Objective Cirrhotic cardiomyopathy(CCM)refers to cardiac dysfunction and electrophysiological disorder caused by liver cirrhosis and is closely associated with the prognosis of patients with liver cirrhosis.Endothelial cell-specific molecule 1(endocan)can be used as a diagnostic marker for cardiovascular diseases,and it remains unclear whether it is involved in the pathogenesis of CCM.The aim of this study is to investigate the expression of serum endocan in patients with CCM and its possible role in the development of CCM.Methods This cross-sectional study was conducted among the patients with liver cirrhosis who were consecutively admitted to Beijing YouAn Hospital,Capital Medical University,from January 2019 to January 2021,and according to the presence or absence of CCM,the patients were divided into CCM group with 19 patients and non-CCM group with 106 patients.ELISA was used to measure the serum level of endocan,and its correlation with liver function and cardiac function was analyzed.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U rank sum test was used for comparison of continuous data with skewed distribution between two groups;the chi-square test was used for comparison of categorical data between groups.A Pearson or Spearman correlation analysis was used to investigate the correlation between indicators,and the receiver operating characteristic(ROC)curve was used to assess the CCM predictive model.Results The CCM group had a significantly higher expression level of serum Endocan than the non-CCM group(2.69±0.43 ng/mL vs 2.23±0.52 ng/mL,t=2.247,P=0.034).The patients with compensated cirrhosis had a significantly lower expression level of serum endocan than those with decompensated cirrhosis(2.41±0.37 ng/mL vs 2.72±0.49 ng/mL,t=3.214,P=0.02).In the CCM group,the serum level of endocan was positively correlated with Child-Pugh score(r=0.509,P=0.026)and MELD-Na score(r=0.484,P=0.036)and was negatively correlated with mean arterial pressure(r=-0.591,P=0.013)and mitral ratio of peak early to late diastolic filling velocity(r=-0.515,P=0.042).The serum endocan had an area under the ROC curve of 0.658(95%CI:0.522～0.781)in predicting CCM,when the cut-off value was 2.61 ng/mL,the sensitivity was 67.1%and the specificity was 73.7%.Conclusion There is a certain association between serum endocan and CCM,and serum endocan may be involved in the pathogenesis of CCM.

Objective:To evaluate the effect of carbon dioxide pneumoperitoneum and/or body position on stroke volume variation in the patients undergoing gynecological laparoscopy.Methods:Twenty patients undergoing gynecological laparoscopy were included in the study. After routine induction of general anesthesia, all the patients were intubated and mechanically ventilated with a tidal volume of 8 ml/kg and a respiratory rate of 8-12 times/min. General anesthesia was maintained. Stroke volume (SV) and stroke volume variation (SVV) were monitored with the FloTrac/Vigileo system at supine position without pneumoperitoneum (T 1), 15° head-down tilt position without pneumoperitoneum (T 2), supine position with pneumoperitoneum pressure (IAP) of 12 mmHg (T 3), 15° head-down tilt position with IAP 12 mmHg (T 4), supine position with IAP of 15 mmHg (T 5) and 15° head-down tilt position with IAP of 15 mmHg (T 6). Results:There were no significant differences in SV and SVV between T 2 and T 1 ( P>0.05). SVV was significantly increased and SV decreased at T 3-6 than at T 1 and T 2 ( P<0.05). There was no significant difference in SV between T 5 and T 3 and between T 6 and T 4 ( P>0.05). SVV was significantly higher at T 5 than at T 3 and at T 6 than at T 4 ( P<0.05). Conclusions:Although body position has no significant impact on SVV, the carbon dioxide pneumoperitoneum has a greater influence, indicating that SVV is not suitable for assessing blood volume status during laparoscopic surgery.

Objective:To explore and analyze the efficacy of preoperative intravenous tranexamic acid (TXA) in reducing bleeding and alleviating early postoperative pain in elderly patients with proximal humeral fractures (PHF) who underwent minimally invasive plate osteosynthesis (MIPO) approach with open reduction and locking plate internal fixation.Methods:A retrospective analysis was conducted on the data of 165 elderly patients with partial or partial PHF who underwent open reduction and locking plate internal fixation via MIPO approach at the Yixing People′s Hospital from June 2018 to June 2021. According to whether TXA was used intravenously 30 minutes before surgery, patients were divided into a TXA group (77 cases) and a control group (88 cases). The surgical time, hemoglobin decrease, total blood loss (TBL), intraoperative blood loss (IBL), postoperative drainage volume, visible blood loss (VBL), hidden blood loss (HBL), blood transfusion status, Visual Analogue Scale (VAS) score for surgical site pain 24 hours after surgery, postoperative hospital stay, shoulder Constant-Murley function score at 1 and 3 months after surgery, and complications were recorded and compared between the two groups.Results:The TBL, VBL, IBL, HBL, postoperative drainage volume, hemoglobin decrease, transfusion rate, postoperative VAS score at the surgical site, and hospital stay in the TXA group were all lower than those in the control group, and the differences were statistically significant (all P<0.05). The VAS score at the surgical site 24 hours after surgery was positively correlated with TBL and HBL in two groups of patients ( r=0.402, 0.418, P<0.001). Compared with the control group, the TXA group had a higher shoulder Constant-Murley function score at 1 month after surgery, and the difference was statistically significant ( P=0.002). There was no statistically significant difference in shoulder Constant-Murley function score and incidence of complications between the two groups at 3 months after surgery (all P>0.05). Conclusions:For elderly patients with partial or partial PHF who underwent open reduction and locking plate internal fixation using MIPO approach, intravenous infusion of TXA 30 minutes before surgery can help alleviate postoperative pain at the surgical site, reduce intraoperative and postoperative bleeding, lower transfusion rates, shorten hospital stay, and do not increase the incidence of complications such as incision abnormalities and thrombosis, which is beneficial for promoting early and rapid recovery of patients.

Objective:To compare the clinical efficacy between 3D printing-assisted percutaneous balloon dilatation calcaneal plasty (3D-PCP) and conventional open reduction and internal fixation (ORIF) via the extended lateral L-shaped approach in the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients.Methods:Retrospectively analyzed were the data of 36 elderly patients with osteoporotic calcaneal fracture of Sanders type Ⅱ or Ⅲ who had been surgically treated at Department of Orthopaedics, Yixing People's Hospital from June 2012 to June 2018. According to their treatment methods, the patients were divided into a 3D-PCP group [16 cases, 9 males and 7 females with an age of (73.0 ± 3.4) years] and an ORIF group [20 cases, 8 females and 12 females with an age of (71.4 ± 2.6) years]. The 2 groups were compared in terms of hospital stay, operation time, intraoperative fluoroscopy frequency, suture removal time, weight bearing time, fracture healing time, visual analogue scale (VAS) for the surgical site 2 days and one year after surgery, American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score, calcaneal imaging parameters (B?hler angle, Gissane angle, and length, width and height of the calcaneus axis) at 2 days and one year after surgery, and postoperative complications.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P > 0.05). All patients were followed up for 14 to 18 months (mean, 15.6 months). Compared with the ORIF group, the 3D-PCP group had significantly shorter hospital stay, significantly shorter operation time, significantly earlier suture removal, significantly earlier weight-bearing, significantly lower VAS scores at 2 days after surgery, significantly higher AOFAS ankle-hindfoot scores at one month after surgery, but significantly more times of intraoperative fluoroscopy (all P < 0.05). In all patients, the VAS scores at 2 days after surgery were significantly lower than those before surgery, and those at one year after surgery significantly lower than those at 2 days after surgery ( P < 0.05). In all patients, the AOFAS ankle-hindfoot scores at one month after surgery were significantly higher than those before surgery ( P < 0.001). In the ORIF group, the AOFAS ankle-hindfoot scores at one year after surgery were significantly higher than those at one month after surgery ( P < 0.05), but in the 3D-PCP group there was no such a significant difference between one year and one month after surgery ( P > 0.05). There was no significant difference in VAS score, AOFAS score, fracture healing time or postoperative imaging parameters between the 2 groups at one year after surgery ( P > 0.05). There was no significant difference either in the incidence of complications between the 2 groups ( P > 0.05). Conclusion:In the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients, compared with conventional ORIF, 3D-PCP shows advantages of shorter operation time, minimal invasion, quicker incision healing, shorter hospital stay, earlier weight-bearing exercise, and better functional recovery but a disadvantage of increased times of intraoperative fluoroscopy.

Objective:To explore the of short-term psychodynamic psychotherapy on anxiety and depression of gout patients and its influence on well-being index, family function and compliance.Methods:60 gout patients were selected from June 2018 to December 2019 in the outpatient department of rheumatism and immunity department of Dongguan Kanghua Hospital by prospective case-control study. They were randomly divided into control group and treatment group, 30 cases respectively. Both groups were given gout related clinical treatment and routine nursing, and the treatment group was given short-term dynamic orientation psychotherapy. The treatment compliance, the psychological status, well-being index and blood uric acid (UA) level of the two groups were compared before intervention, immediately after intervention and 3 months after intervention.Results:The scores of Patient Health Questionnaire-9 (PHQ-9) and the generalized anxiety disorder 7-item scale (GAD-7) in the two groups were gradually decreased immediately and 3 months after intervention ( P<0.05), and the scores of well-being index were gradually increased ( P<0.05); Compared with the control group, the scores of PHQ-9 and GAD-7 in the treatment group decreased more significantly ( P<0.05), and the score of well-being index increased more significantly ( P<0.05); The scores of communication, behavior control and total function of family function in the treatment group decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), and were significantly lower than those in the control group ( P<0.05); The level of serum UA in the two groups decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), but there was no significant difference in UA level at each time point between the two groups. The treatment compliance of the treatment group was significantly better than that of the control group ( P<0.05). Conclusions:The short-term dynamic orientation psychotherapy for gout patients has obvious effect in improving the state of anxiety and depression, improving the index of well-being, family function and treatment compliance.

The coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection is currently a global pandemic.Extensive investigations have been performed to study the clinical and cellular effects of SARS-CoV-2 infection.Mass spectrometry-based proteomics studies have revealed the cellular changes due to the infection and identified a plethora of interactors for all SARS-CoV-2 components,except for the longest non-structural protein 3(NSP3).Here,we expressed the full-length NSP3 proteins of SARS-CoV and SARS-CoV-2 to investigate their unique and shared functions using multi-omics methods.We conducted interactome,phosphoproteome,ubiquitylome,transcriptome,and proteome analy-ses of NSP3-expressing cells.We found that NSP3 plays essential roles in cellular functions such as RNA metabolism and immune response(e.g.,NF-κB signal transduction).Interestingly,we showed that SARS-CoV-2 NSP3 has both endoplasmic reticulum and mitochondrial localizations.In addi-tion,SARS-CoV-2 NSP3 is more closely related to mitochondrial ribosomal proteins,whereas SARS-CoV NSP3 is related to the cytosolic ribosomal proteins.In summary,our integrative multi-omics study of NSP3 improves the understanding of the functions of NSP3 and offers poten-tial targets for the development of anti-SARS strategies.

Objective:To summarize the scientific research management response strategies and practices of designated hospitals under the prevention and control of new coronary pneumonia, provide reference for the scientific and technological management of public health emergencies in domestic hospitals.Methods:Take the hospital scientific research management response under the prevention and control of the new coronavirus pneumonia epidemic in 2020 as an example, discuss and summarize the response strategies and mechanism establishment, work practice and existing problems of designated hospitals in the research management of prevention and control of public health emergencies represented by COVID-19 from the aspects of management system, resource integration, project operation, and scientific and technological service.Results:As a designated hospital of COVID-19 in Beijing, Youan hospital has actively carried out scientific and technological research on epidemic prevention and control while successfully completing patient treatment, established a scientific and efficient scientific and technological research management system, and integrated resources to form an efficient project operation mechanism, Providing a full range of scientific management services, providing policy and material guarantee for the rapid and high-quality completion of scientific and technological research on epidemic prevention and control.Conclusions:The scientific and technological research on public health emergencies has the characteristics of demand-driven, focused on key points, collaborative research, scientific decision-making, In order to carry out the research work smoothly, it is particularly important to form a benign interaction, straighten out the system, do a good job in long-term planning and layout, and establish a scientific and efficient research and management mechanism.

The current outpatient payment method based on fee-for-service induced serious demand, which increased the waste of medical insurance fund. The authors briefly introduced ambulatory patient groups(APG)with the same concept of diagnosis-related groups. According to the current situation of outpatient medical insurance payment and the degree of informatization in China, suggestions are put forward: launch a pilot project first and starting with chronic disease to promote reform; improve the quality of outpatient electronic medical records, and develop APG suitable for China; under the background of aging, cooperate with the total budget to ensure the security of medical insurance.

OBJECTIVETo observe the effects of acupuncture at different acupoints in meridians and meridians on lower limb muscle tension in children with spastic cerebral palsy.

METHODSNinety children with spastic cerebral palsy aged between 2 to 6 years old were divided into a yin-meridian group, a yang-meridian group and a rehabilitation group, 30 cases in each one. The patients in the rehabilitation group were treated with routine rehabilitation treatment; the patients in the yin-meridian group were treated with routine rehabilitation treatment and acupuncture at Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) along meridians; the patients in the yang-meridian group were treated with routine rehabilitation treatment and acupuncture at Futu (ST 32), Zusanli (ST 36), Yanglingquan (GB 34), Guangming (GB 37) and Xuanzhong (GB 39) along meridians. All the three groups were treated once each other day, 10 times as one course, and totally 20-day treatment was given. Before and after treatment, modified Ashworth scale (MAS), clinical spasm index (CSI) and integrated electromyography (iEMG) of surface electromyogram of gastrocnemius muscle were evaluated.

RESULTSCompared before treatment, the MAS and CSI in the yin-meridian group and yang-meridian group were improved after treatment (<0.05, <0.01); the differences before and after treatment in the rehabilitation group were not significant (both >0.05). After treatment, the differences between the rehabilitation group and yin-meridian group, yang-meridian group were significant (<0.05, <0.01); the differences of MAS and CSI between the yin-meridian group and yang-meridian group were not significant (both >0.05). Compared before the treatment, the right-side iEMG and left-side iEMG were reduced in the yin-meridian group and yang-meridian group (all <0.05); the right-side iEMG was increased in the rehabilitation group (<0.05). After treatment, the iEMG in the yin-meridian group and yang-meridian group were lower than that in the rehabilitation group (all <0.05); the differences of iEMG before and after treatment in the yin-meridian group and yang-meridian group were higher than that in the rehabilitation group (all <0.05); the differences of iEMG between the yin-meridian group and yang-meridian group were not significant (both >0.05).

CONCLUSIONAcupuncture at meridians and meridians could reduce muscle tension of lower limb and improve limb spasticity in children with spastic cerebral palsy, and the two acupuncture methods have similar clinical curative effect.

Objective To establish an ELISA for quantitative determination of decoy receptor 3 (DcR3) in human plasma.Methods A solid phase double antibody sandwich method was established for quantitative determination of DcR3.The anti-DcR3 antibody was immobilized onto ELISA plate.DcR3 in samples was captured by anti-DcR3 on ELISA plate and then detected by biotin-anti-DcR3 and subsequent peroxidase-labeled streptavidin,and the color was developed by adding substrate.The standard DcR3 samples on the same plate were detected simultaneously to calculate the DcR3 concentrations in unknown samples.The sensitivity,specificity,precision,recovery,linearity and DcR3 range in normal human adults were assessed.Results The sensitivity of the developed assay was 0.051 ng/mL.The intra-coefficient of variation (CV) was less than 10％ and inter-CV was less than 15％.The average recovery rate was 90.50％.When 2-fold amount of anti-TNF-α was added into the coated antibodies,10-fold amount of biotin-labeled anti-LIGHT,antiFAS or anti-TNF-α was added into the detection antibodies,or 10 fold amount of purified LIGHT protein was added into the standard DcR3 samples as competitor,no disturbing effects on standard curve were found.The linear range of the assay was from 0.25 to 16 ng/mL (r≥0.98).The concentration of DcR3 tested in 128 plasma samples from healthy adults was (0.21 ± 0.05) ng/mL with 95％ CI ranged from 0.14 to 0.28 ng/mL and no difference of age and sex was found.Conclusion The established ELiSA for determining plasma DcR3 exhibited high specificity,sensitivity,precision,fine linearity and wide detecting range.This method could be used for quantification of DcR3 in plasma.