Motivation: Cardiovascular disease is the main cause and disease of morbidity and mortality in the world, and atherosclerosis causes more than 90% of cardiovascular diseases. Goal(s): Early diagnosis and timely treatment of atherosclerosis to reduce the morbidity and mortality of residents. Approach: In the development of atherosclerosis, reducing the content of macrophages which derived foam cells can reverse the formation of atherosclerotic plaque. Results: The dextran sulfate in the nanoparticles can target SR-A of activated macrophages in atherosclerosis, and then the nanoparticles undergo phase transformation in macrophages to induce apoptosis. Impact: The nanoparticles have multi-mode molecular imaging capabilities, and have excellent targeting performance. Under LIFU, it can undergo phase transformation and induce apoptosis of macrophages, providing a promising strategy for the diagnosis and treatment of atherosclerotic plaque in the future.
综述双层探测器光普CT(SDCT)诊断心血管疾病的研究进展.SDCT可通过双层立体探测器,将高、低能两组数据在原始数据域解析,可用来重建反映康普顿效应和光电效应不同组成的能谱图像,同时也可生成传统混合能量图像.SDCT实现能谱扫描常规化的同时,不仅能降低能谱图像噪声,还能提高心血管病变检出敏感性和定性准确性;SDCT在减少对比剂用量、降低辐射剂量、改善图像质量及心血管病变的诊断中有潜在的临床价值.
Objective To evaluate the application of the Chinese version of wellbeing literacy 6 item scale(Well-Lit6)among military cadets in China.Methods A total of 792 undergraduate cadets of a military university were investi-gated by whole-group sampling method.The homogeneous reliability and fold-half reliability of the scale were tested by i-tem analysis of the overall sample;the construct validity was tested by exploratory factor analysis and validation factor analysis;the criterion-related validity and convergent-discriminant validity was tested by correlation analysis;incremental validity was tested by the hierarchical regression analysis;exploring the wellbeing literacy characteristics of military ca-dets by independent samples t-test and one-way analysis of variance.Results The items discrimination of the scale was good,with a coefficient of 0.970 and a split-half reliability of 0.896,the homogeneity reliability and split-half reliability were good,the scale model fit was good,and the construct validity was good.Wellbeing literacy was significantly correla-ted with related indicators(P＜0.001),and the scale had good criterian-related validity and convergent-discriminant va-lidity.After gradually adding demographic variables,known predictors and the wellbeing literacy,the △R2 of dependent variables(subjective wellbeing,life satisfaction,depression and anxiety)among 0.186-0.208,0.128-0.249 and 0.007-0.064 respectively(all P＜0.05),the incremental validity of the scale was better;the differences in total wellbeing lit-eracy scores were statistically significant for age,gender,parenting style and cadet's category(all P＜0.05).Conclusion The Chinese version of the Well-Lit6 demonstrates good reliability and validity among military cadets,which is suitable as a measurement tool for assessing the wellbeing literacy of this group,and there are significant effects of age,gender,cadet category and parenting style on wellbeing literacy of military cadets.
Objective To establish a mouse model of acute liver injury induced by blister agent nitrogen mustard(HN2)and the injury model of HepG2 cells(human hepatocellular carcinoma cell lines)exposed to HN2,and to explore the role and mechanism of autophagy in acute liver injury induced by blister agent.Methods In in vivo model,20 C57BL/6 male mice were randomly divided into the normal control group and the HN2 exposed group;the mice in the HN2 exposed group were intraperitoneally in-jected with nitrogen mustard hydrochloride(2 mg/kg)once time,and the mice in the normal control group were intraperitoneally injected with the same volume of saline.Three days after the exposure,serum and hepatic tissue were collected,the activities of serum aspartate amin-otransferase(AST)and alanine aminotransferase(ALT)were measured,hematoxylin-eosin(HE)staining was performed for pathological examination of hepatic tissue,the morphology of organelle such as mitochondria was observed under electron microscope,and the autophagy related protein LC3-Ⅱ/Ⅰ ratio,protein expression of p62 in hepatic tissue were detected by Western blot.In the in vitro model,HepG2 cells were divided into a normal control group and HN2 ex-posed group;the cells in normal control group were treated with serum-free medium containing dimethyl sulfoxide(DM-SO)(0.1％)for 36 h,while the cells in HN2 exposed group were treated with 8 μmol/L nitrogen mustard hydrochloride of treatment after 36 h.Cell viability was detected by cell counting kit 8(CCK-8),the changes of mitophagy were detec-ted by monodansylcadaverine(MDC)probe method,the changes in liver cell autophagy flow were detected by double la-beled adenovirus(mRFP-GFP-LC3);in the cell model,pretreatment intervention with autophagy agonist rapamycin(RAPA)and autophagy inhibitor 3-methyladenine(3-MA)was administered to detect the cell viability level.Results In the in vivo model,compared with the normal control group,the serum ALT and AST viability of mice in HN2 exposed group significantly increased(all P＜0.05),at the same time,there was large amount of inflammatory cell infiltration in hepatic tissue accompanied by hepatic parenchymal cell injury;a large number of autophagosomes appeared in hepatic pa-renchymal cells,and the LC3-Ⅱ/Ⅰ ratio in hepatic tissue increased(P＜0.05),meanwhile,the protein expression of p62 was significantly downregulated(P＜0.05).In the in vitro model,compared with the normal control group,the cells in HN2 exposed group showed a significant decrease in cell viability(P＜0.05),the fluorescence intensity of MDC and the number of autophagosomes sign;ficantly increased(all P＜0.05).In the HN2 exposed cell model,the cell viability significantly increased after pretreatment with autophagy agonists RAPA(P＜0.05),while the cell viability was signifi-cantly reduced after pretreatment with autophagy inhibitor 3-MA(P＜0.05).Conclusion HN2 exposure can lead to cel-lular autophagy in hepatocytes,which may be a key protective effects in blister agents poisoning.This study provides a new direction for the effective prevention and treatment of acute liver injury induced by blister agents.
Objective To construct a competency appraisal indicator system for standardized wounded soldier(SWS)based on burn injury,so as to provide a basis for scientific and standardized evaluation and screening SWS.Methods Based on the theoretical basis of competency and following the SMART(Specific,Measurable,Attainable,Rel-evant,Time-bound)principle through current situation investigation,literature review,semi-structured interviews and other methods,and the SWS competency appraisal indicator system based on burn injuries was preliminarily formlatued.Two rounds of expert consultation were conducted by the Delphi method,the indicators at all levels were modified and im-proved according to the importance score and variation coefficient of the indicators by the experts,and the hierarchical a-nalysis method was used to determine the weight of indicators at all levels and judge its logic.Results The effective recov-ery rate of the two rounds of the consultation questionnaire of the experts was 100％,the authority coefficients of the ex-perts were 0.846 and 0.891 respectively,and the Kendall harmony coefficients were 0.182 and 0.217 respectively,and consistent ratio(CR)was less than 0.1.Finally,SWS competency appraisal indicator system based on burn injuries was constructed,including 3 first-level indicators,9 second-level indicators and 43 third-level indicators.Conclusion The con-struction of competency appraisal indicator system for SWS based on burn injuries is comprehensive,targeted and reliable,which can provide a basis for the evaluation and screening of SWS.
非酮症高血糖性偏侧舞蹈症(hemichorea associ-ated with non-ketotichyperglycemia,HCNH)是糖尿病较为少见的并发症,患者以突发偏侧肢体舞蹈样动作为首发症状[1-3],目前被认为是一种具有独立临床影像学特殊表现的疾病,是以非酮症高血糖、偏侧舞蹈症及基底节区电子计算机断层扫描(computed tomography,CT)平扫高密度及磁共振成像(magnetic resonance imaging,MRI)T1加权像(T1 weighted ima-ging,T1WI)高信号为三联征的一组综合征.
Objective To explore the effects of total flavonoids of Scutellaria baicalensis georgi on improving airway inflammation and Toll-like receptor 3(TLR3)/TIR domain-containing adaptor inducing interferon-beta(TRIF)pathway expression in asthmatic mice.Methods A total of female Balb/c mice aged 4 to 6 weeks were randomly divided into nor-mal control group,model group,positive control group(dexamethasone,1 mg/kg),total flavonoids of Scutellaria ba-icalensis georgi low-dose group(25 mg/kg)and total flavonoids of Scutellaria baicalensis georgi high-dose group(50 mg/kg),with 10 rats in each.Except the normal control group,the asthmatic mouse model was constructed in the other groups.Hematoxylin-eosin staining(HE)were used to observe the pathological changes of lung tissues of mice,and the airway remodeling of mice was analyzed according to pathological pictures;bronchial wall area/inner perimeter(W/Pi),bronchial smooth muscle area/inner perimeter(S/Pi)and smooth muscle nucleus number/inner perimeter(N/Pi)were calculated.Interleukin 6(IL-6)and IL-8 levels in bronchoalveolar lavagefluid(BALF)were detected by enzyme linked immunosorbent assay(ELISA).The mRNA expression levels of TLR3 and TRIF in lung tissues of mice were detected by quantitative real-time polymerase chain reaction(qPCR).The expression levels of TLR3 and TRIF proteins in lung tis-sues of mice were detected by Western bolt.Results The pathological results showed that the bronchial lumen and alveoli in the normal control group maintained good integrity,while the mice in the model group showed increased mucosal ede-ma,inflammatory cell infiltration(submucosa and mucosal layer)and the number of inflammatory cell infiltration in the airway wall,and decreased inflammatory cell infiltration in the bronchial lumen and alveoli after the administration of total flavonoids of Scutellaria baicalensis georgi,the number of inflammatory cells in the total flavonoids of Scutellaria baicalensis georgi high-dose group was lower than that in the low-dose group.Compared with normal control group,W/Pi,S/Pi,N/Pi,IL-6,IL-8,TLR3 and TRIF mRNA and protein levels in model groups significantly increased(all P＜0.05);compared with model group,W/Pi,S/Pi,N/Pi,IL-6,IL-8,TLR3 and TRIF mRNA and protein levels in total flavonoids of Scutellaria baicalensis georgi low-dose and high-dose groups and positive control group significantly decreased(all P＜0.05);W/Pi,S/Pi,N/Pi,IL-6,IL-8,TLR3,TRIF mRNA and protein levels in total flavonoids of Scutellaria baicalensis georgi low dose group were signifi-cantly higher than those in high dose group(all P＜0.05);there was no significant difference in all indexes between total flavonoids of Scutellaria baicalensis georgi high dose group and positive control group(P＞0.05).Conclusion Total fla-vonoids of Scutellaria baicalensis georgi can effectively improve airway inflammation in asthmatic mice,and its mechanism may be related to inhibiting TLR3/TRIF signaling pathway,reducing inflammatory response and alleviating airway remo-ving.
Objective To explore the predictive value of serum type Ⅰ collagen carboxyl-terminal peptide β-special sequence(β-CTX)and total type Ⅰ collagen amino terminal prolongation peptide(TPINP)levels on postoperative tibial fracture healing.Methods A total of 122 patients with tibial fracture admitted to author's hospital from February 2020 to February 2023 were selected as the subjects.The patients were divided into normal healing group(n=105)and delayed healing group(n=17)according to the postoperative fracture healing.The levels of serum β-CTX and TPINP were detec-ted by electrochemiluminescence;the predictive value of serum β-CTX and TPINP for postoperative fracture healing in pa-tients with tibial fracture was evaluated by receiver operating characteristic(ROC)curve;the influencing factors of post-operative fracture healing in patients with tibial fracture were investigated by binary Logistic stepwise regression analysis.Results The proportion of age ≥60 years old,diabetes history,open fracture,postoperative combined osteofascial com-partment and postoperative local infection in delayed healing group were higher than those in normal healing group(all P＜0.05).The serum β-CTX level in delayed healing group was higher than that in normal healing group,and the TPINP level was lower than that in normal healing group(all P＜0.05).The area under the curve(AUC)and 95％confidence interval(CI)of serum β-CTX and TPINP were 0.759(0.708-0.810)and 0.842(0.791-0.893)for predicting postoper-ative fracture healing in patients with tibial fracture,the cut-off value were 0.61 ng/ml and 52.46 ng/ml respectively,the specificity and sensitivity were 56.82％,65.14％and 92.23％,92.23％respectively,the AUC predicted by the two was 0.901(0.850-0.952),the specificity was 86.71％,and the sensitivity was 85.04％.Binary Logis-tic stepwise regression analysis showed that open fracture(OR=1.910,95％CI:1.363-2.675)and postoperative com-bined osteofascial compartment syndrome(OR=2.237,95％CI:1.538-3.252),β-CTX≥0.61 ng/ml(OR=3.025,95％CI:1.943-4.711),TPINP≤52.46 ng/ml(OR=2.519,95％CI:1.692-3.750)were independent risk factors for delayed healing of tibial fractures after surgery.Conclusion High expression of β-CTX and low expression of TPINP are associated with delayed fracture healing in patients with tibial fracture after surgery.These two indexes can be used as bi-ological markers to predict fracture healing in patients with tibial fracture after surgery,which have clinical application value.
Objective To explore the relationship between perceived social support and stress response of flying ca-dets under public health emergencies.Methods The perceived social support level and stress response symptoms of flying cadets were investigated by perceived social support scale(PSSS)and the PTSD checklist-civilian version(PCL-C).Rela-tionship between perceived social support and stress response were analyzed by Pearson correlation analysis and linear re-gression analysis.Results A total of 175 valid questionnaires were finally obtained in this study.In this study,the detec-tion rate of stress response symptoms in flying cadets was 17.71％(31/175).The total score of PSSS was significantly negatively correlated with the score of PCL-C(r=-0.38,P＜0.01).The scores of the 3 dimensions of percieved scocial support(family support,friend support and others'support)were significantly negatively correlated with the scores of PCL-C(r=-0.36,P＜0.01;r=-0.36,P＜0.01;r=-0.36,P＜0.01).Among the 3 dimensions of PSSS,only other's support could significantly predict the level of post-traumatic stress response(β=-0.334,P＜0.05).Conclusion Un-der public health emergencies,flying cadets have a certain proportion of stress response,and there is a close relationship between their perceived social support and acute stress response(ASR),the support from leaders and colleagues plays an important role in alleviating the stress response level of flying cadets.
Objective To construct a predictive model for the risk of coronary atherosclerotic heart disease[coro-nary heart disease(CHD)for short]using systemic coagulation-inflammation index(SCI),triglyceride glucose(TyG)and atherogenic index of plasma(AIP),and to validate the predictive efficiency of the model.Methods A retrospective collection of patients was conducted from January 2014 to January 2021 in author's hospital.Patients were divided into control group(n=616)and CHD group(n=1056)based on the results of coronary angiography;the study population was then randomly assigned to training set(n=1170)and validation set(n=502)according to the ratio of 7:3.The clini-cal data such as blood routine and blood biochemistry of the patients were collected.In the training set,a stepwise backward regression analysis was performed to identify independent risk factors for developing CHD,the nomo-gram model was constructed,and the predictive efficiency and applicability of the model were internally validated u-sing the validation set.Results The results of the multi-factor Logistic regression analysis on the training set pop-ulation indicated that SCI,AIP,D-dimer(D-D)and high-density lipoprotein cholesterol(HDL-C)were independent protective factors for the occurrence of CHD,while age,TyG,PLR,Fib and ApoA were independent risk factors for the occurrence of CHD.Internal validation of the model showed that the area under the curve(AUC)was 0.739(95％CI:0.624-0.775)in the training set and 0.846(95％CI:0.697-0.886)in the validation set.The calibration curve results suggested good calibration of the model,and the clinical effec-tiveness of the model was tested by decision curve analysis(DCA),showing that the model has good clinical effectiveness when the threshold probabilities for the training set and validation set were within the range of 10％-50％and 10％-75％respectively,clinical impact curve(CIC)confirmed the model's effective predictive ability.Conclusion The predic-tive model demonstrates good discriminative ability and calibration,as well as a favorable net benefit,which indicating its potential for predicting the risk of CHD.
宫腔粘连(intrauterine adhesions,IUA)又称Asherman综合征,是由感染、外伤等多种原因引起的子宫内膜基底层损伤,造成不同程度宫颈或宫腔肌壁间的粘连或闭塞,导致月经异常、周期性腹痛、继发性不孕及反复流产等[1-3].部分妊娠成功的IUA患者甚至会出现胎盘粘连、胎盘植入、早产等症状[4].
Objective To screen and observe the expression and clinical effects of immune cells in patients with re-current miscarriage(RM),and to explore the potential mechanism affecting RM patients.Methods The mRNA data and clinical data of GSE22490,GSE165004 and GSE26787 datasets were screened and downloaded,the differential genes were screened by Sangerbox3.0 software,and 11 kinds of immune cells were obtained.A total of 52 patients with RM and 50 patients with normal fetal delivery and no history of miscarriage were selected from January 2021 to January 2023 in au-thor's hospital.Serum levels of regulatory cell(Treg)(FOXP3)and M1-substyle macrophage(CD86)and natural killer(NK)cells(CD56)were examined by reverse transcription and polymerase chain reaction(RT-PCR).Results A total of 165 differential genes and 11 types of immune cells were screened in the 3 datasets,among which,compared with control group,the expressions of M1-substyle macrophage and NK cells significantly increased(all P＜0.05),while the levels of Treg obviously decreased(P＜0.05).Clinical validation also suggested that the levels of CD56 and CD86 were remarkably higher in patients with RM than those in normal pregnancy,however,the level of FOXP3 significantly decreased(all P＜0.05).Among 52 patients with RM,the miscarriage rate was 9.61％,the successful pregnancy rate was 40.38％.The levels of FOXP3,CD56 and CD86 in pregnant women with successful pregnancy and non-successful pregnancy were compared,and the differences were statistically significant(all P＜0.05).The abnormal expression of CD86 and FOXP3 might be one of the causes in pregnancy failure(P＜0.05).Conclusion Pregnant women with RM may have unique genes and immune cells,which may be manifested as the increase of M1-substyle macrophages,NK cells and the decrease of Treg cells.
Objective To construct the competence system of paramedics in field mobile medical detachment ac-cording to the diversified task requirements of medical service.Methods The item pool was constructed after reorganizing the paramedics'competence of the field mobile medical detachment in the new era through literature review,expert inter-views,field research and other methods;the indicator system was constructed by Delphi method;the index weight was calculated by analytic hierarchy process(AHP)and superiority chart.Results The effective response rate of expert con-sultation was 100％for two rounds,and the expert's authority coefficient was 0.90-0.95.The Kendall harmony coeffi-cients of the first,second and third levels were 0.239,0.305 and 0.260 respectively(P＜0.001),a final version of the nursing personnel competence indicator system of the field mobile medical detachment with 4 first-class items,14 second-level items and 71 third-level items was constructed,and the weighted values of the indicators at all levels were deter-mined.Conclusion Due to the high enthusiasm and authority of experts and good coordination of expert opinions,the for-mation of the paramedics competence indicator system is formed,which may provide a reference for the on-the-job training of paramedics of the field mobile medical detachment.
Objective To analyze the clinical value of dynamic electrocardiogram(DEG)combined serum nitrogen-terminal B type natriureticpeptide precursor(NT-proBNP)and cystatin C(Cys C)in the diagnosis of asymptomatic myo-cardial ischemia in elderly patients with coronary heart disease.Methods A total of 83 suspected elderly asymptomatic myocardial ischemia patients with coronary heart disease were divided into the coronary arteriography(CAG)positive group(n=59)and the CAG negative group(n=24)on base of the results of the CAG examination.The clinical data,duration of myocardial ischemia attacks,distribution of ST segment depression attacks and the expression levels of serum NT-proBNP,Cys C between the two groups were compared.The clinical value of DEG combined serum NT-proBNP and Cys C in diagnosing asymptomatic myocardial ischemia in elderly patients with coronary heart disease was analyzed by re-ceiver operating characteristic(ROC)curve.Results There was no statistically significant difference in clinical data be-tween the two groups(P＞0.05).The duration of myocardial ischemic attack and the expression levels of serum NT-proBNP,Cys C in the CAG positive group were higher than those in the CAG negative group,with statistical significance(all P＜0.05).There was no statistically significant difference in the distribution of ST segment depression onset time be-tween the two groups(P＞0.05).The area under the curve(AUC),sensitivity and specificity of DEG combined serum NT-proBNP,Cys C in the diagnosis of asymptomatic myocardial ischemia in elderly coronary heart disease were better than those of any single indicators(P＜0.05).Conclusion The combined detection of DEG and serum NT-proBNP,Cys C has a good clinical application value in the diagnosis of asymptomatic myocardial ischemia in elderly patients with coronary heart disease.
Objective To investigate the current status of knowledge,attitude and practice of meniscus injury in re-cruits and analyze its influencing factors.Methods A total of 808 recruits were selected as research subjects in April 2022 by convenient sampling,and the recruits were investigated by knowledge-attitude-practice of military meniscus injury sur-vey questionnaire and general information questionnaire.Results The scores for knowledge,attitude and practice of me-niscus injury in recruits were(7.35±4.11),(31.19±5.32)and(39.97±8.43)respectively.There was a positive corre-lation among knowledge and attitude(r=0.368,P＜0.001),knowledge and practice(r=0.462,P＜0.001)and attitude and practice(r=0.572,P＜0.001)of meniscus injury in recruits.Multiple linear regression analysis showed that being an only child,having more training on injury prevention and having professional training on meniscus injuries were factors that promoted high levels of knowledge of meniscus injury in recruits;high score of meniscus injury knowledge and having previous training injuries were factors that promoted high levels of meniscus injury attitude;high score of meniscus injury knowledge,high score of injury attitude and having more training on injury prevention were factors that positively promo-ted recruits meniscus injury behavior.Conclusion Knowledge,attitude and practice related to meniscus injuries in recruits were at a moderate level.Being an only child,having training on injury prevention,having professional training on meniscus injuries and training injury were influencing factors for knowledge,attitude and practice of meniscus injury in recruits,and knowledge and attitude were factors that influenced meniscus injury behavior.
Objective To observe the clinical efficacy of ultrasound-guided multi-point injection of platelet-rich plasma(PRP)in the treatment of primary frozen shoulder.Methods A total of 64 patients with primary frozen shoulder who met the inclusion criteria from January 2019 to December 2021 were selected,and the patients were divided into PRP treatment group and non-PRP treatment group,with 32 patients in each,according to the patients'wishes and daily life needs.Patients in PRP treatment group received ultrasound-guided injection of PRP into the subacromial bursa,coraco-humeral ligament and shoulder joint cavity;patients in non-PRP treatment group were only given symptomatic and sup-portive treatment.The shoulder function was evaluated by visual analogue scale(VAS),Constant-murley score and range of motion(ROM)before and after treatment.Results There was no significant difference in VAS score of shoulder joint between the two groups before treatment(P＞0.05).The VAS score of PRP treatment group were lower than those of non-PRP treatment group at each timing(1 week,6 weeks and 3 months)after treatment,and the differences between the two groups were statistically significant(all P＜0.05).In addition,the shoulder joint VAS score of the two groups after treatment had a significant downward trend,which were significantly lower than those before treatment(all P＜0.05).There was no significant difference in Constant-murly score and the forward flexion,abduction and external rota-tion angles of shoulder joint between the two groups before treatment(P＞0.05),the Constant-murly score and forward flexion,abduction and external rotation angles of shoulder joint in PRP treatment group were higher than those in non-PRP treatment group at each timing(1 week,6 weeks and 3 months)after treatment(all P＜0.05).Constant-murly score and the forward flexion,abduction and external rotation angles of shoulder joint in the two groups showed a significant upward trend,and were significantly higher than those before treatment(all P＜0.05).Conclusion Ultrasound-guided PRP multi-point injection can effectively reduce the pain of patients with frozen shoulder and improve the function of shoulder joint.
原发性支气管肺癌是起源于支气管上皮细胞及腺体的恶性肿瘤,常见于45岁以上吸烟人群,是我国及全球最常见的恶性肿瘤之一[1].2015年我国新发肺癌人数为73.3万,死亡人数为61.0万,发病率及死亡率均居全国首位,与以往相比均呈上升趋势,约75％患者就诊时已是晚期,其5年生存率低于20％[2].既往晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的标准治疗是以放化疗为基础的传统治疗.
Objective To analyze the influencing factors of recurrent laryngeal nerve injury in thyroid cancer lymph node dissection and evaluate the applicative value of ultrasonic scalpel.Methods A total of 210 patients diagnosed and treated for thyroid cancer in the author's hospital from January 2020 to December 2021 were selected as the study sub-jects.The patients were divided into observation group and control group,with 105 patients in each,according to the pa-tient's admission number by thier admission sequence number.The patients in the observation group underwent surgical treatment by ultrasonic scalpel,while those in the control group underwent surgical treatment by conventional scalpel.The differences in perioperative indicators and adverse reactions between the two groups were compared.The patients were divided into injury group(n=18)and non-injury group(n=192)according to whether laryngeal nerve injury oc-cured.The influencing factors of recurrent laryngeal nerve injury during lymph node dissection for thyroid cancer were an-alyzed by Logistic regression.Results The operation time,length of surgical incision,24 h drainage volume,total post-operative drainage volume and length of hospitalization in the observation group were significantly lower than those in the control group(all P＜0.05);the incidences of hypoparathyroidism and recurrent laryngeal nerve injury in the observation group was significantly lower than those in the control group(all P＜0.05).The operation principle of the patients with-out recurrent laryngeal nerve injury was more refined capsule dissection,the dissection method from the anatomical trian-gle of recurrent laryngeal nerve was more used,and the surgical scope was more conservative(all P＜0.01).Logistic re-gression analysis showed that non-meticulous capsule dissection,dissection from the inferior horn of the thyroid and ex-tensive surgical scope were risk factors for recurrent laryngeal nerve injury.Conclusion Ultrasonic scalpel has less damage to recurrent laryngeal nerve in thyroid cancer lymph node dissection,the risk factors of recurrent laryngeal nerve injury are the lack of non-meticulous capsule dissection,dissection from the inferior hom of the thyroid and extensive surgical scope.
Objective To prepare Ezetimibe nanostructured lipid carriers(Eze-NLCs)and evaluate its pharmacoki-netics in rats and its lipid-lowering effects on hyperlipidemia model rats.Methods Using glyceryl behenate(Compritol 888 ATO)as a solid lipid,propylene glycol monooctanoate(Capmul PG 8)as a liquid lipid and solutol HS-15(Kolliphor HS15)as a surfactant,the formulation of Eze-NLCs was optimized through Box-Behnken experimental design.The phys-icochemical properties of Eze-NLCs were evaluated,and the in vitro drug release characteristics of Eze-NLCs in pH 1.2,4.5 and 6.8 medium solutions were investigated;the in vitro pharmacokinetics and pharmacodynamics of Eze suspension and Eze-NLCs after oral administration in rats were compared.Results The optimized formulation of Eze-NLCs was as followed:Concentration of Compritol 888 ATO was 13 mg/ml,concentration of Capmul PG 8 was 25 mg/ml,concentra-tion of Kolliphor HS15 was 10 mg/ml,and the average particle size of 3 consecutive batches of Eze-NLCs was(215.62± 13.55)nm,with an encapsulation efficiency of(86.73±2.58)％.Under transmission electron microscopy,it could be observed that Eze-NLCs were spherical in shape,uniformly dispersed,and had smooth surface.Eze-NLCs exhibited fas-ter drug release in the early stage and slower drug release in the later stage in the 3 pH medium solutions.Compared with the oral administration of Eze suspension in rats,after oral administration of Eze-NLCs,the time to peak(tmax)of Eze-NLCs shortened,the peak concentration(Cmax)increased,the half-life period(T1/2)prolonged,and the area under the cure(AUC)increased.Eze-NLCs significantly reduced the levels of total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)in hyperlipidemic rats,while elevated the level of low-density lipoprotein choles-terol(LDL-C).Conclusion Eze-NLCs prepared in this study can significantly improve the bioavailability and achieve bet-ter blood lipid regulation,which has important value for the clinical application of Eze.
目的 为解决医疗转运中颠簸振动影响静脉穿刺的问题,研制一种静脉穿刺减振平台,降低医疗转运中来自外界的颠簸振动,辅助护士有效进行静脉穿刺.方法 静脉穿刺减振平台包括减振平台主体和附属装置,减振平台主体包含四个减振模块和一个海绵块,减振模块由弹簧和阻尼器发挥主要减振作用;附属装置包含海绵垫、床档、安全固定带以及手臂绑带等.结果 该减振平台可有效衰减医疗转运中的颠簸振动,提高静脉穿刺效率、降低穿刺相关不良事件发生率、提高伤病员舒适度.结论 静脉穿刺减振平台为护士提供一个相对稳定的静脉穿刺平台,具有即装即用、满足多种卧位、长度可调节等优势,可广泛应用于战场救护、灾害救援以及平时急救等医疗转运场景.
