Superior vena cava syndrome and pulmonary artery stenosis in a patient with lung metastases of bladder cancer / 复旦学报（医学版）

Superior vena cava syndrome(SVCS)is a group of clinical syndromes caused by obstruction of the superior vena cava and its major branches from various causes.Pulmonary artery stenosis(PS)is a complication of lung cancer or mediastinal tumours.SVCS combined with PS due to pulmonary metastases from bladder cancer is extremely rare and has not been reported in the literature.Here we reported an old male patient with pulmonary metastases from bladder cancer presenting with swelling of the head,neck and both upper limbs.SVCS combined with PS was clarified by pulmonary artery computed tomography angiography(CTA)and digital subtraction angiography(DSA).Endovascular stenting was used to treat SVCS.Angiography also showed that PS had not caused pulmonary hypertension and did not need to be treated.The swelling of the patient's head,neck and upper limbs was gradually reduced after the procedure.

Based on the novel anti-heart failure drug ARNI,the mechanism of prevention of cardiotoxicity caused by anthracycline antitumor drugs was discussed / 实用医学杂志

Objective To explore the efficacy of a new anti-heart failure drug,Entresto,in the prevention of cardiotoxicity caused by doxorubicin(DOX).Methods Male adult ICR mice were randomly divided into three groups(n = 8):control group,DOX group and DOX plus Entresto group.Cardiac function of mice was measured by echocardiography.H9c2 cells were pretreated with Entresto(0-48 μmol/L)for 24 hours in the presence or absence of DOX(1 mmol/L),and then cell viability,oxidative stress,apoptosis and mitochondrial function were evaluated.Results As compared with the control group,leakage of CK,CK-MB and LDH increased significantly in the DOX group(P<0.01),and left ventricular systolic dysfunction occurred.Entresto administration reversed these changes in the DOX group.The level of ROS and the number of apoptotic cells in cardiomyocytes in the DOX plus Entresto group were lower than those in the DOX group(P<0.05).As compared with the DOX group,the level of ROS and the number of apoptotic cells in H9c2 cells decreased significantly in the Entresto plus DOX group(P<0.05),and mitochondrial membrane potential increased significantly(P<0.05).Entresto reversed the inhibitory effect of DOX on SIRT1/PGC-1α/MFN2 signaling pathway.Conclusions Entresto improves DOX-induced cardiotoxicity by inhibiting ROS-mediated oxidative stress and apoptosis,and its mechanism may be related to SIRT1/PGC-1α/MFN2 signal transduction pathway.

Platelet-camouflaged silver nanoparticle hydrogel accelerates wound healing in type 1 diabetic rats / 中国组织工程研究

BACKGROUND:Bacterial infections and impaired angiogenesis have been obstacles to diabetic wound healing,and the problem of multidrug resistance cannot be ignored,so there is an urgent need to find a new therapeutic strategy. OBJECTIVE:To prepare platelet-camouflaged silver nanoparticle hydrogel and observe its therapeutic effect on diabetic wounds. METHODS:(1)In vitro test:The ultra-small silver nanoparticles(usAgNPs)were obtained by reflux heating.usAgNPs-PL/CMC hydrogel was prepared by coupling it with platelets(PL)and adding it to the carboxymethyl cellulose(CMC)hydrogel.The microstructures,swelling properties,and mechanical properties of the hydrogel were characterized.The antibacterial activity of the hydrogel was tested by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)5[(phenylamino)carbonyl]-2H-tetrazolium hydroxide method,reactive oxygen species method,bacterial biofilm method,and bacterial activity.(2)In vivo test:Forty SD rats were randomly divided into sham operation group,model group,CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group,with eight rats in each group.The type 1 diabetes model was established in the other four groups except the sham operation group.After successful model establishment,a skin wound(20 mm in diameter)deep to the fascia layer was made on the back of rats of the five groups.Rats in the sham operation group and model group were injected with normal saline.The rats in the CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group were implanted with the corresponding hydrogel,separately.The wound healing condition and healing quality were observed after 14 days of treatment. RESULTS AND CONCLUSION:(1)In vitro test:The usAgNPs-PL/CMC hydrogel had a uniform three-dimensional network structure,good mechanical properties,and strong water absorption ability,which could remarkably inhibit the growth of Escherichia coli and Staphylococcus aureus,and had a good inhibition and clearance effect on the formation of biofilms of the two bacteria,and had a good antibacterial ability.(2)In vivo test:After 14 days of treatment,the wounds of the usAgNPs-PL/CMC hydrogel group were basically closed.The wound healing rate was the highest,and the number of wound colonies was significantly lower than that of the model group.After 14 days of treatment,hematoxylin-eosin and Masson staining showed that the tissue structure of regenerated dermis appeared on the wounds of the usAgNPs-PL/CMC hydrogel group,usAgNPs/CMC hydrogel group,and CMC hydrogel group,and the epidermis of the new granulation tissue was complete and thick.Parallel mature collagen fibers were observed in the usAgNPs-PL/CMC hydrogel group.After 7 days of treatment,CD31 immunohistochemistry and Ki67 immunofluorescence staining showed that the usAgNPs-PL/CMC hydrogel group had the highest number of microvessels and fibroblasts.(3)The results showed that usAgNPs-PL/CMC hydrogel could accelerate wound healing in type 1 diabetic rats by rapidly inhibiting bacteria and promoting angiogenesis.

Clinical significance of digital measurement of occipital condyle and foramen magnum in children / 中国组织工程研究

BACKGROUND:Due to the young age of children,the occipital condyle and foramen magnum are not fully developed,and they are prone to various diseases and injuries in the occipitocervical junction,which requires surgical treatment in severe cases.However,anatomical parameters for the development of the occipital condyle and foramen magnum in children are lacking. OBJECTIVE:To measure the morphological structure of the occipital condyle and foramen magnum by three-dimensional reconstruction technique,and to provide important anatomical parameters for occipitocervical junction lesions,related surgical procedures and forensic identification. METHODS:Imaging data of 389 cases of primitive children and adolescents involved in skull base undergoing spiral CT scanning(247 males and 142 females)aged 1-18 years were collected and divided into 1-3-year-old group,4-6-year-old group,7-9-year-old group,10-12-year-old group,13-15-year-old group,and 16-18-year-old group according to their age.Mimics 16.0 software was used to reconstruct the skull base and measure the length and width of the foramen magnum.A formula was used to calculate the area and index of the foramen magnum.We measured the length,width and height of the occipital condyle,the angle between the long axis and the sagittal axis of the occipital condyle(O-S angle),the included angle between the midpoint of the front and back edges of the foramen magnum and the connection between the back edge of occipital condyle and the intersection point of the foramen magnum(F-O angle),and the included angle between the midpoint of the front and back edges of the foramen magnum and the midpoint of the back wall of the sublingual neural tube(F-H angle).Gender,side and age differences were analyzed among the indicators. RESULTS AND CONCLUSION:(1)In foramen magnum measurement,there was no significant difference between sexes in the index of the foramen magnum(P>0.05),but there were significant differences in length,width and area of the foramen magnum(P<0.05).(2)The O-S angle,F-O angle and F-H angle of the occipitral condyle were not significantly different between genders(P>0.05),but length,width and height of the occipital condyle were significantly different between genders(P<0.05).(3)There were no significant differences in the length of the occipital condyle among different groups(P>0.05),but there were significant differences in the width and height of the occipital condyle,O-S angle,F-O angle and F-H angle among different groups(P<0.05).(4)Length,width and area of the foramen magnum,length,width and height of the occipital condyle showed a wavy increasing trend with the increase of age,while O-S,F-O and F-H angles showed a wavy decreasing trend with the increase of age,while the index of the foramen magnum showed no significant change.(5)In conclusion,there are gender and lateral differences in the morphological indexes of the foramen magnum and the occipital condyle in children.These differences can provide an important reference for clinical surgical approach selection and forensic examination.

Finite element analysis of biomechanical effect of lumbar range of motion on the implants after lumbar fusion / 中国组织工程研究

BACKGROUND:At present,lumbar interbody fusion is widely used in the treatment of a variety of lumbar diseases.However,how to reduce postoperative complications such as pseudarthrosis formation,screw loosening and fracture,and cage failure remains a serious challenge. OBJECTIVE:To analyze the effect of total lumbar range of motion on the stress or strain of bone grafts,cage,and screw-rod system,so as to better guide patients to carry out lumbar activities to reduce the risks of pseudarthrosis formation and instrumentation failure. METHODS:An intact human L1-S1 finite element model was constructed using Mimics,3-Matic,HyperMesh,and Abaqus software and the transforaminal lumbar interbody fusion was simulated.The average strain of the interbody bone grafts and the peak stresses of the cage and screw-rod system were compared before and after applying the bending moment,and the changing trend with the total range of motion was analyzed.The stress nephogram was drawn to observe the stress distribution. RESULTS AND CONCLUSION:(1)Compared with applying the vertical compression load alone,the average strain of the interbody bone grafts,peak stresses of the cage and screw-rod system after applying bending moment increased by 2.6%-55.3%,65.6%-166.8%,and 36.0%-353.4%,respectively.(2)With the increase of total range of motion,the average strain of the interbody bone grafts increased nonlinearly and produced the maximum value under left and right axial rotation,while the peak stresses of the cage and screw-rod system increased linearly and produced the maximum value under left and right lateral bending.(3)The stress distribution of the interbody bone grafts and cage was related to the loading condition.The stress of the screw-rod system was mainly concentrated in the interfaces of the screw-bone and screw-rod.(4)Therefore,increasing axial rotation activity after operation may reduce the risk of pseudarthrosis formation,while reducing lateral bending activity may reduce the failure of the cage and screw-rod system.

Research progress on the role of cancer stem cell biomarkers in the progression and treatment of cervical cancer / 新乡医学院学报

Cancer stem cells(CSCs)are a small subgroup of cells capable of initiating cancer and are associated with chemotherapy resistance and cancer recurrence.Cervical cancer is one of the major malignant tumors threatening women's health worldwide.With the popularization of cervical cancer screening,some early cervical cancer and precancerous lesions have been discovered and timely treated,but the treatment and prognosis of mid-to late-stage cervical cancer have not been markedly improved.The treatments of mid-to late-stage cervical cancer are still surgery,radiotherapy and chemotherapy.There-fore,effective targeting strategies for cervical cancer CSCs are increasingly important for monitoring the progress of cervical cancer treatment and evaluating new treatment methods.This article provides a brief review of the role of biomarkers of cervical cancer CSCs in the progression of cervical cancer and their potential as therapeutic targets.

Methodological evaluation of automatic iodine detector for measuring urinary iodine / 中华地方病学杂志

Objective:To evaluate the feasibility of using an automatic iodine detector to detect urinary iodine.Methods:Using an automatic iodine detector to determine urinary iodine, within the range of the 50 - 1 000 μg/L standard curve, methodological evaluations on the linear relationship of the standard curve, precision, and accuracy (determination of urinary iodine standard substances GBW09108x, GBW09110c, GBW09111b, GBW09112b, and spiked recovery experiments) were conducted. Method comparison experiments with the arsenic cerium catalytic spectrophotometry recommended by the National Reference Laboratory for Iodine Deficiency Disorders (NRL) was conducted.Results:The method has a good linear relationship within the range of 50 - 1 000 μg/L standard curve, │ r│ > 0.999 0. The coefficient variations for measuring iodine levels in urine samples with low, medium, and high iodine concentrations were 2.4%, 0.8%, and 1.1%, respectively. The recovery rates of urine samples with low, medium, and high iodine concentrations ranged from 93.0% to 104.1%, with a total average recovery rate of 98.9%. The determination results of standard substances GBW09108x, GBW09110c, GBW09111b, and GBW09112b were all within the given standard value ± uncertainty range [(80.8 ± 9.0), (227.0 ± 15.0), (525.0 ± 17.0), (794.0 ± 28.0) μg/L]. There was no statistically significant difference between the results obtained by using the iodine automatic detector and the NRL recommended standard method ( t = - 1.94, P = 0.062). Conclusions:The iodine automatic detector has a high degree of automation, strong environmental adaptability, and excellent detection efficiency in determining urinary iodine. The experimental results of methodological characteristics are good and can be used for the detection of urinary iodine samples.

Harmonic waves analysis for observing morphological brain network changes in depressive disorder patients / 中国医学影像技术

Objective To explore the feasibility of harmonic waves analysis for observing morphological brain network changes in patients with depressive disorder(DD).Methods Whole brain 3D high resolution T1WI of 55 DD patients(DD group)and 46 normal controls(NC group)were acquired.Six kinds of morphological features brain network were constructed with FreeSurfer tool,including the number of brain region vertices,surface area,gray matter volume,average cortical thickness,Gaussian curvature and fold index.Laplace operator was applied to obtain common harmonic wave.The harmonic power of different morphological features and the gray matter volume in different brain regions were compared between groups.Results No significant difference of total harmonic energy was found between groups.The specific harmonic wave energies were significantly different between groups,including the number of brain region vertices corresponding to the 2nd,6th,15th,44th and 57th harmonic waves,surface area corresponding to the 2nd,6th,16th and 57th harmonic waves,gray matter volume corresponding to the 2nd,12th,13th,15th and 57th harmonic waves,average cortical thickness corresponding to the 2nd,19th,35th,36th and 44th harmonic waves,Gaussian curvature corresponding to the 34th,40th,54th and 57th harmonic waves,as well as fold index corresponding to the 5th,16th,21st and 57th harmonic waves.Gray matter volumes of transverse temporal gyrus in left hemisphere in DD group were significantly larger than that in NC group(t=2.900,P=0.004).Conclusion Harmonic waves analysis was feasible for observing morphological brain network changes in DD patients.

Analysis of the effect of 12week highintensity fitness exercises on improving metabolic disorders among obese adolescents / 中国学校卫生

Objective@#To analyze the effects of 12week highintensity fitness exercise on body composition,lipid metabolism and gut microbiota in obese adolescents, so as to provide references for improving the health levels of obese adolescents.@*Methods@#From January to June 2023, 20 obese adolescents from Huaifeng Vocational and Technical School in Huaian City were recruited for the study. Participants were assigned to an exercise group (n=10) and a control group (n=10) for a 12week exercise intervention by random number table method, and both groups had the same diet during the intervention period. The exercise group engaged in three exercises every week, mainly consisting of moderate to highintensity aerobic exercise combined with highintensity intervals. In the first week, there was a 30 minutes of aerobic exercise, followed by 10 minutes of highintensity interval training in the total intervention time each week, and the rest of the time was aerobic exercise with a total intervention time of 60 minutes to maintain; the control group did not receive specific interventions. Body composition was measured using bioelectrical impedance analysis, and lipid levels were determined using an automatic biochemical analyzer. The expression levels of serum inflammatory factors were measured at baseline and after 12 weeks of intervention, and gut microbiota was analyzed using 16S rRNA gene sequencing. Statistical analysis was performed using t test and Chisquare test.@*Results@#After 12 weeks of intervention, the levels of triglycerides (TG), and lowdensity lipoprotein cholesterol (LDL-C) in obese adolescents in the exercise group decreased from (1.7±0.6, 3.5±0.8) mmol/L to (0.9±0.3, 2.6±0.4) mmol/L, while highdensity lipoprotein cholesterol (HDL-C) increased from (1.1±0.2) mmol/L to (1.4±0.2) mmol/L; and serum interleukin-1 receptor antagonist(IL-1Rn) decreased from (8.4±1.6) to (4.5±0.4) ng/mL in the exercise group (t=7.34,2.49,-3.05,2.56, P<0.05). The α-diversity results showed that the Chao index (268.00±22.67) and Ace index (243.98±38.64) in the exercise group were higher than those in the control group (184.52±19.28, 171.43±23.33), and the differences were statistically significant (t=2.48, 2.53, P<0.05). The Shannon index (5.36±1.41) in the exercise group was higher than that in the control group (4.73±1.12), and the Simpson index (0.78±0.10) was lower than that in the control group (0.89±0.10), but the differences were not statistically significant (t=1.83, -2.10, P>0.05). The β-diversity results showed that the intergroup differences in gut microbiota structure between the exercise group and the control group were greater than the intragroup differences, and the differences in gut microbiota structure between the exercise group and the control group were statistically significant (R2=0.083，P<0.05). After intervention, there were significant differences in the relative abundances at the levels of phylum, class, genus, and species in gut microbiota among obese adolescents between the exercise group and the control group (P<0.05).@*Conclusion@#The 12week highintensity fitness exercise can alleviate obesity symptoms in obese adolescents through the gut microbiota-lipid metabolism pathway and improve mild chronic inflammatory status.

Investigation on polyurethane grouting waterproof material-induced occupational acute 1,2-dichloroethane poisoning in the construction industry / 中国职业医学

ObjectiveTo analyze the causes of occupational acute 1,2-dichloroethane (1,2-DCE) poisoning accident during the use of polyurethane grouting materials for waterproof plugging operation in the construction industry. Methods By combining the clinical symptoms of the patient, worksite survey of occupational health and workplace occupational hazards monitoring method, the cause of an occupational acute 1,2-DCE poisoning accident was investigated at a construction site during the use of polyurethane grouting material for waterproofing and plugging operations. Results The patient was engaged in waterproof grouting work using polyurethane grouting material. The main volatile organic components in the raw materials were 1,2-DCE, with traces of dichloromethane, methyl acetate and others. The result of post-incident on-site investigation showed that the short-term exposure concentration of 1,2-DCE in the workplace air was 578.70 mg/m3, which was more than 30 times higher than the national occupational health standard limit. The mass concentration of 1,2-DCE in the patient's blood was 230 μg/L. Combined with the patient's occupational hazard exposure history, clinical manifestations, worksite survey of occupational health, and laboratory test results, according to GBZ 39-2016 Diagnosis of Occupational Acute 1,2-Dichloroethane Poisoning, this incident was diagnosed as a severe occupational acute 1,2-DCE poisoning event caused by the use of inferior polyurethane grouting material. Conclusion The excessive concentration of 1,2-DCE in the workplace air is the main cause of this poisoning accident. Construction sites with confined space operations should improve various occupational health management systems, occupational health engineering protective facilities, and personal protective equipment must be provided for workers.

Vitamin D Plays a Crucial Role in Regulating Dopamine Nervous System in Brain / 生物化学与生物物理进展

Vitamin D is a unique fat-soluble vitamin that plays an indispensable role in human health. It exists in various forms, the most significant being vitamin D2 (derived from plant sources) and vitamin D3 (synthesized naturally in human skin upon exposure to sunlight). Vitamin D’s primary function is to facilitate the absorption of calcium and phosphorus, which are crucial for maintaining healthy bones. Beyond its role in bone health, vitamin D significantly influences the immune system, muscle function, cardiovascular health, and the regulation of brain functions. A deficiency in vitamin D can lead to various chronic diseases such as rickets, osteoporosis, decreased immunity, increased risk of mental disorders, and cancers. The synthesis of vitamin D in the human body, both peripherally and centrally, relies on sunlight exposure, dietary sources, and various supplements. As a neuroactive steroid, vitamin D impacts both the physiological and pathological processes of the nervous system and plays a key role in brain health. It profoundly affects the brain by regulating neurotransmitter synthesis and maintaining intracellular calcium balance. As an essential chemical molecule, vitamin D participates in complex signal transduction pathways, impacting neurotransmitter functions and synaptic plasticity. Vitamin D’s role in regulating dopamine (DA)—a neurotransmitter critical for motivation, reward perception, and other higher cognitive functions—is particularly noteworthy. Recent studies have revealed that vitamin D not only promotes the synthesis of DA but also plays a role in regulating DA levels within the brain. It exerts neuroprotective effects on DA neurons through anti-inflammatory, antioxidant actions, and neurotrophic support, thereby creating an optimal environment for DA neurons, influencing neuronal structure, and affecting the movement of calcium ions within nerve cells, positively impacting the overall health and functionality of the DA system. Furthermore, vitamin D can regulate the synthesis and release of DA, thus affecting the signal transmission of various DA neural projection pathways in the brain. This function is vital for understanding the complex interactions between neural mechanisms and their effects on key behaviors and cognitive functions. This review aims to delve deeply into the synthesis, metabolism, and pathways of vitamin D’s action, especially its regulatory mechanisms on DA neurons. Through this exploration, this article seeks to provide a solid theoretical foundation and research framework for a deeper understanding of vitamin D’s role in motivation and reward behaviors. This understanding is crucial for appreciating the broader significance of vitamin D in the fields of neuroscience and neurology. In summary, research and discoveries regarding vitamin D’s impact on the nervous system highlight its importance in neural health and function. These insights not only enhance our understanding of the complex workings of the nervous system but also open new avenues for the prevention and treatment of neurological diseases. The exploration of vitamin D’s multifaceted roles offers promising prospects for developing new therapeutic strategies, underscoring the compound’s potential in addressing a range of neural dysfunctions and diseases. As research continues to evolve, the profound implications of vitamin D in the field of neurology and beyond become increasingly apparent, marking it as a key target for ongoing and future scientific inquiry.

The killing effects of gentamicin on uropathogenic Escherichia coli and its cytotoxicities in in vitro experiments of urinary tract infection / 西安交通大学学报(医学版)

【Objective】 To compare the killing effects of different concentrations of gentamicin (0, 10, 20, 50, 100, and 200 μg/mL) on uropathogenic Escherichia coli (UPEC) and its cytotoxicities on urinary urothelial cells and inflammatory cells such as macrophages in vitro. 【Methods】 The killing effects of different concentrations of gentamicin on different amounts (108, 107, and 106) of UPEC strain J96 were compared. The cytotoxicities of different concentrations of gentamicin on primary cultured male C57BL/6 mouse renal tubular epithelial cells, mouse macrophages and human bladder epithelial cell line J82 at different time points (2 h and 24 h) were detected by CCK-8 assay. According to the experiments above, we chose appropriate gentamicin concentrations and incubation time in in vitro cell culture experiments to verify J96 adhesion and invasion to mouse renal tubular epithelial cells or phagocytosis and clearance of J96 by mouse macrophages. 【Results】 The killing effect of gentamicin (≥10 μg/mL) on J96 was stronger than that of 1% P/S (P<0.000 1). High concentrations of gentamicin (≥100 μg/mL) could kill up to 108 J96 within 30 min. 50 μg/mL gentamincin treatment for 2 h was cytotoxic for human bladder epithelial cell line J82 (P<0.05). 【Conclusion】 The appropriate concentration and duration of gentamicin treatment for different cells in vitro were determined. Urothelial cells, especially human bladder epithelial cell line J82, were more sensitive to gentamicin.

Hereditary pheochromocytoma/paraganglioma and associated syndromes:a clinical and genetic study / 陆军军医大学学报

Objective To summarize and analyze the clinical phenotypes,hereditary features and treatment and follow-up strategies of different hereditary pheochromocytoma/paragangliomas(PCC/PGL)and related syndromes.Methods Forty-four clinically diagnosed PCC/PGL patients admitted in our hospital from January 2000 to August 2022 were enrolled,and the clinical data of them and their family members were collected.Second-generation sequencing was performed on 43 patients for genetic detection,and Sanger sequencing was applied to verify the mutation of the probands and family members.Results There were 15 patients diagnosed with hereditary PCC/PGL,including 7 cases of von Hippel-Lindau(VHL)syndrome,3 cases of multiple endocrine neoplasia type 2(MEN2),and 5 cases of familial paraganglioma syndrome.Seven VHL syndrome families were diagnosed as VHL2A(c.500G＞A),VHL2B(c.239G＞T and c.444_457del),and VHL2C(c.293A＞G)according to their clinical manifestations.All probands received surgical treatment,and 2 cases of recurrent PCC and the patients with multiple renal cancer also received targeted therapy with sunitinib.Three MEN2 families carried c.1901G＞C,c.1832G＞A,and c.1901G＞A missense mutations,respectively,and were diagnosed with MEN2A clinically.All of them underwent adrenalectomy and thyroidectomy,including one for preventive thyroidectomy.Among the 5 familial paraganglioma syndrome families,4 patients carried SDHB mutations(SDHB:c.343C＞T,c.541-2A＞G,c.575G＞A,c.268C＞T)and 1 patient carried an SDHD mutation(SDHD:c.337_340del).Sporadic retroperitoneal PGL were most common.Conclusion More than 1/3 of PCC/PGL patients carry germline gene mutations,showing obvious genotype-phenotype correlation.Genetic diagnosis technology plays an important guidance role for clinical precision treatment and follow-up,and genetic counseling.

Effects of mindful attention awareness on sleep quality of soldiers stationed in plateau areas: Chain-mediated effect of burnout and occupational stress / 环境与职业医学

Background Sleep quality is one of the important factors affecting soldiers’ task performance. Objective To explore the effects of mindful attention awareness, burnout, and occupational stress on sleep quality among soldiers in plateau areas. Methods A total of 1090 soldiers were selected from four units in plateau areas by cluster sampling method and were asked to participate a cross-sectional questionnaire survey using the Pittsburgh Sleep Quality Index (PQSI), Occupational Stress Inventory (OSI), Maslach Burnout Inventory-General Survey (MBI-GS), and Mindful Attention Awareness Scale (MAAS). Correlation analysis, regression analysis, and mediated effect test were conducted for the study. Results Of the 1090 soldiers recruited, 1082 soldiers returned valid questionnaires, and the valid recovery rate was 99.26%. The median (P25, P75) score of PSQI was 4.00 (2.00,7.00), the median score of OSI was 26.00 (17.00, 34.00), the median score of MBI-GS was 3.53 (3.13, 4.00), and the median score of MAAS was 71.00 (59.00, 82.00). The burnout and mindful attention awareness levels varied among military personnel of different age groups (P<0.05), so did the burnout and occupational stress levels among military personnel of different length of service groups (P<0.05), and the occupational stress, PSQI, burnout, and mindful attention awareness levels among military personnel with different educational backgrounds and genders (P<0.05). The results of mediated effect test showed that occupational stress and burnout had both a parallel mediated effect and a sequential mediating effect on the relationship between mindful attention awareness and sleep quality, with effect sizes of 15.3%, 21.5% and 31.8%, respectively. Conclusion There is a mediated effect on the relationship between mindful attention awareness and sleep quality by the occupational stress and burnout of military personnel in plateau areas, and sleep quality is also affected by mindful attention awareness through the chain-mediated effect of occupational stress and burnout.

Clinical Characteristics and Treatment of Blastic Plasmacytoid Dendritic Cell Neoplasm / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical manifestations, diagnosis, treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm(BPDCN).@*METHODS@#The clinical features, bone marrow morphology and immunophenotyping, treatment and prognosis of 4 patients with BPDCN were analyzed retrospectively.@*RESULTS@#4 patients had bone marrow， spleen and lymph nodes involvement， 2 patients had skin lesions， and 3 patients had central nervous system infiltration． Tailing phenomenon of abnormally cells could be seen in bone marrow. The immunophenotyping showed that CD56, CD4 and CD123 expression was observed in 4 patients， and CD304 in 3 patients． One patient refused chemotherapy and died early. Both patients achieved complete remission after the initial treatment with DA+VP regimen, 1 of them achieved complete remission after recurrence by using the same regimen again． One patient failed to respond to reduced dose of DA+VP chemotherapy, and then achieved complete remission with venetoclax+azacitidine.@*CONCLUSION@#The malignant cells in BPDCN patients often infiltrate bone marrow, spleen and lymph nodes, and have specical phenotypes, with poor prognosis. The treatment should take into account both myeloid and lymphatic systems. The treatment containing new drugs such as BCL-2 inhibitors combined with demethylation drugs is worth trying.

Effect of pH on the chelation between strontium ions and decellularized small intestinal submucosal sponge scaffolds / 北京大学学报(医学版)

OBJECTIVE@#To investigate the preparation of decellularized small intestinal submucosa (dSIS) sponge scaffolds with chelated strontium (Sr) ions at different pH values, and to select the appropriate pH values for synthesizing Sr/dSIS scaffolds using the physicochemical properties and biocompatibility of the scaffolds as evaluation indexes.@*METHODS@#(1) Sr/dSIS scaffolds preparation and grouping: After mixing dSIS solution and strontium chloride solution in equal volumes, adjusting pH of the solution to 3, 5, 7, and 9 respectively, porous scaffolds were prepared by freeze-drying method after full reaction at 37℃, which were named Sr/dSIS-3, -5, -7, and -9 respectively, and the dSIS scaffolds were used as the control group. (2) Physicochemical property evaluation: The bulk morphology of the scaffolds was observed in each group, the microscopic morphology analyzed by scanning electron microscopy, and the porosity and pore size determined, the surface elements analyzed by energy spectroscopy, the structure of functional groups analyzed by infrared spectroscopy, the chelation rate determined by atomic spectrophotometry, the water absorption rate detected by using specific gravity method, and the compression strength evaluated by universal mechanical testing machine.(3) Biocompatibility evaluation: The cytotoxicity and proliferative effect to bone mesenchymal stem cells (BMSCs) of each group were evaluated by Calcein-AM/PI double staining method.@*RESULTS@#Scanning electron microscopy showed that the scaffolds of each group had an interconnected three-dimensional porous structure with no statistical difference in pore size and porosity. Energy spectrum analysis showed that strontium could be detected in Sr/dSIS-5, -7 and -9 groups, and strontium was uniformly distributed in the scaffolds. Functional group analysis further supported the formation of chelates in the Sr/dSIS-5, -7 and -9 groups. Chelation rate analysis showed that the Sr/dSIS-7 group had the highest strontium chelation rate, which was statistically different from the other groups (P < 0.05). The scaffolds in all the groups had good water absorption. The scaffolds in Sr/dSIS-5, -7 and -9 groups showed significantly improved mechanical properties compared with the control group (P < 0.05). The scaffolds in all the groups had good biocompatibility, and the Sr/dSIS-7 group showed the best proliferation of BMSCs.@*CONCLUSION@#When pH was 7, the Sr/dSIS scaffolds showed the highest strontium chelation rate and the best proliferation effect of BMSCs, which was the ideal pH value for the preparation of the Sr/dSIS scaffolds.

Methodological evaluation of an automatic iodine element detector for measuring water iodine / 中华地方病学杂志

Objective:To evaluate the feasibility of using an automatic iodine element detector to detect water iodine.Methods:Water iodine was determined by an automatic iodine element detector. The methodological characteristics of this method was tested, including linear relationship of standard curves, precision tests, standard recovery experiment, and certified reference material GBW09113j, GBW09114j determination experiments. The methodological comparison experiment was conducted using arsenic cerium catalytic spectrophotometry.Results:Using an automatic iodine detector, in the range of 2, 10, 20, 40, 60, 80, 100, and 120 μg/L standard curve, the correlation coefficient ( r) for six parallel measurements ranged from - 0.999 9 to - 0.999 6. Precision analysis showed that the low, medium, and high iodine concentration water samples were measured six times in parallel, with corresponding coefficient of variation ( CV) of 2.2%, 3.0%, and 3.2%, all of which were less than 5%. The standard recovery experiment showed that the recovery rates of low, medium, and high iodine concentration water samples after two rounds of standard were 97.0%, 98.8%, and 99.5%, respectively, with a total average recovery rate of 98.4%. The detection results of the two reference materials were within the range of the given standard given by the national standard values [(8.2 ± 1.2), (61.0 ± 6.0) μg/L]. The iodine content of 30 water samples was determined by the automatic iodine detector and the arsenic cerium catalytic spectrophotometry, and the results showed no statistically significant significance ( t = - 1.62, P = 0.116). Conclusions:Although the concentration range of standard curve does not cover 0 - < 2 μg/L, the determination of water iodine by automatic iodine detector has advantages of high automation, high precision, good accuracy, and the results are in good agreement with the results of arsenic cerium catalytic spectrophotometry. It has good application prospects in water iodine determination.

Correlation of distal femoral torsion with increased risk of non-contact anterior cruciate ligament rupture / 中华创伤杂志

Objective:To investigate the relationship between distal femoral torsion (DFT) and anterior lateral ligament (ALL) injury in patients with non-contact anterior cruciate ligament (ACL) rupture and correlation between DFT and increased risk of non-contact ACL rupture.Methods:A retrospective case-control study was conducted to analyze the clinical data of 64 patients with non-contact ACL rupture admitted to the First Affiliated Hospital of Chongqing Medical University from May 2017 to March 2022, including 48 males and 16 females, with age ranging from 21 to 46 years [(33.9±10.1)years]. The patients were categorized into ACL rupture group ( n=32) and ACL rupture+ALL injury group ( n=32) according to whether they had concomitant ALL injury or not, and 32 patients with meniscal injury alone were matched according to their gender, age and body mass index as the meniscal injury group. The reference standard for DFT was the surgical posterior femoral condylar angle (sPCA) defined based on the angle between the line through the lateral condylar convexity and the medial condylar groove and the line connecting the bony posterior condyle as measured by MRI. The differences in sPCA were analyzed between overall non-contact ACL ruptured patients and patients in other groups, as well as between patients of different genders. The area under the curve (AUC) of a receiver operating characteristic (ROC) curve was carried out to determine the cut-off value of sPCA, and its correlation with an increased risk of non-contact ACL rupture was analyzed. Results:Overall non-contact ACL ruptured patients′ sPCA [(3.6±1.1)°] was significantly greater than that in the meniscal injury group [(2.4±1.5)°] ( P<0.01). The sPCA in the ACL rupture group [(3.5±1.2)°] and the ACL rupture+ALL injury group [(3.7±1.0)°] were also significantly greater than that in the meniscal injury group (all P<0.05); the ACL rupture+ALL injury group showed a trend of increased sPCA compared with the ACL rupture group, but the difference was not statistically significant ( P>0.05). In all groups and the whole population of the study, sPCA was increased in females compared with males with no statistically significant difference (all P>0.05). ROC curve analysis showed that in the overall non-contact ACL rupture patients, the AUC of sPCA in predicting the rupture risk of ACL was 0.74, with the cut-off value of 2.72°, the sensitivity of 84%, and the specificity of 69%. When sPCA was more than 2.72°, it was significantly associated with an increased risk of non-contact ACL rupture ( OR=11.88, 95% CI 4.08, 33.49). Conclusions:The sPCA is significantly increased in patients with non-contact ACL rupture. However, increased sPCA is not associated with ALL injury and not significantly increased in female patients compared with male patients. When sPCA is more than 2.7°, the risk of non-contact ACL rupture is significantly increased.

Analysis of the current situation and influencing factors of work engagement of wound therapists / 中华护理杂志

Objective To understand the current status and analyze the factors affecting the work engagement of wound therapists,and to provide references for promoting their work engagement.Methods From September 2022 to March 2023,wound therapists who were certificated by European Wound Management Association for more than 3 months were selected as subjects by convenient sampling method.The data was collected by the General Information Questionnaire,Hospitals and Wound Clinics Questionnaire,Areas of Worklife Scale and Specialty Nurse Work Engagement Scale,and the factors influencing the work engagement of wound therapists were analyzed by univariate and multiple liner regression.Results A total of 219 wound therapists were included.The total mean score of areas of worklife was(99.37±13.70);the average score of items was(3.55±0.49);the total mean score of the specialty nurse work engagement was(140.01±16.00);the average score of items was(4.38±0.50).The results of multiple linear regression analysis showed that reward,community,fairness,and values were factors influencing the work engagement of wound therapists(P＜0.05).Conclusion The higher average score of each dimension of areas of worklife could predict the higher level of work engagement for wound therapists.Nursing managers should pay more attention to the job-matching degree of specialty nurses and adopt scientific and effective management methods to improve the job-matching,which will help improve the specialty nurses'work engagement and satisfaction and reduce job burnout.

Predictive value of combined three serum cytokine levels for delayed cerebral ischemia in patients after aSAH / 中华老年心脑血管病杂志

Objective To investigate the predictive value of soluble tyrosine kinase-1(sFlt-1),chiti-nase protein 40(YKL-40)and lipoprotein phospholipase A2(Lp-PLA2)for delayed cerebral is-chemia(DCI)in patients after aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 100 aSAH patients treated in Department of Neurology of Nanyang First People's Hospital from January 2018 to December 2022 were enrolled,and then divided into DCI group(n=31)and non-DCI group(n=69).The levels of sFlt-1,YKL-40,and Lp-PLA2 in the serum were detected.ROC curve was plotted to evaluate the predictive value of serum sFlt-1,YKL-40 and Lp-PLA2 levels for DCI after aSAH.Results The serum levels of sFlt-1,YKL-40 and Lp-PLA2 were high-er in the DCI group than the non-DCI group(0.13±0.02 g/L vs 0.07±0.01 g/L,292.65±78.60μg/L vs 206.33±59.28 μg/L,396.59±41.12 μg/L vs 281.19±66.02 μg/L,P＜0.01).Logistic re-gression analysis revealed that elevated levels of sFlt-1,YKL-40 and Lp-PLA2,Hunt-Hess grade ≥3,modified Fisher grade ≥3,and WFNS grade ≥3 were risk factors for DCI after aSAH.ROC curve analysis showed that the AUC values of serum sFlt-1,YKL-40 and Lp-PLA2 levels in predicting DCI after aSAH was 0.806,0.789 and 0.893,respectively,and the value was 0.950 when the three indicators combined together.Conclusion Serum sFlt-1,Lp-PLA2 and YKL-40 levels are all elevated in the aSAH patients with DCI,and their combined detection is helpful for diagno-sing the occurrence of DCI after aSAH.