Retrospective Investigation and Research on Fall Events Among Hospitalized Patients in the Rehabilitation Department.

Objective: We investigated the clinical characteristics, fall outcomes, and related factors of falls in patients who were hospitalized in the rehabilitation department, and explored strategies to reduce the incidence of falls and prevent falls in patients. Methods: Data from 60 patients who fell in the rehabilitation department between 2016 and 2021 were analyzed for clinical characteristics, associated factors, incidence of falls, injuries, and patient demographics. Under the random stratified sampling method, 60 patients who did not fall during the same period were selected as the control group, and relevant data was collected. Measurement data were compared using an independent sample t-test. Enumeration data were compared using chi-squared (χ2) test was employed to compare these data between the two groups. Non-parametric data were analyzed using the Mann-Whitney U-test. Factors potentially influencing falls were scrutinized through both univariate and binary logistic regression analyses. Results: The median annual incidence of falls among patients who were hospitalized in the rehabilitation department was 0.04%, while the overall fall injury rate was 60%. Falls were most prevalent within 30 days of hospitalization (71.67%). The most common fall-related condition was craniocerebral disease (83.33%). The incidents of falls location of fall were mainly reported in nearby areas of rehabilitation ward (70%). Most accidents occurred between 7:00 a.m.-12:00 p.m. and 3:01 p.m.-6:00 p.m. (63.33%), and dyskinesia was the most common cause of falls (71.67%). There were 39 patients (65.00%) with Barthel Index (BI) scores ranging between 40-60. Conclusion: Patients in the rehabilitation department had a greater incidence of falls and fall injuries. Within 30 days of admission, patients with moderately dependent craniocerebral disorders and dyskinesia frequently experienced falls during typical daytime shifts in areas characterized by endemic conditions.

Sonographic Findings of Vascular Signals for Retained Products of Conception in Women Following First-Trimester Termination of Pregnancy.

OBJECTIVES: To evaluate the occurrence of retained products of conception (RPOC) after termination of pregnancy in the first trimester and to assess the vascular signals with transvaginal ultrasonography (TVUS) examination in the detection of retained products. METHODS: A retrospective cohort study was performed using TVUS examination in patients following termination of pregnancy. In cases of RPOC, 3 scales of vascular signal were identified: type 1, no or small amount, spot flow signals; type 2, medium amount, strip-like flow signals; type 3, rich amount, circumferential-like flow signals. The correlation between vascular signals and placenta accreta spectrum (PAS) staging was proposed by sonography and histopathology findings. RESULTS: The 3 vascular patterns were differently distributed within non-RPOC as well as RPOC patients with and without PAS: type 1 vascular signal detection rates of non-RPOC and RPOC were 97.8% (262/268) and 28.1% (18/64), respectively. Of 64 cases of RPOC, 48.4% (31/64) of the patients had type 2 vascular signals. Vascular signals were enhanced in RPOC with PAS patients whose diagnosis was confirmed by histopathology. CONCLUSIONS: The vascularity (amount of flow), vascular pattern (spot, strip- or circumferential-like flow), and the flow penetrating myometrium were significant findings for distinguishing concomitant RPOC with and without PAS. Additionally, RPOC may contribute to PAS progression, or PAS and RPOC in coordination strengthen the observed vascular signals.

A correlation study between prostate necrosis rate calculated by 3D Slicer software and clinical efficacy of prostatic artery embolization, along with an analysis of predictors of clinical success after prostatic artery embolization.

PURPOSE: To analyze the correlation between the prostate necrosis rate at 1-month after prostatic artery embolization (PAE) and the clinical efficacy at 1-year after PAE, and to explore potential predictors of clinical success after PAE for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). METHODS: The prostate magnetic resonance imaging data at 1-month after PAE were imported into 3D Slicer software for calculating the prostate necrosis rate and thus analyzing the relationship between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after PAE. The 151 patients with PAE technical success were divided into a clinical success group (n = 126) and a clinical failure group (n = 25). Independent predictors of clinical success after PAE were analyzed by multifactorial logistic regression, and the predictive performance of each factor was evaluated by applying the receiver operating characteristic curve and the area under the curve (AUC). RESULTS: There was a linear negative correlation between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after surgery (P < 0.001). In the clinical success group, both the initial prostate volume (PV) and the prostate necrosis rate at 1-month after PAE were significantly higher than in the clinical failure group (P < 0.001), and acute urinary retention (AUR) and adenomatous-dominant BPH were also associated with clinical success (P < 0.05). Multifactorial logistic regression analysis revealed that larger initial PV, a higher prostate necrosis rate at 1-month after surgery, and AUR were independent predictors of clinical success after PAE. The AUC values for these three indicators and their combination were 0.720, 0.928, 0.599, and 0.951, respectively, in which the prostate necrosis rate at 1-month after PAE demonstrating a high predictive value. CONCLUSION: The higher the prostate necrosis rate at 1-month after PAE, the better the clinical efficacy at 1-year after PAE is likely to be, and the prostate necrosis rate at 1-month after PAE is expected to become a predictor of clinical success after PAE.

Secretome of EMSCs neutralizes LPS­induced acute lung injury via aerosol administration.

Ectodermal mesenchymal stem cells (EMSCs) are cells harvested from the stem cell niche (nasal mucosa) with high therapeutic potential. To the best of our knowledge, however, the anti­inflammatory properties of these neural crest­derived EMSCs have been rarely reported. The present study aimed to explore the effects of aerosolized EMSC­Secretome (EMSC­Sec) and clarify underlying mechanisms in treating acute lung injury (ALI). EMSCs were isolated by adherent method and identified by immunofluorescence staining. EMSC­Sec was collected and evaluated using western blotting, BCA and ELISA tests. Then, mouse lung epithelial cells (MLE­12) were used to mimic inflammatory stimulation with lipopolysaccharide (LPS). After developing an ALI model through intraperitoneal injection of LPS, mice were treated with an EMSC­Sec spray. The lung in each group underwent an observation and measurement to preliminarily assess the extent of damage. H&E staining, immunohistochemical staining, immunofluorescence and western­blotting were utilized to further access the impacts of EMSC­Sec. The results showed that EMSC­Sec had great anti­inflammatory potential and was highly successful in vitro and in vivo. EMSC­Sec mitigated LPS­induced ALI with low inflammatory cell inflation and mild damage. EMSC­Sec could regulate inflammation via the NF­κB(p50/p65)/NLRP3 pathway. Overall, the present study demonstrated that EMSC­Sec regulated inflammation, hoping to provide a novel strategy for ALI treatment.

Preparation of Chitosan-Modified Bentonite and Its Adsorption Performance on Tetracycline.

In this study, chitosan-modified bentonite was synthesized using the coprecipitation method. When the Na2CO3 content was 4% (weight of soil) and the mass ratio of chitosan to bentonite was 1:5, the adsorption performance of the chitosan/bentonite composite was best. The adsorbent was characterized by scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and Brunauer-Emmett-Teller measurement. Various characterization results demonstrate that chitosan successfully entered the bentonite interlayer and increased layer spacing but did not modify bentonite's laminar mesoporous structure, and the -CH3 and -CH2 groups of chitosan appeared on chitosan-modified bentonite. Tetracycline was used as the target pollutant in the static adsorption experiment. The adsorption capacity was 19.32 mg/g under optimal conditions. The adsorption process was more consistent with the Freundlich model and the pseudo-second-order kinetic model, indicating that it was a nonmonolayer chemisorption process. The adsorption process is a spontaneous, endothermic, entropy-increasing process, according to thermodynamic characteristics.

Molecular Biomarker Exploration of Rituximab plus CHOP Therapy in Real-World Diffuse Large B-Cell Lymphoma Patients.

BACKGROUND: Presently, several classification methods are based on diffuse large B-cell lymphoma (DLBCL), but its clinical application has not yet been testified in Asian populations. METHODS: Twenty-five DLBCL patients were subjected to second-generation gene sequencing (NGS), and retrospective analysis of clinical features of the patients was to explore genotyping and survival prognosis biomarkers. RESULTS: The prevalent mutant genes in DLBCL patients cover myeloid differentiation factor 88 (MyD88) (40%), TP53 (32%), B-cell translocation gene 2 (BTG2) (28%), PIM1 (28%), and CREB-binding protein (CREBBP) (24%) in this study. The classical International Prognostic Index (IPI) scores were associated with progression-free survival (PFS) (HR: 7.52, 95% CI 1.51 - 37.6, p = 0.00393) via univariate analysis. Furthermore, patients with ETS-variant gene 6 (ETV6) (HR: 5.1, 95% CI 0.927 - 28.1, p = 0.0371), platelet-derived growth factor receptor A (PDGFRA) (HR: 4.29, 95% CI 0.824 - 22.3, p = 0.0594), platelet-derived growth factor receptor B (PDGFRB) (HR: 10.8, 95% CI 0.979 - 119, p = 0.0149) was distinctively correlated with poor PFS except for the IPI score. Nevertheless, the mutation of PDGFRA/B gene was not distinct in further multivariate analysis (PFS: HR: 2.72, 95% CI 0.52 - 14.23, p = 0.2369). Additionally, better survival prognosis was in DLBCL patients who did not progress within 12 months (POD12). Ultimately, caspase recruitment domain 11 (CARD11) gene mutations were enriched in patients with primary intranodal tumors, but the prognostic relevance was not discovered. CONCLUSIONS: ETV6 and platelet-derived growth factor receptor (PDGFR)A/B gene mutations are supposed to be potential biomarkers for the prognosis of DLBCL patients via the statistical analysis of this small sample, and POD12 is also expected to be an effective endpoint for efficacy assessment.

Extravillous trophoblast invasion and decidualization in cesarean scar pregnancies.

INTRODUCTION: The increasing cesarean section rate has led to an increase in the number of subsequent pregnancies resulting in a cesarean scar pregnancy. There appears to be preferential attachment of the blastocyst to the scar site, which may be associated with defective decidua in that region, resulting in abnormal implantation, which can in turn negatively affect the success of the pregnancy. The aim of the current study was to evaluate the extravillous trophoblast, decidua, and myometrium in scar and adjacent non-scar regions of the implantation site of a cesarean scar pregnancy. MATERIAL AND METHODS: Samples containing a gestational mass were obtained by laparoscopic excision from patients with a cesarean scar pregnancy at 6-11 weeks of gestation as diagnosed by transvaginal or transabdominal ultrasound (n = 8 type II cesarean scar pregnancy). Cesarean scar pregnancy tissues were separated into scar and non-scar regions, and the scar regions were sub-separated into non-implantation and implantation sites. Serial sections were histologically examined after hematoxylin and eosin, Masson's trichrome and immunochemical staining, and changes in the myometrium, extravillous trophoblast, and decidua were evaluated. RESULTS: In cesarean scar pregnancy, compared with scars not in the implantation site, scars in the implantation site displayed increased fibrosis, and had disrupted myometrium, which was related to varying patterns of E-cadherin expression as a response to extravillous trophoblast invasion. In addition, local decidua was found at the non-scar implantation sites, with multinucleated trophoblast giant cell accumulation and shallow invasion. These features were not evident in the scar implantation sites. CONCLUSIONS: This study emphasizes that the decidua drives multinucleated trophoblast giant cell differentiation, limiting the degree of invasion. Better characterization of this differentiation process may be helpful for better management and avoidance of the consequences of cesarean scar pregnancy.

Efficacy and Safety of Qinpi Tongfeng Formula Combined with Bloodletting Therapy in the Treatment of Acute Gouty Arthritis: A Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Acute gouty arthritis (AGA) is a common arthritis disease, with the characteristics of acute onset, severe condition, and poor prognosis. The conventional treatments have shown certain curative effects but are accompanied with many adverse reactions. The combination of orally taken Qinpi Tongfeng Formula (QPTFF) and bloodletting therapy could effectively alleviate arthralgia and joint swelling in AGA patients. However, there is a lack of high-quality randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of the combined therapy against AGA. METHODS: This is a prospective, randomized, parallel controlled trial conducted in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine to explore the efficacy and safety of QPTFF combined with bloodletting therapy in the treatment of AGA. Eighty-six AGA patients meeting the inclusion and exclusion criteria will be randomly divided into the treatment group and control group in a 1 : 1 ratio using a randomization table. The investigators and the patients will not be blinded, while the outcome assessors and statisticians will be blinded to the allocation. Patients in the treatment group will take QPTFF and bloodletting therapy simultaneously, while patients in the control group will be instructed to orally take colchicine tablets. The primary outcome is the total effective rate, and the secondary outcomes are the pain changes after the first treatment, pain scores, complete pain relief time, joint symptom scores, TCM syndrome score, and laboratory test. SPSS22.0 will be used for statistical analysis. Discussion. This study will evaluate the clinical efficacy and safety of QPTFF combined with bloodletting therapy in the treatment of AGA, and the results of this study will provide reliable clinical evidence for the clinical use of QPTFF combined with bloodletting in the treatment of AGA. The trial is registered with ChiCTR2100048836.

Cavernous lymphangioma of the urinary bladder in an adult woman: an additional case report of a rare lesion and literature review.

BACKGROUND: Urinary bladder lymphangioma is a rare and benign lesion that is often causes symptoms related to irritation and urinary tract obstruction. Because a lymphangioma may resemble a true neoplasm of the urinary bladder clinically, the lesion must be removed for accurate histologic diagnosis and to rule out malignancy. CASE PRESENTATION: We present a case of a 40-year-old female who was evaluated for painless gross hematuria. Clinical and diagnostic work up revealed a sharply defined mass involving the wall and bulging into the cavity on the dome of the bladder. Partial cystectomy was performed and histologic findings were compatible with cavernous lymphangioma. The symptom of hematuria relieved after the procedure and the patient was in good status without evidence of recurrence by cystoscopy at follow-up 6 months later. CONCLUSIONS: Lymphangioma of the urinary bladder is treated with surgical excision and seems to have no recurrence once completely resected, but long-time follow-up may be needed.

Impact of CYP2A6 gene polymorphism on the pharmacokinetics of dexmedetomidine for premedication.

BACKGROUND: Dexmedetomidine is a widely used sedative in clinic, which is mainly metabolized by cytochrome P450 2A6 (CYP2A6). Dexmedetomidine was rarely reported for off-label usage of premedication, but lacking relevant pharmacokinetic investigations. Therefore, our study determined the dexmedetomidine pharmacokinetics of CYP2A6*4 allele in Chinese patients pretreated with dexmedetomidine whose mutation frequency of CYP2A6*4 are high, in order to provide clinical references. METHODS: Thirty-one elective surgery patients received premedication with 0.5 µg/kg dexmedetomidine via intravenous pump. Their plasma concentrations at multiple time-points and polymorphism of CYP2A6*4 were determined and statistically analyzed. RESULTS: 9 patients were *1/*4 or *4/*4, and 22 patients were *1/*1. The main pharmacokinetic parameters were area under curve (AUC) 1396.19 ± 332.47h· ng· l-1, peak blood concentration (Cmax) 495.50 ± 104.90ng· l-1, distribution volume (V) 0.68 ± 0.20 L/kg, clearance (CL) 0.38 ± 0.11 L/h/kg, distribution half-life (t1/2α) 0.05 ± 0.01h, elimination half-life (t1/2ß) 2.53 ± 0.04h. No significant pharmacokinetic differences were found among CYP2A6*1/*1, *1/*4, and *4/*4 patients. CONCLUSIONS: In Chinese patients pretreated with dexmedetomidine, T1/2ß was consistent with that published, but T1/2α, V and Cl were lower. It was unnecessary to consider the mutation when developing the precision regimen of dexmedetomidine.

Notch3 inhibits epithelial-mesenchymal transition in breast cancer via a novel mechanism, upregulation of GATA-3 expression.

Notch3 and GATA binding protein 3 (GATA-3) have been, individually, shown to maintain luminal phenotype and inhibit epithelial-mesenchymal transition (EMT) in breast cancers. In the present study, we report that Notch3 expression positively correlates with that of GATA-3, and both are associated with estrogen receptor-α (ERα) expression in breast cancer cells. We demonstrate in vitro and in vivo that Notch3 suppressed EMT and breast cancer metastasis by activating GATA-3 transcription. Furthermore, Notch3 knockdown downregulated GATA-3 and promoted EMT; while overexpression of Notch3 intracellular domain upregulated GATA-3 and inhibited EMT, leading to a suppression of metastasis in vivo. Moreover, inhibition or overexpression of GATA-3 partially reversed EMT or mesenchymal-epithelial transition induced by Notch3 alterations. In breast cancer patients, high GATA-3 expression is associated with higher Notch3 expression and lower lymph node metastasis, especially for hormone receptor (HR) positive cancers. Herein, we demonstrate a novel mechanism whereby Notch3 inhibit EMT by transcriptionally upregulating GATA-3 expression, at least in part, leading to the suppression of cancer metastasis in breast cancers. Our findings expand our current knowledge on Notch3 and GATA-3's roles in breast cancer metastasis.

[Numerical simulation of fluid-structure interaction in fusiform aneurysm treated with stent with triangular wire cross-section].

A new stent with triangular wire cross-section was proposed. The new stents were compared with traditional circular wire cross-section stent in the same porosity in order to investigate its effectiveness in treating intracranial aneurysms. Three models were established separately, including the aneurysm model with circle cross section stent, the aneurysm model with triangular cross section stent and the aneurysm model with non-stent. Then the same boundary conditions were set to contrast the resistance to flow, velocity, pressure, wall shear stress and total mesh displacement. The resistance to flow of triangular cross section stent was lower than circle cross section stent and the velocity, pressure, total mesh displacement of aneurysm model with triangular cross section stent were all higher than those of the model with circle cross section stent. Moreover, the peak value and valley value of wall shear stress in aneurysm model with triangular cross section stent were higher than those of the other. Triangular cross section stent might play a negative role to aneurysm rupturing. Thus, the therapeutic effect of stent with triangle cross section was not better than the stent with circle cross section. In the clinical application, doctors should consider the various factors, and choose the most suitable one.

Expression of a putative stem cell marker Musashi-1 in endometrium.

AIM: Firstly to examine the expression characteristics of Musashi (Msi)-1 in fetal endometrium, reproductive normal endometrium, endometrial hyperplasia and endometrioid adenocarcinoma, next, to focus on exploring the possibility that Msi-1 serves as a marker of the endometrial stem cells in-situ. METHODS: Immunohistochemical staining was performed to detect the expression of Msi-1 in 20 cases of fetal endometrium, 20 cases of normal endometrium, 20 cases of endometrial hyperplasia and 50 cases of endometrioid adenocarcinoma respectively. RESULTS: In fetal endometrium, Msi-1 positive cells were observed from the 12th week in epithelium, but the number of Msi-1 positive cells decreased with an increase in gestational age. In reproductive normal endometrium, Msi-1 expression presented as dispersed single cell and cell groups in the stroma adjacent to the myometrium. In endometrial hyperplasia and endometrioid adenocarcinoma, Msi-1 expression significantly increased and was more widely distributed. CONCLUSIONS: Msi-1 positive cells mainly lie in the stroma of normal endometrium, and the distribution pattern is consistent with that of the speculated endometrial stem cells. The high expression of Msi-1 in fetal endometrium and endometrioid adenocarcinoma suggests that Msi-1 positive cells have several characteristics of stem cells, such as high proliferative potentiality and multipotency. Considering these factors, this makes Msi-1 potentially a promising stem cell marker.

Mercury distribution in seawater discharged from a coal-fired power plant equipped with a seawater flue gas desulfurization system.

BACKGROUND AND PURPOSE: More and more coal-fired power plants equipped with seawater flue gas desulfurization systems have been built in coastal areas. They release large amount of mercury (Hg)-containing waste seawater into the adjacent seas. However, very limited impact studies have been carried out. Our research targeted the distribution of Hg in the seawater, sediment, biota, and atmosphere, and its environmental transportation. METHODS: Seawater samples were collected from five sites: 1, sea areas adjacent to the power plant; 2, near discharge outlets; 3, the aeration pool of the power plant; and 4 and 5, two reference sites. The total gaseous Hg was determined in situ with a Tekran 2537B. Analyses of total Hg (TM) followed the USEPA methods. RESULTS: In most part of the study area, TM concentrations were close to the reference values and Hg transfer from the seawater into the sediment and biota was not obvious. However, in the aeration pool and near the waste discharge outlets, atmospheric and surface seawater concentrations of TM were much higher, compared with those at a reference site. The concentration ranges of total gaseous Hg and TM in seawater were 3.83-8.60 ng/m(3) and 79.0-198 ng/L near the discharge outlets, 7.23-13.5 ng/m(3) and 186-616 ng/L in the aeration pool, and 2.98-4.06 ng/m(3) and 0.47-1.87 ng/L at a reference point. CONCLUSIONS: This study suggested that the Hg in the flue gas desulfurization waste seawater was not only transported and diluted with sea currents, but also could possibly be transferred into the atmosphere from the aeration pool and from the discharge outlets.

[Down-regulation of vascular endothelial growth factor expression in ovarian cancer cell line SKOV3 by interferon-gamma].

OBJECTIVE: To determine whether interferon-gamma (IFN-gamma)inhibit the expression of vascular endothelial growth factor (VEGF) in ovarian cancer cell line SKOV3 with the level of mRNA and protein. METHODS: Cultured SKOV3 was treated by IFN-gamma with different concentration and time. The morphological changes of SKOV3 treated by IFN-gamma through microscope and proliferation by methyl thiazolyl tetrazolium (MTT). The expression of VEGF mRNA in SKOV3 culture was determined by relative quantitative reverse-transcription polymerase chain reaction. The VEGF protein level in supernatants was determined by enzyme-linked immunosorbent assay (ELISA) and in cytoplasma by immunocytochemical staining. RESULTS: There is a small changes in shape on SKOV3, but no alter of cell proliferation during treating with different concentration and time. Expression of VEGF mRNA and protein decreased with the INF-gamma concentration increasement, but no time-effect pattern exist. The effect peak appeared when the concentration was 1,000 U/ml. CONCLUSION: IFN-gamma can inhibit the expression of VEGF in ovarian cancer cell line SKOV3 with the level of mRNA and protein.