Objectives: We investigated whether intravenous lidocaine reduces pain on awakening in a dose-dependent manner and aimed to determine the median effective dose (ED50) of lidocaine in 160 children aged 3-12 years (American Society of Anesthesiologists physical status I-II) undergoing elective tonsillectomy with or without adenoidectomy at Yichang Central People's Hospital. Methods: Patients were randomized into four dose groups (A-D: 0.0, 1.0, 1.5, and 2.0 mg/kg, respectively) and underwent the same anesthetic induction and maintenance protocols. The primary outcome was pain on awakening, while secondary outcomes included pain scores at 1, 4, 12, and 24 hours after awakening; incidences of laryngospasm, bronchospasm, or perioperative stridor; and time to extubation. Intraoperative cardiac events were classified as safety events. Data were analyzed using ANOVA with Bonferroni correction. Intravenous lidocaine reduced pain on awakening in a dose-dependent manner. Results: The ED50 of intravenous lidocaine for pain on awakening was 1.75 mg/kg. Significant differences were observed between Groups A and D (P <= 0.001). No incidents of laryngospasm, bronchospasm, or perioperative stridor were observed. Furthermore, significant between-group differences were observed in time to extubation (P <= 0.05). Conclusion: These findings demonstrate that lidocaine dose-dependently reduced pain on awakening in children undergoing tonsillectomy with or without adenoidectomy (ED50 = 1.75 mg/kg), with no severe adverse events.
Objective: To evaluate the effects of a comprehensive cardiac rehabilitation intervention based on King's Goal Attainment Theory on exercise endurance, cardiac function, anxiety, depression, and sleep quality in middleaged and elderly patients following percutaneous coronary intervention (PCI). Method: A total of 72 middle-aged and elderly post-PCI patients were enrolled and equally randomized into a control group and an intervention group (34 cases in the control group and 38 cases in the intervention group). Both groups received conventional pharmacotherapy. The control group underwent standard cardiac rehabilitation, whereas the intervention group received a 6-month comprehensive cardiac rehabilitation program grounded in King's Goal Attainment Theory. Outcome measures included the 6-minute walk test (6MWT), left ventricular ejection fraction (LVEF), cardiac index (CI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Assessments were performed at baseline and at 3 and 6 months post-intervention Results: The intervention group showed a significantly higher overall response rate than the control group (P < 0.05). At both 3 and 6 months, all outcome measures improved significantly from baseline in both groups. Compared with the control group, the intervention group demonstrated significantly greater improvements in 6MWT, LVEF, PSQI, and PHQ-9 scores at both time points (P < 0.05). Conclusion: Compared with conventional cardiac rehabilitation, the comprehensive cardiac rehabilitation intervention based on King's Goal Attainment Theory is more effective in enhancing exercise endurance and cardiac function and in alleviating depressive symptoms and sleep disturbances among middle-aged and elderly patients after PCI.
Objective: Qingre Yangyin Chushi Decoction (QYCD) is an effective clinically empirical prescription widely used in the treatment of various rheumatic diseases. This study aims to explore the mechanism of action of QYCD on joint injury in collagen-induced arthritis (CIA) model rats using network pharmacology methods. Methods: A rat model of collagen-induced arthritis was established based on literature data. Hematoxylin-Eosin (HE) staining and micro-computed tomography (micro-CT) scanning were used to observe the pathological morphological changes and microstructure of the ankle joints in rats. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum inflammatory factors and bone injury indicators. The GeneCards database was used to search and predict RA-related targets, and overlapping targets between drugs and diseases were analyzed based on GEO chip transcriptional disease target prediction. Network pharmacology techniques were used to screen the potential core active components of QYCD, and molecular docking technology was employed to verify the identified core targets and candidate compounds, aiming to explore the potential mechanism of QYCD in treating rheumatoid arthritis (RA). Results: QYCD alleviated inflammatory cell infiltration and cartilage surface erosion in CIA rats. QYCD reduced the levels of pro-inflammatory cytokines IFN-gamma and IL-17A in CIA rats, while increasing the levels of anti-inflammatory cytokines IL-4 and TGF-beta. Through network pharmacology screening, nine candidate compounds were identified. By analyzing the intersections of drugs, diseases, and transcriptional targets, seven core targets were determined, namely COL1A1, LDLR, VEGFA, MYC, MCL1, EGFR, and FOSL2, which are involved in the EGFR, HIF-1, VEGF, and PI3K-AKT signaling pathways. The results of molecular docking analysis indicated that most compounds exhibited strong binding interactions with target proteins, indicating strong binding affinity (binding energy less than -6 kcal/ mol). Conclusion: These compounds can form stable complexes with proteins and are potential active compounds for the treatment of RA.
Aim: To implement best evidence-based practices for preventing and managing refeeding syndrome (RFS) in ICU patients using the JBI Evidence Implementation Framework, with the goal of reducing RFS incidence and improving patient outcomes. Methods: Literature related to RFS prevention and management was systematically retrieved. Following quality appraisal, best evidence was synthesized. Evidence-based audit criteria were developed by integrating the summarized evidence with clinical context and expert judgment. A quality improvement project was conducted in the ICU, involving baseline and post-implementation audits to evaluate the effectiveness of the evidence implementation. Results: Eighteen articles were included, from which 24 best practice recommendations were summarized. Eighteen evidence-based audit criteria were developed. Following implementation, a statistically significant reduction was observed in the incidence of RFS (P<0.05). The incidence of complications associated with RFS, including electrolyte imbalances and cardiac dysfunction, also significantly decreased (P<0.05). Conclusion: Implementing best evidence-based practices for RFS prevention and management, guided by the JBI Evidence Implementation Framework, effectively reduces the incidence of RFS, improves patient outcomes, and enhances nursing quality in the ICU setting.
Objective: Alterations in platelet count, D-dimer levels, and fibrinogen concentration were studied in the blood of patients with active tumors following the administration of everolimus, with the objective of elucidating their significance in relation to thrombosis. Methods: Fourteen patients treated with everolimus alone and fourteen healthy controls in our hospital between January 2020 and January 2025 were selected. The baseline plasma levels of D-dimer, fibrinogen, and platelet count on day 0 were compared to those after 21 days of treatment with everolimus tablets. Results: Platelet count, D-dimer and fibrinogen of patients with active tumors before treatment were higher than those of healthy controls (P<0.05). After 21 days of treatment, the plasma platelet count and D-dimer significantly decreased (P<0.05), whereas non-significant differences were observed in plasma levels of fibrinogen (P>0.05). Conclusion: The study confirmed that everolimus partially regulates cancer patients' coagulation profile, especially reducing elevated D-dimer, potentially lowering thrombotic risks. Limitations included small sample size, single-center design, short follow-up, and no tumor stage subgroup analysis. Future multi-center, long-term studies with stratified analyses and mechanistic/combination therapy exploration are needed to optimize coagulation and prognosis.
Objective: Conventional two-dimensional (2D) in vitro models do not adequately reproduce the structural and functional complexity of the three-dimensional (3D) tumor microenvironment. In vivo animal studies, although physiologically relevant, often encounter limitations such as low reproducibility and ethical constraints. In contrast, in vitro 3D culture systems have gained increasing attention in cancer research owing to their improved ability to mimic in vivo conditions, enhanced reproducibility, and cost-effectiveness. Methods: In this study, we established a 3D prostate cancer model using a polyurethane foam scaffold to evaluate the pharmacodynamic effect of the antitumor agent zoledronic acid. Cell viability and inhibition rates of PC-3 cells were quantified using the CCK-8 assay. The growth patterns and spatial distribution of cells on the scaffold were further examined by scanning electron microscopy (SEM). Results obtained from the 3D model were compared directly with those from conventional 2D cultures. Results: Increasing the concentration of zoledronic acid or prolonging the treatment period produced a dose- and time-dependent inhibition of PC-3 cell proliferation. Across all tested conditions, inhibition rates in the 2D model were significantly higher than those observed in the 3D model. Stated differently, PC-3 cells exhibit greater drug tolerance within the 3D scaffold system. The 3D polyurethane foam-based prostate cancer model demonstrated growth characteristics and drug-response patterns more closely aligned with in vivo tumor behavior than traditional 2D cultures. Conclusion: The 3D model provides superior predictive value for assessing anticancer drug efficacy and represents a more reliable platform for pharmacodynamic evaluation compared to conventional 2D culture systems.
Objectives: While the fusion of three-dimensional (3D) cardiac electroanatomical imaging with computed tomography (CT) is a promising approach for guiding radiofrequency ablation (RFA) of arrhythmias, the optimal fusion technique remains undetermined. This study was designed to systematically evaluate and compare the accuracy of prevailing fusion methods to establish an evidence-based standard for clinical practice. Methods: In this prospective study, 30 patients with atrial fibrillation scheduled for ablation were enrolled. All patients underwent pre-operative left atrial CT angiography. Participants were assigned to one of six groups based on the image fusion technique employed: Body Surface, Right Atrial, Aortic, or their respective combinations. Cardiac models were reconstructed from CT data using the CARTO3 system. Image registration was performed by aligning catheter-acquired surface points with the corresponding CT model points. The primary endpoint for assessing accuracy was the mean distance between corresponding landmarks on the CT model and the real-time electroanatomic map. Data are presented as mean +/- SD and compared using t-tests or chi-square tests as appropriate. Results: Quantitative analysis revealed significant differences in fusion accuracy among the techniques. The aortic fusion group demonstrated the highest precision with a mean distance of 1.2 +/- 0.8 mm, significantly superior to both the body surface group (2.1 +/- 1.8 mm) and the right atrial group (3.3 +/- 2.2 mm). Conclusions: The aortic fusion method achieves the highest precision for 3D electroanatomical-CT integration in atrial fibrillation ablation procedures. However, considering the balance between procedural complexity, potential vascular risks, and clinical practicality, body surface fusion represents a more viable approach for broader clinical implementation, pending further technical refinements to enhance its accuracy.
Purpose: To thoroughly explore the functions and underlying associated signaling pathways of currently emerging precision medicines for cardiovascular disease, a series of analyses were conducted. Methods: In this study, currently available precision medicines for cardiovascular disease were categorized into 6 types. Specific drug-target interaction profiles were constructed, and correlated molecular pathways were further identified through enrichment analysis. Results: The precision medicines were divided into 6 categories, namely calcium channel blockers, lipid-lowering drugs, antihypertensive drugs, antithrombotic drugs, antiarrhythmic drugs, and diuretics. For calcium channel blockers: 18 agents were selected, and their target genes were identified. CACNA1C emerged as the most frequently targeted gene, while Benidipine targeted the largest number of genes (13 genes). For lipid-lowering drugs: 29 drugs were included, with HMGCR recognized as the most promisingtarget gene. For antihypertensive drugs: A total of 72 drugs were collected. ADRB1 was found to be the most targeted gene, with 10 drugs targeting it. For antithrombotic drugs: PTGIR and P2RY12 were the most frequently targeted genes, each with five related drugs. For antiarrhythmic drugs: 18 drugs and their correspondingtarget genes were identified, with SCN5A beingthe most targeted gene. For diuretics: Approximately 14 drugs and their target genes were obtained, and SL-C12A3 was the target gene which was most interacted with. Conclusions: Based on this innovative study, currently emerging precision medicines for cardiovascular disease can be classified into 6 types. The functions of their targeted genes were also investigated, collectively providing valuable references for future clinical drug administration.
Objective: To construct a prognostic scoring scale by integrating the data of tumor individualized immunohistochemical characteristics, so as to assist in individualized systematic treatment decision-making. Methods: A total of 1,216 female patients with T1-2N0M0 stage breast cancer were selected as the study participants. Formalinfixed, paraffin-embedded (FFPE) tumor specimens were examined histologically and immunohistochemically in the pathological experimental center of the First Affiliated Hospital of Gannan Medical University. Antibody staining tor, E-cadherin, CD4, CD8, CK5/6, EGFR) were used to process the archived materials. The risk factors of death in this group were analyzed, and the prognosis score scale was constructed, and the research results were compared. Results: The factors influencing mortality with clinical and statistical significance were evaluated. Logistic regression method was used to select the 10 factors that had the most significant impact on the results, and multiple scales were compiled, including regression scale 10 (based on the identified 10 most significant factors). The survival analysis of high-risk and low-risk patients using regression scale showed that there were significant differences between these groups (& Rcy;<0.00001). The curative effect of the medium and high-risk patients combined with the adjuvant chemotherapy group was evaluated. The results showed that there was a significant difference in the survival rate of the medium and high-risk patients receiving adjuvant chemotherapy (& Rcy;=0.0057). The regression scale of 10-year prognosis had sufficient sensitivity (58.05%), specificity (69.47%) and effectiveness (63.76%). Conclusion: The regression prognostic scale constructed in this study contains markers with high prognostic value. Multivariate analysis of the 10-year prognostic regression scale for breast cancer has improved its accuracy and reliability. This IHC-based model provides a cost-effective and biologically comprehensive alternative to existing genomic tools, particularly valuable for risk stratification in settings with limited resources.
Objectives: This study was conducted to verify the efficacy of Bencao Shengji ointment (BSO) in treating third-degree burn wounds in mice. Methods: In this study, a mouse model of third-degree burn wounds was established, and the mice were randomly divided into three groups. In Group A, a gel containing recombinant human epidermal growth factor was applied externally. In Group B, BSO was applied externally, and in Group C, Bencao Nursing Solution (BNS) was applied externally. The efficacy of traditional Chinese herbal medicine preparations was verified by observing and comparing burn wound healing, inflammatory reactions and scar formation in the skin of mice in the three groups from Day 4 to Day 60. Results: The wound healing in Groups B and C was better than that in Group A from Day 4 to Day 14. Compared with those in Group B and Group C, the degree of wound necrosis and extent of inflammatory reactions in Group A were greater. From Day 15 to Day 45, the scars that formed after healing in Group A were more obvious, and the scars that formed in Group B were the smallest. On the 60th day, the mice in Group B had the shallowest burn scars on their skin, whereas the mice in both Group A and Group C exhibited moderate to severe scar formation. Conclusions: BSO can better promote the healing of third-degree burn wounds and reduce the formation of scars.
Objectives: The triglyceride-glucose waist-to-height ratio (TyG-WHtR) is a promising marker of insulin resistance and cardiometabolic risk. However, prospective evidence that links cumulative exposure to TyG-WHtR with incident hypertension is still limited, particularly among ageing populations. This study aimed to examine the prospective association between the cumulative average TyG-WHtR and the risk of developing hypertension in middleaged and older Chinese adults. Methods: Data relating to 5,803 adults aged >= 45 years from the China Health and Retirement Longitudinal Study (CHARLS) was analysed. TyG-WHtR was calculated at baseline (2011) and follow-up (2015) and the exposure variable was the cumulative average. Incident hypertension between 2015 and 2018 was ascertained. RCS (restricted cubic spline) and multivariable logistic regression modelling were utilised to examine the relationship between hypertension risk and cumulative average TyG-WHtR. ROC (receiver operating characteristic) curve analysis was used to further assess predictive accuracy. Results: Hypertension was developed in 1,685 participants (29.0%) over a median follow-up period of 36.5 months. A higher cumulative average TyG-WHtR was substantially linked to an elevated risk of hypertension in a dose-dependent way. People in the highest quartile were found to have markedly higher odds of hypertension (fully adjusted OR = 1.73, 95% CI: 1.17-2.55, P = 0.006) than those in the lowest quartile. A positive linear correlation was validated using RCS analysis (P-overall = 0.007). The ROC curve showed there to be good predictive accuracy and the fully adjusted model yielded an AUC of 0.962 (95% CI: 0.955-0.969). Conclusion: The cumulative average TyG-WHtR is independently linked to incident hypertension in elderly and middle-aged Chinese people. This index could be an economical and accessible means for early risk assessment and prevention in community and clinical settings.
Objectives: This study identifies multifactorial predictors integrating molecular biomarkers and clinical profiles for melasma recurrence after Q-switched Nd:YAG 1064-nm laser therapy. Methods: A prospective observational study analyzed 104 melasma patients (18-55 years) treated between January-December 2024. Serum levels of bFGF, VEGF, and TGF-beta were quantified via protein microarray and ELISA. Clinical variables and serum biomarkers were assessed using Mann-Whitney U tests, univariate analysis and multivariate logistic regression. Results: Within 12 months post-treatment, 31 patients (29.81%) experienced melasma recurrence. The study revealed abnormal serum levels of growth factor proteins in the recurrence group. Notably, there were increased levels of bFGF (P=0.002) and VEGF (P=0.001), as well as decreased levels of TGF-beta (P30 years (OR=4.854, 95% CI=1.665-13.956), sun exposure >16 hours per month (OR=6.027, 95% CI=2.144- 16.843), negative psychological state (OR=3.638, 95% CI=1.403-11.892), sleep duration 32.5 ng/L (OR=6.376, 95% CI=2.242-15.154), and VEGF levels >34.7 ng/L (OR=6.345, 95% CI=1.729-16.583). Conversely, serum TGF-beta levels >3713.4 ng/L were found to have a protective effect (OR=0.11, 95% CI=0.05-0.23). Conclusions: Recurrence post-laser melasma treatment involves synergistic interactions between angiogenic biomarkers (bFGF/VEGF), immunosuppressive TGF-beta, and modifiable lifestyle factors. These findings emphasize dual targeting of molecular pathways and behavioral interventions to mitigate recurrence.
Objective: To investigate the therapeutic efficacy and underlying mechanisms of human umbilical cord mesenchymal stem cell (HUCMSC) transplantation in rats with stress urinary incontinence (SUI). Methods: SUI rat models were established through ovariectomy combined with vaginal dilation. The model rats were randomly divided into two groups: the HUCMSC treatment group and the model control group. The treatment group received periurethral injections of approximately 5x10(6) HUCMSCs, while the model control group received an equal volume of normal saline. A separate group of normal rats injected with normal saline served as the normal control group. Leak point pressure (LPP) and maximum bladder capacity (MBC) were measured at two time points: 1 week post-modeling and 2 weeks post-transplantation. In addition to LPP and MBC assessments, hematoxylin-eosin (HE) and Masson staining were performed to evaluate inflammatory cell infiltration, as well as damage and recovery of muscle and collagen fibers in the urethral sphincter tissue. Immunohistochemical staining was used to analyze the expression of myosin heavy chain (MHC) and protein gene product 9.5 (PGP9.5) in the rat urethral sphincters. Results: One week after SUI modeling, the model group exhibited significantly lower levels of LPP and MBC compared with the normal control group (P < 0.05), respectively. Two weeks following HUCMSC intervention, urodynamic assessments demonstrated that the treatment group had significantly higher LPP and MBC values than the model control group (P < 0.05), and with no significant difference observed relative to the normal control group (P > 0.05). Hematoxylin-eosin (HE) staining revealed reduced inflammatory cell infiltration and relatively intact urethral lumen architecture in the treatment group, consistent with morphological features of the normal control group. Masson staining indicated recovery and proliferation of muscle and collagen fibers in the treatment group, in contrast to severe structural damage and depletion of these fibers in the model group. Immunohistochemical analysis showed that the expression levels of MHC and PGP9.5 in the treatment group were significantly higher than those in the model control group (P < 0.05), while no significant difference was noted compared with the normal control group (P > 0.05). Conclusion: HUCMSC transplantation effectively ameliorates SUI in rats by repairing injured urethral sphincters and peripheral nerves, thereby improving urinary control function.
Objectives: This study aimed to optimize traditional frozen section (FS) methods through tissue-specific modifications to enhance section quality, reduce diagnostic time, and improve diagnostic clarity. Methods: Comparative analysis was performed on three tissue types: cavity-rich pulmonary tissue, adipose-rich lymph nodes, and calcified thyroid specimens. Using conventional versus optimized FS protocols, with improvements assessed via section integrity, flatness, knife mark frequency, and Hematoxylin and eosin (H&E) staining quality. For cavity-rich pulmonary tissue, a thin adhesive layer was applied to completely encapsulate the tissue surface, followed by immediate cryocompression using the freezing hammer. For adipose-rich lymph nodes, each sample head should ideally contain a single lymph node, while addressing sectioning direction, and avoiding excessively low temperatures. For calcified thyroid specimens, increased sectioning speed through rapid handle rotation achieved swift tissue cutnary tissue demonstrated improved integrity with well-preserved alveolar architecture upon H&E staining, optimally maintaining the native tissue morphology. The modified technique yielded adipose-rich lymph nodes with superior flatness, eliminating tissue wrinkling. H&E staining revealed intact, spherical lymph nodes without peripheral curling or overlapping. For calcified thyroid specimens, the optimized method produced undamaged sections where calcification foci remained undisturbed during microtomy, with adjacent tissue architecture being well-preserved in the vertical orientation. Conclusion: These findings underscore how tissue-specific FS protocols yield sections with complete preservation, uniform thickness, optimal staining contrast, and nuclear-cytoplasmic differentiation, all critical for precise intraoperative evaluation.
Objectives: Our previous work revealed that CD36 accelerates the progression of cervical cancer. Here, we elucidate the role of CD36 in regulating stemness and chemotherapy resistance in cervical cancer cells. Methods: Bioinformatic analysis was used to assess the correlation between CD36 expression and chemotherapy drug sensitivity in advanced cervical cancer. The effects of CD36 on cell proliferation were evaluated using Cell Counting Kit-8 and colony formation assays. Tumorsphere formation assays were performed to assess stemness. Western blot analysis was conducted to examine correlations between CD36 expression and stem cell markers. Chemotherapy resistance was further evaluated using colony formation, Cell Counting Kit-8 assays, and flow cytometry. Finally, the molecular mechanisms by which CD36 influences stemness and resistance were explored through bioinformatics analysis and western blotting. Results: CD36 expression was positively correlated with cisplatin resistance in advanced cervical cancer. CD36 overexpression enhanced both stemness and chemotherapy resistance. Notably, CD44, Hippo, and MEK5/ERK5 pathways were implicated in CD36-mediated effects. Conclusion: CD36 may serve as an effective therapeutic target to improve the prognosis of cervical cancer.
