. The patient continued with oral glucocorticoid therapy.

Objective:To establish new scar-endoscopic submucosal dissection (scar-ESD) classification based on the relationship between scars and lesion location under endoscopy, and to explore the clinical efficacy of ESD.Methods:Clinical data of 132 patients who underwent ESD with scars from January 2015 to August 2022 at the Digestive Endoscopy Center of Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine. According to the scar-ESD classification, the lesions without surgical anastomosis at the same location were classified as type A: A0, A1, A2, and A3; and those with surgical anastomosis were classified as type B: B0, B1, and B2. The ESD operation time, specimen size, intraoperative assistant methods, intraoperative perforation, en-bloc resection rate, specimen damage rate, and postoperative complications were recorded for each subtype.Results:The age of the 132 patients was 64.22±9.51, with a male-to-female ratio of 3∶1. Forty-nine lesions (37.12%) were located in the esophagus, 40 cases (30.30%) in the stomach, and 43 cases (32.58%) in the colon. The operation time was 49.66±32.96 minutes. The operation time for A0 subtype was 30.38±12.85 minutes, which was significantly shorter than that of the A2 (52.10±36.55 minutes, t=2.15, P<0.05). The operation time for B0 subtype was 45.03±24.35 minutes, which was significantly shorter than that of the B2 (90.71±44.95 minutes, t=3.95, P<0.05). Intraoperative assistance was used in 38 cases (28.79%). Intraoperative perforation occurred in 5 cases (3.79%), including 4 cases of A2 and 1 case of A3, and the highest incidence occurred in the colon [9.30% (4/43)]. The en-bloc resection rate was 97.73% (129/132), the R0 resection rate was 88.64% (117/132), and the curative resection rate was 84.09% (111/132). The specimen damage occurred in 23 cases (17.42%), with the highest incidence in the stomach [32.50% (13/40)]. There were significant differences between A2 and A0 subtypes ( t=2.31, P<0.05) in this variable, and between B2 subtype and A0, A1, A2, A3, and B0 subtypes ( P<0.05). Conclusion:The scar-ESD classification is beneficial for describing and predicting difficulty of ESD. ESD is still the preferred treatment for early digestive lesions with scars, and the efficacy is satisfactory. But it requires experienced physicians to perform the operation.