Objective To investigate the effects patterned structure located on the surface of mechanical valve leaflet exerted on the hydrodynamic properties of valve prostheses.Methods Bileaflet aortic mechanical valves of GKS 21A and 23 A were randomly selected as the control group,hydrodynamic performance of each valve were assessed,as per ISO5840 by calculating mean transvalvular pressure(MTP),regurgitation fraction(REG),effective orifice area(EOA)and effective orifice area(eLoss).Then,laser etching was applied to construct a parallel-groove array pattern on leaflet surface perpendicular to the direction of the blood flow.The valve was subjected a-gain to the same test,and the data obtained were recorded and analyzed.Results In the pulsating flow test,the MTP of the experimental group was smaller than that of the control group at the same flow rate and size.The RE in GKS 21A experimental group was smaller than that in control group,and the RE in GKS 23A experimental group was larger than that in control group.The EOA in the experimental group was larger than that in the control group at the same flow rate and size.The eLoss in the GKS 21A experimental group was smaller than that in the control group,and the eLoss in the GKS 23A experimental group was larger than that in the control group.Conclusion The parallel-groove array pattern on the surface of the leaflet affected the hemodynamic performance of the valve prostheses.

Palliative care, as an emerging discipline, is rapidly advancing in China. However, progress in quality management has been relatively slow, hindering the homogeneity of palliative care services in a certain degree. This article takes the Shanghai Palliative Care Service Management Center as an example, outlines its practical model and achievements in the field of quality management since its establishment, and further analyzes the existing problems based on the city-wide palliative care service quality evaluation results. The article summarizes relevant experiences and offers corresponding insights, enriching research cases and practical support in the quality management of palliative care, which may have practical application value for enhancing the homogeneity of palliative care services in the region.

Pain management, listed as the fifth vital sign, has gained increasing attention from clinicians. Conventional analgesics have limited duration, leading to intense monitor and frequent dosing during the early phase in order to prevent the progression of chronic pain. Thus, prolonging the duration of analgesics has become one focus of the pain research. Several strategies, such as adding adjuvants, producing derivatives, and applying extended-release carriers, make it possible for super long-acting analgesics to come into reality. This review briefly introduces the strategies and development of the super long-acting analgesics, including the successful translation and commercialization of the present products of super long-acting analgesics. It also summarizes the application and translation of extended-release drug carriers, providing invaluable reference for the future research on the field of super long-acting analgesics.

Objective:To evaluate the effect of superior cervical ganglion block (SCGB) on cardiac function and nucleotide like receptor protein 3 (NLRP3) signaling pathway in a rat model of myocardial ischemia-reperfusion (I/R).Methods:Sixty healthy SPF male Sprague-Dawley rats, weighing 250-300 g, aged 2-3 months, were divided into 4 groups ( n=15 each) using a random number table method: sham operation group (sham group), myocardial I/R group (IR group), myocardial I/R + normal saline group (IR+ NS group), and myocardial I/R + SCGB group (IR+ SCGB group). Myocardial I/R model was developed by ligation of the left anterior descending branch of the coronary artery for 45 min followed by restoration of blood flow in anesthetized aninals. IR+ SCGB group received SCGB (0.25% ropivacaine 0.1 ml) at 10 min before reperfusion once a day for 2 consecutive weeks, while 0.9% sodium chloride was given instead of ropivacaine in IR+ NS group. Blood samples were collected at 24 h and 14 days of reperfusion for determination of serum concentrations of norepinephrine (NE), troponin T (TnT), tumor necrosis factor-alpha (TNF-α), interleukin-18 (IL-18) and IL-1β by enzyme-linked immunosorbent assay. Echocardiography was performed before ischemia and at 14 days of reperfusion, and left ventricular short axis shortening rate (FS), ejection fraction (EF), and cardiac output (CO) were measured. The rats were sacrificed at 14 days of reperfusion and the hearts were taken for determination of the contents of norepinephrine (NE) in myocardial tissues in the infarction area (by enzyme-linked immunosorbent assay), percentage of myocardial fibrosis area (by Masson staining), M1 macrophage marker CD68 + cell count in the infarction area (by immunohistochemical method), and expression of NLRP3 and gasdermin D (GSDMD) in myocardial tissues (by Western blot). Results:Compared with Sham group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly increased, the expression of NLRP3 and GSDMD in myocardial tissues was up-regulated, CD68 + cell count was increased, and EF, CO and FS were decreased in IR group ( P<0.05). Compared with IR group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly decreased, the expression of NLRP3 and GSDMD in myocardial tissues was down-regulated, CD68 + cell count was decreased, and EF, CO and FS were increased in IR+ SCGB group ( P<0.05), and no statistically significant changes were found in the parameters mentioned above in IR+ NS group ( P>0.05). Conclusions:SCGB can improve the cardiac function in a rat model of myocardial I/R, and the mechanism may be related to the inhibition of NLRP3 signaling pathway.

Tryptophan 2,3-dioxygnease 2 (TDO2) is specific for metabolizing tryptophan to kynurenine (KYN), which plays a critical role in mediating immune escape of cancer. Although accumulating evidence demonstrates that TDO2 overexpression is implicated in the development and progression of multiple cancers, its tumor-promoting role in esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we observed that TDO2 was overexpressed in ESCC tissues and correlated significantly with lymph node metastasis, advanced clinical stage, and unfavorable prognosis. Functional experiments showed that TDO2 promoted tumor cell proliferation, migration, and colony formation, which could be prevented by inhibition of TDO2 and aryl hydrocarbon receptor (AHR). Further experimentation demonstrated that TDO2 could promote the tumor growth of KYSE150 tumor-bearing model, tumor burden of C57BL/6 mice with ESCC induced by 4-NQO, enhance the expression of phosphorylated AKT, with subsequent phosphorylation of GSK3

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO
COVID-19 ; Healthy Volunteers ; Humans ; Masks ; Oximetry ; Oxygen/blood*

OBJECTIVE： To study the effects of 60Co-γ radiation on the botanical traits and property of Andrographis paniculata， and to screen suitable irradiation dose. METHODS： The seeds of A. paniculata were irradiated by 60Co-γ rays with different irradiation doses（0，10，20，50，100，200，300 Gy）. The botanical traits indexes of A. paniculata as seed germination rate， root length， seedling rate， seedling height， leaf area， fresh weight， dry weight， stomata number of lower epidermis of leaf， and its property indexes as the contents of andrographolide， dehydrated andrographolide and chlorophyll， activity of T-SOD enzyme and CuZn-SOD enzyme， were determined after radiation. The coefficient of variation （CV） was calculated. The linear regression analysis was performed for seedling rate， and medial lethal dose was calculated. The correlation analysis was performed between the parameters of botanical trait and quality property with irradiation dose. Cluster analysis was conducted for M1 generation of A. paniculata in different irradiation dose groups by connection method combined with squared euclidean distance. RESULTS： Different irradiation doses showed different effects on botanical traits and property of A. paniculata. According to the average value of CV， the index of botanical traits was ranked as leaf area ＞ fresh weight ＞ dry weight ＞ plant height ＞ root length ＞ stomata number ＞ seedling rate ＞ germination rate； among different irradiation dose groups， the coefficient of variation was ranked as 50 Gy＞200 Gy＞100 Gy＞20 Gy＞10 Gy＞300 Gy＞0 Gy. According to the average value of CV， the index of property was ranked as dehydrated andrographolide content＞andrographolide content＞chlorophyll content＞CuZn-SOD enzyme activity＞T-SOD enzyme activity； among different irradiation dose groups， the coefficient of variation was ranked as 100 Gy＞50 Gy＞200 Gy＞20 Gy＞10 Gy＞300 Gy＞0 Gy. The medial lethal dose was 195.10 Gy. According to the botanical traits， M1 generation of A. paniculata of 7 dose groups could be divided into 4 types. According to the property， M1 generation of A. paniculata of 7 dose groups could be divided into 3 types. CONCLUSIONS： The suitable irradiation dose interval for irradiating A. paniculata is 50-200 Gy.

OBJECTIVE: To investigate whether rapamycin treatment starting at 24 h after cerebral ischemia/reperfusion(I/R) has protective effect on brain injury in rats. METHODS: The rat I/R model was established by middle cerebral artery occlusion according to Longa's method. A total of 104 Sprague Dawley rats were randomly divided into sham group, model group, and rapamycin-treated groups (6 h or 24 h after modeling). Neurological function was assessed with neurological severity score (NSS). Triphenyl tetrazolium chloride (TTC) staining and Fluoro-Jade B (FJB) staining were used to examine the infarct volume and neuronal apoptosis, respectively. The expression of p-S6 protein in mTOR signaling pathway was detected by Western blot analysis. RESULTS: Compared with sham group, NSS of the model group was significantly increased and TTC staining indicated obvious infarct area (all <0.01). Furthermore, significantly increased number of FJB-positive cells and p-S6 expression in the penumbra area were shown in the model group (all <0.01). Compared with the model group, both rapamycin-treated groups demonstrated decreased NSS, infarction volume and FJB positive cells as well as p-S6 expression in the penumbra area (<0.05 or <0.01). There was no significant difference between the groups of rapamycin administrated 6 h and 24 h after modeling (all >0.05). CONCLUSIONS Rapamycin treatment starting at 24 h after I/R exhibits protective effect on brain injury in rats.
Animals ; Brain Ischemia ; drug therapy ; Immunosuppressive Agents ; therapeutic use ; Infarction, Middle Cerebral Artery ; drug therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Sirolimus ; therapeutic use ; Treatment Outcome

Objective To evaluate the efficacy and safety of posaconazole for preventing invasive fungal disease (IFD) in the aplastic anemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 46 aplastic anemia patients received allogeneic HSCT. They were treated with oral posaconazole 200 mg, three times a day from HSCT pretreatment to granulocyte recovery after transplantation. G test and GM test were done 1, 2 and 4 weeks after the end of posaconazole treatment, and chest CT scan repeated 4 weeks after the end of posaconazole treatment. Posaconazole prophylaxis was defined as successful if there were no clinical manifestations indicative of fungal infection. Results All the 46 patients experienced neutropenia. The median of absolute neutrophil count (ANC) nadir was 0.02 (0-0.05)×109/L for a median time of 10 (8-19) days. The median duration of posaconazole prophylaxis was 26 (15-41) days. Neutropenic fever was reported in 45 patients, which lasted a median time of 5 (1-13) days. Six patients (13.3％ of the patients with neutropenic fever) failed to respond to the empirical treatment of broad spectrum antibiotics with persistent fever over 7 days. Their treatment was switched to short-term empirical treatment with broad spectrum antifungal agents. However, subsequent G test, GM test and chest CT showed negative results. None of the six patient was consistent with IFD diagnosis. Breakthrough fungal infection was not considered. Oral posaconazole solution was resumed for preventing IFD. G test, GM test and chest CT scan did not show any sign of fungal infection 1, 2 and 4 weeks after the end of posaconazole prophylactic treatment in all the 46 patients, proving the success of oral posaconazole in preventing IFD. Posaconazole was not discontinued due to adverse drug reaction in any patient. Conclusions Posaconazole is effective for preventing IFD in the aplastic anemia patients receiving HSCT with good safety profile and few adverse reactions.

OBJECTIVETo understood the accuracy of oral fluid-based rapid HIV self-testing among men who have sex with men (MSM) and related factors.

METHODSSurvey was conducted among MSM selected through non-probability sampling to evaluate the quality of their rapid HIV self-testing, and related information was analyzed.

RESULTSThe most MSM were aged 21-30 years (57.0%). Among them, 45.7% had educational level of college or above, 78.5% were unmarried, 59.3% were casual laborers. The overall accuracy rate of oral fluid based self-testing was 95.0%, the handling of"inserting test paper into tube as indicated by arrow on it"had the highest accuracy rate (98.0%), and the handling of"gently upsetting tube for 3 times"had lowest accuracy rate (65.0%); Chi-square analysis showed that educational level, no touch with middle part of test paper, whether reading the instruction carefully, whether understanding the instruction and inserting test paper into tube as indicated by the arrow on it were associated with the accuracy of oral fluid-based rapid HIV self-testing, (P<0.05). Multivariate logistic regression analysis indicated that educational level, no touch with middle part of test paper and understanding instructions were associated with the accuracy of oral fluid-based rapid HIV self-testing.

CONCLUSIONSThe accuracy of oral fluid-based rapid HIV self-testing was high among MSM, the accuracy varied with the educational level of the MSM. Touch with the middle part of test paper or not and understanding the instructions or not might influence the accuracy of the self-testing.

Adult ; Demography ; HIV Infections ; diagnosis ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; methods ; Saliva ; Self Care ; Surveys and Questionnaires ; Young Adult