Application of Objective Structured Teaching Examination (OSTE) in Assessing Classroom Teaching Skills for Nursing undergraduates: A Quasi-experimental Study / Evaluación de las habilidades docentes en el aula de los estudiantes universitarios de enfermería con el instrumento OSTE: Un estudio cuasiexperimental / Avaliação das competências docentes em sala de aula de estudantes universitários de enfermagem com o instrumento OSTE: um estudo quase-experimental

Objective.To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China). Methods. A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Original article Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations. Results. Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom.Conclusion. Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students.

Objetivo. Evaluar las habilidades pedagógicas de los estudiantes de tercer curso de enfermería de la Universidad de Yangzhou (China). Métodos. En este estudio se empleó un diseño cuasi-experimental multisitio. Por muestreo por conveniencia se seleccionaron 55 participantes. Se empleó la escala Examen Objetivo Estructurado de la enseñanza(OSTE- Objective Structured Teaching Evaluation, en inglés) para evaluar las habilidades pedagógicas. La evaluación abarcó cuatro estaciones distintas: Análisis de los antecedentes de la enseñanza (E1), Presentación del plan de la lección (E2), Clase simulada (E3) y Reflexión sobre la enseñanza (E4). Antes de la evaluación, los instructores asignaron tareas a los estudiantes que debían realizar en las cuatro estaciones. Resultados. Participaron en la investigación 55 estudiantes de enfermería con un promedio de edad fue de 21.3±0.7 años y predominó el sexo femenino (78.2%). La puntuación media más alta se alcanzó en la E1 (83.1), seguida por E2 y E3 (82.5 y 82.3, respectivamente, mientras que la puntuación media más baja se registró en la E4 (79.6). En la E3 los instructores asignaron puntuaciones más bajas en comparación a las autorreportadas por los estudiantes estandarizados en términos de organización de la enseñanza, características de la enseñanza y rendimiento general (p<0.05). Más del 80% de los estudiantes se mostraron totalmente de acuerdo y recomendaron el OSTE como método principal para evaluar las habilidades docentes en el aula. Conclusión. Se identificaron en los estudiantes participantes las deficiencias en las habilidades pedagógicas; esta información permitirá realizar intervenciones específicas para mejorar situaciones específicas de la situación encontrada. El instrumento OSTE fue un método útil para la valoración de las habilidades pedagógicas de los estudiantes universitarios de enfermería.

Objetivo. Avaliar as competências pedagógicas dos estudantes do terceiro ano de enfermagem da Universidade de Yangzhou (China). Métodos. Um desenho quase-experimental multisite foi utilizado neste estudo. Por amostragem de conveniência, foram selecionados 55 participantes. A escala Objective Structured Teaching Evaluation (OSTE) foi utilizada para avaliar as competências pedagógicas. A avaliação abrangeu quatro estações distintas: Análise do percurso docente (E1), Apresentação do plano de aula (E2), Aula simulada (E3) e Reflexão sobre o ensino (E4). Antes da avaliação, os instrutores atribuíram tarefas aos alunos, que deveriam completar as quatro estações consecutivamente. Resultados. Participaram da pesquisa 55 estudantes de enfermagem com idade média de 21.3±0.7 anos e predominou o sexo feminino (78.2%). A maior pontuação média foi alcançada em E1 (83.1), seguida de E2 e E3 (82.5 e 82.3, respectivamente, enquanto a menor pontuação média foi registrada em E4 (79.6). Em E3 os instrutores atribuíram pontuações mais autorrelatado por alunos padronizados em termos de organização do ensino, características de ensino e desempenho geral (p<0.05). Mais de 80% dos alunos concordaram fortemente e recomendaram o OSTE como principal método para avaliar habilidades de ensino em sala de aula. Conclusão. Foram identificadas deficiências nas competências pedagógicas dos alunos; esta informação permitirá realizar intervenções específicas para melhorar situações específicas da situação encontrada. O instrumento OSTE foi um método útil para avaliar as competências pedagógicas de estudantes universitários de enfermagem.

Clinical application and perspectives of unilateral biportal endoscopic technique / 解放军医学杂志

Unilateral biportal endoscopic(UBE)technique is a minimally invasive spinal technique developed rapidly in recent years.Compared with traditional spinal endoscopy,the prominent feature of UBE is that it can open two channels on the same side of the spine,which can be used to provide visual field and insert operating instruments respectively,greatly expanding the operating space and reducing the difficulty of surgery.It has the advantages of less bleeding,little injury,quick recovery and mild pain,and has unique advantages in the treatment of lumbar spinal stenosis,lumbar disc herniation and other lumbar degenerative diseases.With the continuous in-depth exploration and development of the UBE technique,the field of diseases that can be treated by this technology has gradually expanded.It is not only limited to lumbar diseases,but also has made great progress in cervical and thoracic diseases,which has attracted the attention of many spinal surgeons.UBE technique has become one of the promising surgical methods for spinal-related diseases,but there are also complications such as incomplete decompression,nerve root and dural injury,epidural hematoma,relatively prolonged operation time,operation fatigue and other deficiencies.This paper summarizes the progress of the UBE technique,discusses its complications and deficiencies,proposes relevant solutions and possible future directions for its development,so as to provide reference for the clinical practice of UBE technique.

Summary of the best evidence for the prevention and management of stoma prolapse in enterostomy patients / 中国实用护理杂志

Objective:To summarize the relevant evidence for prevention and management of stoma prolapse in patients with enterostomy, so as to provide reference for the clinical prevention and management of stoma prolapse measures.Methods:According to the evidence-based resource "6S" evidence pyramid model, systematically searched about the evidence of enterostomy patients prolapse prevention and management in UpToDate, BMJ best practice, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, CNKI, Wanfang database,VIP Database, SinoMed,etc. The search time limit was from 30 January 2017 to 30 May 2023, 2 researchers independently evaluated the quality of the literature, selected and extracted the evidence.Results:A total of ten articles were included, including one clinical decision, five guidelines, one expert consensus, one evidence, one systematic review, one position statement. Through analysis, 20 best evidences were identified, including perioperative evaluation, preoperative colostomy site marking, reducing abdominal pressure, enterostomy prolapse nursing, health education and the follow-up.Conclusions:Best evidence summary for the prevention and care of stoma prolapse in enterostomy patients provides evidence-based reference for clinical application. Nurses should carefully select and apply evidence in combination with clinical situations and patients′ wishes, so as to develop a personalised stoma prolapse prevention and management programme for patients with enterostomy.

Three-dimensional digital model-assisted minimally invasive needle penetration and steel plate internal fixation in treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures / 中国组织工程研究

BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

Design of heating and pressurizing flushing device and effectiveness assessment in hysteroscopic surgery / 中国医学装备

Objective:To design a heating and pressurizing flushing device and to assess its application effect in hysteroscopic surgery.Methods:The heating and pressurizing flushing device was composed of a heating and pressing device,a liquid crystal control panel module,flushing pipeline,heating pipeline and a support frame.A total of 100 female patients who underwent gynecological hysteroscopic surgery at Shengjing Hospital of China Medical University from May 2021 to April 2022 were selected and divided into observation group and control group by random number table method,with 50 cases in each group.The observation group adopted a heating and pressurizing device to perform heating and pressurizing operations during hysteroscopic surgery,the control group adopted manual inflatable pressurized infusion bags to perform heating and pressurizing operations during hysteroscopic surgery by inflating and squeezing the air bag.The clarity of dilated uterus,operation time,preoperative,intraoperative and postoperative body temperature of the patients,and satisfaction of doctors and nurses were compared between the two groups.Results:The clarity rate of dilated uterus and satisfaction of doctors and nurses in the observation group were significantly higher than those in the control group,the difference was statistically significant(x2=7.862,8.392,P<0.05).The operation time of the observation group was significantly lower than that of the control group,the difference was statistically significant(t=51.099,P<0.05).The body temperature of the patients at 15 minutes during operation and 20 minutes after operation in the observation group were higher than those in the control group,the difference was statistically significant(t=-13.153,-17.911,P<0.05).Conclusion:The use of heating and pressurizing device in gynecological hysteroscopic surgery can increase the clarity of dilated uterus,effectively shorten operation time,save human resources,reduce complications and improve the satisfaction of medical staff.The clinical application effect is good.

Protective Effects and Mechanism of Modified Baishile Decoction on Hippocampal Neuronal Cell Injury Induced by Oxygen Glucose Deprivation Combined with Lipopolysaccharide / 中国中医药信息杂志

Objective To observe the protective effect of modified Baishile Decoction on hippocampal neuronal cells cultured in vitro;To explore its mechanism of treating post-stroke depression.Methods Hippocampal neuronal cells from mammary rats were isolated and cultured in vitro,cell injury was induced by oxygen glucose deprivation combined with lipopolysaccharide.The cells were divided into normal group,model group,blank serum group(10%)and modified Baishile Decoction containing serum group(10%).Invertedmicroscope was used to observe cell morphological changes,CCK-8 method was used to detect cell survival rate,Hoechst33342 staining was used to observe apoptosis,ELISA was used to detect Glu,5-HT,TNF-α,IL-1β,and IL-6 contents in cell supernatant,the expressions of purinergic P2X7 receptor(P2X7R)and NOD-like receptor protein 3(NLRP3)were detected by immunofluorescence staining.Results Compared with the normal group,the hippocampal neurons in the model group showed significant changes in cell morphology,the cell survival rate significantly decreased(P<0.01),the cell apoptosis increased(P<0.01);Glu,TNF-α,IL-1β,IL-6 contents in cell supernatant significantly increased(P<0.05,P<0.01),5-HT content significantly decreased(P<0.01),P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly increased(P<0.01).Compared with the model group,the morphology of hippocampal neurons in modified Baishile Decoction containing serum group was significantly improved,the cell survival rate significantly increased(P<0.01),the cell apoptosis reduced(P<0.01);Glu,TNF-α and IL-1β content in cell supernatant significantly reduced(P<0.05,P<0.01),5-HT content significantly increased(P<0.01),and P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly decreased(P<0.01).Conclusion Modified Baishile Decoction may exert a protective effect on oxidative glucose deprivation combined with lipopolysaccharide induced hippocampal neuronal inflammation damage by inhibiting the P2X7R/NLRP3 signaling pathway,regulating neurotransmitter secretion,and inhibiting inflammatory factor release,thus treating post-stroke depression.

Clinical characteristics and prognosis of male dermatomyositis patients with positive anti-melanoma differentiation associated gene 5 antibody / 中华风湿病学杂志

Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.

Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension / 临床肝胆病杂志

ObjectiveTo investigate the influencing factors for overt hepatic encephalopathy （OHE） in patients with hepatitis B cirrhosis after transjugular intrahepatic portosystemic shunt （TIPS）， and to construct an individualized risk prediction model. MethodsA total of 302 patients with hepatitis B cirrhosis who underwent TIPS in Department of Gastroenterology， The General Hospital of Western Theater Command， from January 2017 to December 2021 were enrolled， and according to the presence or absence of OHE after surgery， they were divided into non-OHE group with 237 patients and OHE group with 65 patients. The two groups were compared in terms of general data， laboratory markers， Child-Turcotte-Pugh （CTP） score， MELD combined with serum sodium concentration （MELD-Na） score， and albumin-bilirubin （ALBI） score before surgery. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate logistic regression analyses were used to identify the influencing factors for OHE after TIPS in patients with hepatitis B cirrhosis， and independent influencing factors were used to construct a nomogram model. The receiver operating characteristic （ROC） curve analysis and the calibration curve analysis were used to evaluate the discriminatory ability and calibration of the model， and the decision curve analysis and the clinical impact curve （CIC） were used to evaluate the clinical effectiveness of the model . ResultsAge （odds ratio ［OR］=1.035， 95% confidence interval ［CI］： 1.004‍ ‍—‍ ‍1.066， P<0.05）， white blood cell count （WBC）/platelet count （PLT） ratio （OR=33.725， 95%CI： 1.220‍ ‍—‍ ‍932.377， P<0.05）， international normalized ratio （INR） （OR=5.149， 95%CI： 1.052‍ ‍—‍ ‍25.207， P<0.05）， and pre-albumin （PAB） （OR=0.992， 95%CI： 0.983‍ ‍—‍ ‍1.000， P<0.05） were independent predictive factors for OHE after TIPS in patients with hepatitis B cirrhosis. The nomogram model constructed based on age， WBC/PLT ratio， INR， and PAB had an area under the ROC curve of 0.716 （95%CI： 0.649‍ ‍—‍ ‍0.781）， with a sensitivity of 78.5% and a specificity of 56.1%. ConclusionThe nomogram model constructed based on age， WBC/PLT ratio， INR， and PAB can help to predict the risk of OHE after TIPS in patients with hepatitis B cirrhosis.

Nutritional literacy of school age children in grades 4-9 and its relationship with physical health in Guizhou Province / 中国学校卫生

Objective@#To understand the level of nutritional literacy and its influencing factors among schoolage children in grades 4-9 in Guizhou Province, and to explore the relationship between nutritional literacy and physical health, so as to provide reference for improving nutritional literacy and physical health of schoolage children.@*Methods@#Using multistage stratified cluster sampling method, 1 155 schoolage children in grades 4-6 in elementary school and grades 7-9 in secondary schools in three prefectural and municipal cities of Guizhou Province (Zunyi, Tongren, and Bijie) were sampled from February to July 2023, and were surveyed for nutritional literacy by using the "Food and Nutritional Literacy Questionnaire for Chinese Schoolage Children", and their physical health data (data on body measurement indicators, such as height, weight, lung capacity, and vertical jump) were obtained from the physical health surveillance platform. Pearson correlation analysis and binary Logistic regression modeling were used to explore the association between nutritional literacy and physical health.@*Results@#The nutritional literacy score of the study population was (63.50±8.63), and the scores of each level of nutritional literacy in descending order were interactivity (66.09±13.99), functionality (63.84±8.80), and criticism (61.15±14.65); and the scores of cognitive domain of nutritional literacy, and skill domain were (64.71±10.77) (62.97±9.21); food selection, food preparation, and food intake dimension scores were (64.68±13.52) (56.39±12.17) (63.63±10.04), respectively. Differences in the total nutritional literacy scores of schoolaged children who were only children or not, by gender, ethnicity, grade level, primary caregiver, primary caregivers education, and family economic situation were statistically significant (t/F=2.88, -3.28, 5.02, 18.32, 4.67, 32.47, 32.53, P<0.05); the physical health pass rate was 85.8%, and the mean scores of the total physical health score, physical form, physical function, and physical fitness dimensions were (71.86±10.52) (93.29±12.06) (72.12±14.42) (67.26±13.13), respectively; after controlling for confounders, the nutritional literacy scores were positively correlated with physical health (OR=1.03, 95%CI=1.01-1.05, P<0.05).@*Conclusion@#Nutritional literacy scores of schoolage children in grades 4-9 in Guizhou Province are low, and there is a positive correlation between nutritional literacy and physical health in this school age children.

Low-dose ATG combined with low-dose PTCY in preventing GVHD after haploidentical transplantation:a retrospective analysis of 90 cases / 陆军军医大学学报

Objective To retrospectively analyze the efficacy and safety of low-dose antithymocyte globulin(ATG)combined with low-dose post transplantation cyclophosphamide(PTCY)in prevention of graft versus host disease(GVHD)after haploidentical transplantation.Methods Clinical data of 90 patients receiving haplotype matched transplantation in No.920 Hospital of PLA Joint Logistic Support Force from January 2022 to February 2023 were collected,and they were divided into study group(n=47)and control group(n=43)according to different GVHD prevention programs.The patients of the study group were given low-dose ATG combined with low-dose PTCY,and those of the control group received standard dose of PTCY.The implantation status,occurrence of GVHD,survival status and other indicators were analyzed between the 2 groups.Results ① Both groups of patients were successfully implanted,the median duration for neutrophil implantation(11 vs 17 d,P＜0.05)and platelet implantation(12 vs 20 d,P＜0.05)was significantly shorter in the study group than the control group.The incidence of grade Ⅱ～Ⅳ aGVHD(12.8％vs 34.9％,P＜0.05)and grade Ⅲ～Ⅳ aGVHD(6.4％ vs 20.9％,P＜0.05)was significantly lower in the study group than the control group,so was the non-recurrent mortality rate(6.4％vs 20.9％,P＜0.05)and the incidence of hemorrhagic cystitis(12.8％ vs 34.9％,P＜0.05).② By the end of the study,there were no significant differences in the incidence of mild and moderate and severe cGVHD,recurrence rate,reactivation rates of EBV and CMV,overall survival rate or progression-free survival rate between the 2 groups.Conclusion For haploidentical transplantation,low-dose ATG combined with low-dose PTCY has the advantages of lower incidence of GVHD,non-recurrent mortality,incidence of hemorrhagic cystitis and faster implantation.

Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T:a case report and literature review / 陆军军医大学学报

Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.

Network pharmacology analysis on Panacis Quinquefolii Radix- Acori Tatarinowii Rhizoma for diabetes encephalopathy and experimental verification of its anti-inflammatory mechanism / 国际中医中药杂志

Objective:To predict the mechanism of Panacis Quinquefolii Radix- Acori Tatarinowii Rhizoma (PQ-AT) in the treatment of diabetes encephalopathy (DE) using network pharmacology combined with molecular docking; To conduct experimental verification.Methods:The active components and targets of PQ and AT were screened by TCMSP database. The GeneCards and Disgenet were used to collect DE related target genes. String database and Cytoscape software were used to structure PPI network and perform visualization analysis. The common targets were imported into Metascape platform for GO annotation and KEGG enrichment analysis. Molecular docking was used to verify the binding ability of active components to core targets. Rats were randomly divided into a blank group, a model group, and a low-dose group of PQ-AT (1.08 g/kg), a high-dose group of PQ-AT (2.16 g/kg), and a metformin group (0.18 g/kg) using a random number table. To establish the rat model of diabetes encephalopathy, intraperitoneal injection of streptozotocin was used in addition to the blank group. After a 12-week drug intervention, TNF-α and Cyclooxygenase-2 (PTGS2) protein expression in the cerebral cortex of rats was detected using Western blot.Results:A total of 26 active components in PQ-AT and 107 related targets of DE were obtained, mainly including TNF, JUN, and PTSG2, which were mainly concentrated in TNF signaling pathway, cancer and other signal pathways. Molecular docking showed that the main active components of PQ-AT had relatively stable binding activity with TNF-α and PTGS2. Western blot results shows that compared with the model group, the expressions of PTGS2 and TNF-α significantly decreased in each administration group ( P<0.05 or P<0.01). Conclusion:PQ-AT can act on TNF, CASP3, JUN, STAT3, PTGS2 and other core targets to regulate signal pathways such as TNF, and inhibit inflammatory reaction to achieve the effect of treating DE.

Observation on clinical effect of fire needling for mild to moderate benign prostatic hyperplasia with kidney yang deficiency / 中国针灸

OBJECTIVE@#To observe the effect of fire needling on prostate symptoms, quality of life, average daily number of nightly urination, urine flow rate and prostat volume in patients with mild to moderate benign prostatic hyperplasia (BPH) of kidney yang deficiency.@*METHODS@#A total of 60 patients with mild to moderate BPH of kidney yang deficiency were randomly divided into an observation group (30 cases, 3 cases dropped off) and a control group (30 cases, 4 cases dropped off). The observation group was treated with fire needling at Guanyuan (CV 4), Shuidao (ST 28) and Qugu (CV 2) twice a week (2-3 d interval between each treatment), continuous treatment for 4 weeks. The control group received lifestyle advice and education, once a week for 4 weeks. In the two groups, the international prostate symptom score (IPSS), the quality of life (QoL) score and the average daily number of nightly urination were observed before treatment, after treatment and during the follow-up of the 4th week; the urinary maximum flow rate (Qmax), the average flow rate (Qave), and the prostate volume were assessed before and after treatment in the two groups. The safety was observed in the observation group.@*RESULTS@#After treatment and during follow-up, the IPSS scores, QoL scores, and the average daily number of nightly urination in the observation group were decreased compared with those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). After treatment, there was no significant difference in Qmax, Qave and prostate volume between the two groups and within the each group (P>0.05). There were no fire needling-related adverse reactions, and no obvious abnormality was found in urine routine and coagulation function tests before and after treatment in the observation group.@*CONCLUSION@#Fire needling can improve lower urinary tract symptoms and quality of life, reduce frequency of nightly urination in patients with mild to moderate BPH of kidney yang deficiency, and has good safety.

Overview on the modern development of fire needling device: from tradition to innovation / 中国针灸

The appropriate needle device is crucial for obtaining the curative effect of fire needling therapy. The article introduces the material specification, clinical operation, indications, characteristics and advantages of the contemporary traditional fire needling devices (e.g. He's fire needle and Shi 's fire needle) and the contemporary new-type ones (e.g. fire needling with filiform needle and micro-needle); and determines the innovations of modern fire needling. It is anticipated that the needle specifications, production process and operation standard of fire needling devices should be further unified so as to provide the references for the selection of fire needling devices in treatment based on clinical syndrome differentiation and expand the clinical application of fire needling therapy.

Accuracy of Mean Value of Central Venous Pressure from Monitor Digital Display: Influence of Amplitude of Central Venous Pressure during Respiration / 中国医学科学杂志(英文版)

Background A simple measurement of central venous pressure (CVP)-mean by the digital monitor display has become increasingly popular. However, the agreement between CVP-mean and CVP-end (a standard method of CVP measurement by analyzing the waveform at end-expiration) is not well determined. This study was designed to identify the relationship between CVP-mean and CVP-end in critically ill patients and to introduce a new parameter of CVP amplitude (ΔCVP= CVPmax - CVPmin) during the respiratory period to identify the agreement/disagreement between CVP-mean and CVP-end.Methods In total, 291 patients were included in the study. CVP-mean and CVP-end were obtained simultaneously from each patient. CVP measurement difference (|CVP-mean - CVP-end|) was defined as the difference between CVP-mean and CVP-end. The ΔCVP was calculated as the difference between the peak (CVPmax) and the nadir value (CVPmin) during the respiratory cycle, which was automatically recorded on the monitor screen. Subjects with |CVP-mean - CVP-end|≥ 2 mmHg were divided into the inconsistent group, while subjects with |CVP-mean - CVP-end| < 2 mmHg were divided into the consistent group.Results ΔCVP was significantly higher in the inconsistent group [7.17(2.77) vs.5.24(2.18), P<0.001] than that in the consistent group. There was a significantly positive relationship between ΔCVP and |CVP-mean - CVP-end| (r=0.283, P <0.0001). Bland-Altman plot showed the bias was -0.61 mmHg with a wide 95% limit of agreement (-3.34, 2.10) of CVP-end and CVP-mean. The area under the receiver operating characteristic curves (AUC) of ΔCVP for predicting |CVP-mean - CVP-end| ≥ 2 mmHg was 0.709. With a high diagnostic specificity, using ΔCVP<3 to detect |CVP-mean - CVP-end| lower than 2mmHg (consistent measurement) resulted in a sensitivity of 22.37% and a specificity of 93.06%. Using ΔCVP>8 to detect |CVP-mean - CVP-end| >8 mmHg (inconsistent measurement) resulted in a sensitivity of 31.94% and a specificity of 91.32%.Conclusions CVP-end and CVP-mean have statistical discrepancies in specific clinical scenarios. ΔCVP during the respiratory period is related to the variation of the two CVP methods. A high ΔCVP indicates a poor agreement between these two methods, whereas a low ΔCVP indicates a good agreement between these two methods.

Visualization and hotspots analysis of research on adenocarcinoma of esophagogastric junc-tion based on Web of Science / 中华消化外科杂志

In recent years, the incidence of adenocarcinoma of esophagogastric junction (AEG) has increased gradually. Due to the unique anatomical location and the different biological features from esophageal cancer and gastric cancer, AEG cannot be simply equated with esophageal cancer or gastric cancer, and the definition, classification and treatment methods of AEG are still controversial. As a result, the study of AEG is becoming increasingly important. Using bibliometrics, the authors search English literatures from the Web of Science Core Collection database from the establishment to December 31, 2022, with the keyword adenocarcinoma of esophagogastric junc-tion. To systematically review the international literatures on AEG, EndNote and Excel are used to manage literatures and perform statistical analysis, and VOSviewer and CiteSpace are used to analyze the social network, time series of countries, institutions, authors and keywords, the co-citation of authors and the citation bursts of keywords. The authors summarize the research status and hot trends in this field, hoping to provide reference for future research.

Detrimental effects of soot from air pollution on tear film function in mice / 中华实验眼科杂志

Objective:To observe the detrimental effect of airborne black carbon suspension solution of different concentrations on the tear film function of mice.Methods:Twenty-eight SPF-grade male BALB/c mice, aged 6-8 weeks, were randomly divided into four groups, 0.5 mg/ml group, 1 mg/ml group, 5 mg/ml group, and control group, with 7 mice in each group.The right eyes of mice were dropped by 4 μl of 0.5 mg/ml, 1 mg/ml, 5 mg/ml black carbon suspension, or phosphate buffer solution, 3 times a day according to grouping.Tear volume, tear break-up time (TBUT), corneal fluorescein staining (CFS), and conjunctival congestion were assessed before treatment and 4, 7, 10, and 14 days after treatment.The use and care of experimental animals complied with the Regulations for Administration of Laboratory Animals in Peking Union Medical College Hospital (No.XHDW-2022-053).Results:At 14 days after treatment, the tear volumes of 0.5 mg/ml group, 1 mg/ml group, 5 mg/ml group and control group were (2.74±0.74), (2.73±0.76), (2.31±0.67), and (5.31±0.36)mm, respectively.TBUT of the four groups were (4.87±0.28), (4.00±0.76), (3.23±0.43), and (6.22±0.22)seconds, respectively.CFS of the four groups were 4(3, 4), 5(5, 6), 7(7, 8) and 0(0, 1) points, respectively.Conjunctival congestion grades of the four groups were 2(2, 3), 2(2, 3), 3(2, 3) and 0(0, 1), respectively.There were statistically significant differences in tear volume among the four groups at different time points ( Fgroup=83.325, P<0.001; Ftime=86.551, P<0.001; Finteraction=5.181, P<0.001). Before and at each time point after treatment, tear volumes were significantly lower in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and tear volumes in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group were significantly lower at 4, 7, 10, and 14 days after treatment than before treatment (all at P<0.05). There were statistically significant differences in TBUT among the four groups at different time points ( Fgroup=75.130, P<0.001; Ftime=56.265, P<0.001; Finteraction=6.103, P<0.001). Before and at each time point after treatment, TBUT was significantly shorter in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and the TBUT was significantly shorter in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group at 4, 7, 10, and 14 days after treatment than before treatment, shorter in 1 mg/ml group and 5 mg/ml group at 14 days after treatment than 4, 7 and 10 days after treatment (all at P<0.05). There were statistically significant differences in CFS score and conjunctival congestion grades among the four groups at different time points, but the interactions between concentration group and measurement time were not statistically significant (CFS: Hgroup=59.249, P<0.001; Htime=49.959, P<0.001; Hinteraction=15.980, P=0.192.conjunctival congestion grade: Hgroup=57.622, P<0.001; Htime=42.062, P<0.001; Hinteraction=12.565, P=0.401). Before and at each time point after treatment, the CFS scores and conjunctival congestion grades were significantly higher in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and CFS scores and conjunctival congestion grades were significantly higher in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group at 4, 7, 10, and 14 days after treatment than before treatment (all at P<0.05). Conclusions:The exposure of airborne black carbon on the ocular surface causes damage to tear film function and ocular surface inflammation in BALB/c mice.Within a certain concentration and time range, the tear secretion decreases, TBUT shortens, CFS and conjunctival congestion increase.

Effects of Anemarrhenae Rhizoma on the dissolution of 6 inorganic elements in Gypsum Fibrosum under different compatibility ratio based on grey correlation analysis and TOPSIS model / 中国药师

Objective To discuss the effect of Anemarrhenae Rhizoma with different proportions on the dissolution of 6 inorganic elements(K,Ti,Sr,Ba,Ca,Mg)in Gypsum Fibrosum under different compatibility based on grey correlation analysis and technique for order preference by similarity to an ideal solution(TOPSIS)method and to provide reference for clinical application.Methods Inductively coupled plasma mass spectrometry(ICP-MS)was established for simultaneous analysis of inorganic elements K,Ti,Sr,Ba,Ca,Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The gray correlation ananlysis and TOPSIS method were used to comprehensively analyze the changes of six inorganic elements in Gypsum Fibrosum under different compatibility.Results The findings of the ICP-MS determination of inorganic elements in Gypsum Fibrosum-Anemarrhenae Rhizoma were good in terms of linearity,precision,repeatability and stability.The average recovery was 81.78％-104.13％,and the RSD was 2.10％-4.62％(n=6).The dissolution of six inorganic elements in Gypsum Fibrosum after compatibility with different proportions of Anemarrhena Rhizoma was significantly higher than that of Gypsum Fibrosum single decoction(P＜0.05).The dissolution scores of six inorganic elements in Gypsum Fibrosum were the highest when the compatibility proportion of Gypsum Fibrosum-Anemarrhenae Rhizoma was 30∶9.Conclusion ICP-MS is a sensitive and accurate method for determining K,Ti,Sr,Ba,Ca and Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The best compatibility ratio of Gypsum Fibrosum-Anemarrhenae Rhizoma is 30:9,which can effectively improve the dissolution of six inorganic elements in Gypsum Fibrosum,and provide the basis for the further compatibility study of Gypsum Fibrosum and Anemarrhenae Rhizoma.

Current status of diagnosis and treatment of chronic lymphocytic leukemia in China: A national multicenter survey research / 中华血液学杂志

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.

LncRNA DRAIC regulates the proliferation, apoptosis, migration and invasion of lung adenocarcinoma cells by targeting let-7i-5p / 中华肿瘤杂志

Objective: To investigate the effects of lncRNA DRAIC on proliferation, apoptosis, migration and invasion of lung adenocarcinoma cells and its mechanism. Methods: Reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expression of DRAIC in lung cancer tissues and corresponding adjacent normal tissues of 40 patients with lung adenocarcinoma who underwent surgery in Tangshan People's Hospital from 2019 to 2020. Lung adenocarcinoma cells A549 and H1299 were cultured in vitro and divided into si-NC group, si-DRAIC group, miR-NC group, let-7i-5p mimics group, si-DRAIC+ inhibitor-NC group, and si-DRAIC+ let-7i-5p inhibitor group. CCK-8 method and clone formation experiment were used to detect cell proliferation. Flow cytometry was used to detect cell apoptosis. Transwell array was used to detect the cell migration and invasion. Western blot was used to detect the protein expressions of Caspase-3, Caspase-9, Bcl-2 and Bax. The double luciferase reporter gene experiment was used to verify the regulatory relationship between DRAIC and let-7i-5p. Independent sample t test was used for comparison between two groups, one-way ANOVA was used for comparison between multiple groups, and Pearson correlation analysis was used for correlation analysis. Results: Compared with adjacent tissues, the expression level of DRAIC in lung adenocarcinoma tissues increased (P<0.05), but the expression level of let-7i-5p decreased (P<0.05). The expression levels of DRAIC and let-7i-5p in lung adenocarcinoma tissues were negatively correlated (r=-0.737, P<0.05). The absorbance value of A549 and H1299 cells in the si-DRAIC group at 48, 72 and 96 hours were lower than those in the si-NC group (P<0.05), the number of clones formed [(91.00±6.08 vs. 136.67±6.51); (50.67±1.53 vs. 76.67±4.51)], the number of migration [(606.67±31.34 vs. 960.00±33.06); (483.33±45.96 vs. 741.67±29.67)], the number of invasion [(185.00±8.19 vs. 447.33±22.05); (365.00±33.87 vs. 688.00±32.97)] were lower than those in the si-NC group (P<0.05). However, the apoptosis rates of cells [(13.43±2.79)% vs. (4.53±0.42)%; (23.77±1.04)% vs. (6.60±1.42)%] were higher than those in the si-NC group (P<0.05). The protein expressions of Caspase-3, Caspase-9 and Bax in si-DRAIC group were higher than those in si-NC group, and the protein expression of Bcl-2 was lower than that in si-NC group (P<0.05). DRAIC is located in the cytoplasm. DRAIC targeted and negatively regulated the expression of let-7i-5p. The absorbance values of A549 and H1299 cells in the let-7i-5p mimics group at 48, 72 and 96 hours were lower than those in the miR-NC group (P<0.05), the number of clones formed [(131.33±14.47 vs. 171.33±6.11); (59.33±4.93 vs. 80.33±7.09)], the number of migration [(137.67±3.06 vs. 579.33±82.03); (425.00±11.14 vs. 669.33±21.13)], the number of invasion [(54.00±4.36 vs. 112.67±11.59); (80.00±4.58 vs. 333.33±16.80)] were lower than those in the miR-NC group (P<0.05). However, the apoptosis rates of cells [(14.57±1.10)% vs. (6.97±1.11)%; (23.97±0.42)% vs. (7.07±1.21)%] were higher than those in the miR-NC group (P<0.05). The protein expressions of Caspase-3, Caspase-9 and Bax in let-7i-5p mimics group were higher than those in miR-NC group, and the protein expression of Bcl-2 was lower than that in miR-NC group (P<0.05). The absorbance values of A549 and H1299 cells in the si-DRAIC+ let-7i-5p inhibitor group at 48, 72 and 96 hours were higher than those in the si-DRAIC+ inhibitor-NC group (P<0.05), the number of clones formed [(82.00±5.29 vs. 59.00±5.57); (77.67±4.93 vs. 41.33±7.57)], the number of migration [(774.33±35.81 vs. 455.67±19.04); (569.67±18.72 vs. 433.67±16.77)], the number of invasion [(670.33±17.21 vs. 451.00±17.52); (263.67±3.06 vs. 182.33±11.93)] were higher than those in the si-DRAIC+ inhibitor-NC group (P<0.05). However, the apoptosis rates of cells [(7.73±0.45)% vs. (19.13±1.50)%; (8.00±0.53)% vs. (28.40±0.53)%] were lower than those in the si-NC group (P<0.05). The protein expressions of Caspase-3, Caspase-9 and Bax in si-DRAIC+ let-7i-5p inhibitor group were higher than those in si-DRAIC+ inhibitor-NC group, and the protein expression of Bcl-2 was lower than that in si-DRAIC+ inhibitor-NC group (P<0.05). Conclusion: DRAIC is highly expressed in lung adenocarcinoma, and DRAIC promotes the proliferation, migration and invasion of lung adenocarcinoma cells and inhibits apoptosis by targeting let-7i-5p.