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Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

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World Journal of Clinical Cases 2024年第9期12卷 1597-1605页

作者： Xiao-Juan Wang Yu-Peng Shi Li Wang Ya-Ni Li Li-Juan Xu Yue Zhang Shuang Han Department of Gastroenterology Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong UniversityXi'an 710054Shaanxi ProvinceChina

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage *** condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality *** To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic *** We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record *** pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and *** Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among ***,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial *** admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal *** routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding ***-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite ***,diet-related bleeding was more common

关键词： Acute non-varicose upper gastrointestinal bleeding Clinical characteristics Cause of disease Endoscopic homeostatic therapy

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Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action(EQIA)study:a national cohort study in China from 2017 to 2019

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Frontiers of medicine 2024年第2期18卷 315-326页

作者： Wei Cheng Jieqing Chen Xudong Ma Jialu Sun Sifa Gao Ye Wang Longxiang Su Lu Wang Wei Du Huaiwu He Yujie Chen Zunzhu Li Qi Li Jianhua Sun Hongbo Luo Jinbang Liu Guangliang Shan Bing Du Yanhong Guo Dawei Liu Chang Yin Xiang Zhou on behalf of the China National Critical Care Quality Control Center-the ECMO quality improvement action(EQIA)study Department of Critical Care medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing100730China Information Center Department/Department of Information Management State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing100730China Department of Medical Administration National Health Commission of the People’s Republic of ChinaBeijing100044China School of Population medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100730China Department of Epidemiology and Biostatistics Institute of Basic Medicine SciencesChinese Academy of Medical Sciences(CAMS)&School of Basic MedicinePeking Union Medical CollegeBeijing100730China National Institute of Hospital Administration National Health Commission of the People’s Republic of ChinaBeijing100044China 不详

This cohort study was performed to explore the influence of intensive care unit(ICU)quality on in-hospital mortality of veno-venous(V-V)extracorporeal membrane oxygenation(ECMO)-supported patients in *** study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019,using data from the National Clinical Improvement System and China National Critical Care Quality Control *** quality was assessed by quality control indicators and capacity *** the 2563 V-V ECMO-supported patients in 318 hospitals,a significant correlation was found between ECMO-related complications and *** reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients(cutoff:1.5%and 7.0%;95%confidence interval:1.05–1.48 and 1.04–1.45;odds ratios:1.25 and 1.23;P=0.012 and P=0.015,respectively).Meanwhile,the V-V ECMO center volume was a protective factor(cutoff of≥50 cases within the 3-year study period;95%confidence interval:0.57–0.83,odds ratio:0.69,P=0.0001).The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these ***,ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation in-hospital mortality high-volume centers quality control intensive care unit capacity parameters

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Malignant triton tumor in the abdominal wall:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1467-1473页

作者： Ho Jik Yang Donghyun Kim Won Suk Lee Sang-Ha Oh Department of Plastic and Reconstructive Surgery Chungnam National University Sejong HospitalSejong 30099South Korea Department of Plastic and Reconstructive Surgery Chungnam National University HospitalDaejeon 35015South Korea Department of emergency Eulji University HospitalDaejeon 35233South Korea Department of Plastic and Reconstructive Surgery Chungnam National University College of MedicineDaejeon 35015South Korea

BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive *** are primarily located along peripheral *** of MTTs in the abdominal wall have not been *** has a poorer prognosis than classic MPNSTs,and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis *** for MTTs mirrors that for MPNSTs and is predominantly *** SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdo-minal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the *** had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the *** computed tomography(CT)showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis *** was no sign of metastasis(T1N0M0).An incisional biopsy identified sporadic MTT of the lower abdomen.A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was ***-quently,the general surgeon utilized an approach akin to the open peritoneal onlay mesh *** patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin *** complications arose,and annual follow-up CTs did not show signs of recurrence or *** An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction,eliminating the need for postoperative radiotherapy.

关键词： Malignant triton tumor Abdominal wall Surgical excision Reconstruction Case report

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TcPO2 changes are more pronounced than SpO2 changes during simulated altitude changes in a hypobaric oxygen chamber: a nonrandomized controlled trial

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emergency and Critical Care medicine 2024年第3期4卷 105-110页

作者： Li Y. Chen L. Fu Z. Wang Z. Sun S. Luan X. Ma D. Hu T. School of Nursing and Rehabilitation Shandong University Shandong Jinan China Department of emergency and Critical Care medicine Qilu Hospital of Shandong University Shandong Jinan China Department of Pulmonary and Critical Care medicine Qilu Hospital of Shandong University Shandong Jinan China emergency Management Center of State Grid Shandong Electric Power Company Shandong Jinan China School of Nursing and Rehabilitation Cheeloo College of Medicine University of Shandong Department of Infection Control Qilu Hospital of Shandong University Shandong Jinan China School of Mechanical Engineering Shandong University Key Laboratory of the Ministry of Education for Efficient and Clean Machinery Manufacturing National Experimental Teaching Demonstration Center for Mechanical Engineering Shandong Jinan China

Background: Hypoxia is a significant risk factor of hypertension. However, no studies have used transcutaneous tissue partial pressure of oxygen (TcPO2) and partial pressure of carbon dioxide (TcPCO2) monitors to measure the respective partial pressures in healthy individuals. Oxygen saturation (SpO2) is often used for traditional monitoring of vital signs. This study investigated the changes in TcPO2 and SpO2 values during rapid changes in altitude. The trial was registered at *** (registration no. NCT06076057). Methods: Healthy adult volunteers were instructed to sit vertically in a hypobaric oxygen chamber, which ascended from 0 m to 2500 m at a uniform speed within 10 min. The Danish Radiometer TCM4 was used to measure TcPO2 and TcPCO2 with the ventral side of the upper arm as the measurement site. The Shenzhen Kerokan P0D-1 W pulse oximeter was used to measure heart rate and SpO2, with values recorded once every 500 m. Results: Altogether, 49 healthy volunteers were recruited between March 2023 and August 2023. With increasing altitude, TcPO2 and SpO2 decreased significantly (P 500 m, statistical significance was identified between TcPO2 in both sexes (P < 0.05). Statistical significance in TcPCO2 and heart rate was observed at the different elevations (P < 0.05). Conclusion: In acutely changing low-pressure hypoxic environments, TcPO2 changed more dramatically than SpO2 © Wolters Kluwer Health, Inc. All rights reserved.

关键词： Altitude change Low-pressure oxygen chamber Transcutaneous oxygen saturation Transcutaneous partial pressure of oxygen

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Is Helicobacter pylori infection protective against esophageal cancer?

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World Journal of Gastroenterology 2024年第38期30卷 4168-4174页

作者： Rick Maity Arkadeep Dhali Jyotirmoy Biswas General medicine Institute of Post Graduate Medical Education and ResearchKolkata 700020India Department of Gastroenterology Sheffield Teaching Hospitals NHS Foundation TrustRoyal Hallamshire HospitalSheffield S102JFUnited Kingdom School of medicine and Population Health University of SheffieldSheffield S102HQUnited Kingdom Deanery of Clinical Sciences University of EdinburghEdinburgh EH164SBUnited Kingdom Department of General medicine College of Medicine and Sagore Dutta HospitalKolkata 700058India

Helicobacter pylori(***)infection affects a substantial proportion of the global population and causes various gastric disorders,including gastric *** studies have found an inverse relationship between *** infection and eso-phageal cancer(EC),suggesting a protective role against *** editorial focuses on the possible mechanisms underlying the role of *** infection in EC and explores the role of gut microbiota in esophageal carcinogenesis and the prac-ticality of *** *** has two major subtypes:Esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC),which have different etiologies and risk *** microbiota can contribute to EC via inflammation-induced carcinogenesis,immunomodulation,lactagenesis,and genotoxin *** infection is said to be inversely related to EAC,protecting against EAC by inducing atrophic gastritis,altering serum ghrelin levels,and triggering cancer cell *** *** infection has no significant association with ESCC,COX-2-1195 polymorphisms and endogenous nitrosamine production can impact the risk of ESCC in ***-infected *** are concerns regarding a plausible increase in EC after *** eradication ***,*** eradication is not associated with an increased risk of EC,making it safe from an EC perspective.

关键词： Helicobacter pylori Helicobacter pylori infection Esophageal cancer Esophageal squamous cell carcinoma Esophageal adenocarcinoma Barrett’s esophagus Microbiota Dysbiosis Eradication

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Mannitol inhibits the proliferation of neural stem cell by a p38 mitogen-activated protein kinase-dependent signaling pathway

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Chinese Journal of Traumatology 2024年第1期27卷 42-52页

作者： Hai-Zhen Duan Xin Zhou Quan Hu Meng-Long Liu Shu-Hong Wang Ji Zhang Xu-Heng Jiang Tian-Xi Zhang An-Yong Yu Department of emergency Affiliated Hospital of Zunyi Medical UniversityZunyi563000Guizhou provinceChina Dazhou Vocational college of Chinese medicine Dazhou635000Sichuan provinceChina Dachuan District Traditional Chinese medicine Hospital Dazhou635000Sichuan provinceChina

Purpose:Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic ***,long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and *** that neural stem cell(NSC)is a subpopulation of main regenerative cells in the central nervous system after injury,the effect of mannitol on NSC is still *** present study aims to elucidate the role of mannitol in NSC ***:C57 mice were derived from the animal house of Zunyi Medical University.A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this ***,mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence *** order to investigate the impact of mannitol on NSC proliferation,both cell counting kit-8 assays and neurospheres formation assays were *** vitro effects of mannitol were examined at various doses and time *** order to elucidate the role of Aquaporin 4(AQP4)in the suppressive effect of mannitol on NSC proliferation,various assays including reverse transcription polymerase chain reaction,western blotting,and immunocytochemistry were conducted on control and mannitol-treated ***,the phosphorylated p38(p-p38)was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC ***,to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent(MAPK)signaling pathway in the observed inhibition of NSC proliferation by mannitol,SB203580 was *** data were analyzed using SPSS 20.0 software(SPSS,Inc.,Chicago,IL).The statistical analysis among multiple comparisons was performed using one-way analysis of variance(ANOVA),followed by Turkey’’s post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality *** betwe

关键词： Mannitol Cerebral edema Neural stem cell Proliferation AQP4 p38 MAPK signaling pathway

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Nursing effect of narrative nursing intervention on postoperative patients with severe lung cancer

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World Journal of Clinical Cases 2024年第1期12卷 76-85页

作者： Bin Wen Ying Liu Xiao-Xia Min An-Qi Wang Department of Intensive Care Tongren Hospital of Wuhan University and Wuhan Third HospitalOptics Valley BranchWuhan 430074Hubei ProvinceChina The First Department of Thoracic Oncology Hubei Cancer Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430079Hubei ProvinceChina Department of emergency medicine Taizhou First People's HospitalTaizhou 318020Zhejiang ProvinceChina

BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer *** To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care *** A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 *** control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the *** The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.

关键词： Narrative care Lung cancer Care unit Pain Quality of life

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Coupled single-cell and bulk RNA-seq analysis reveals the engulfment role of endothelial cells in atherosclerosis

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Genes & Diseases 2024年第5期11卷 442-455页

作者： Jianxiong Xu Jinxuan Wang Hongping Zhang Yidan Chen Xiaojuan Zhang Ying Zhang Ming Xie Jun Xiao Juhui Qiu Guixue Wang Key Laboratory for Biorheological Science and Technology of Ministry of Education State and Local Joint Engineering Laboratory for Vascular ImplantsBioengineering Modern Life Science Experiment Teaching Center of Bioengineering CollegeChongqing UniversityChongqing 400030China Jinfeng Laboratory Chongqing 401329China School of Basic Medical Sciences Chengdu Medical CollegeChengduSichuan 610500China Chongqing emergency Medical Center(Chongqing University Central Hospital) Chongqing 400014China

The clearance of apoptotic cell debris,containing professional phagocytosis and non-professional phagocytosis,is essential for maintaining the homeostasis of healthy ***,we discovered that endothelial cells could engulf apoptotic cell debris in atherosclerotic ***-cell RNA sequencing(RNA-seq)has revealed a unique endothelial cell subpopulation in atherosclerosis,which was strongly associated with vascular injury-related ***,integrated analysis of three vascular injury-related RNA-seq datasets showed that the expression of scavenger receptor class B type 1(SR-B1)was up-regulated and specifically enriched in the phagocytosis pathway under vascular injury ***-cell RNA-seq and bulk RNA-seq indicate that SR-B1 was highly expressed in a unique endothelial cell subpopulation of mouse aorta and strongly associated with the reorganization of cellular adherent junctions and cytoskeleton which were necessary for ***,SR-B1 was strongly required for endothelial cells to engulf apoptotic cell debris in atherosclerotic plaque of both mouse and human ***,this study demonstrated that apoptotic cell debris could be engulfed by endothelial cells through SR-B1 and associated with the reorganization of cellular adherent junctions and cytoskeleton.

关键词： Apoptotic cell debris Atherosclerosis Endothelial engulfment Single-cell RNA sequencing Scavenger receptor class B type 1

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Semi-synthetic chondroitin sulfate CS-semi5 upregulates miR-122-5p,conferring a therapeutic effect on osteoarthritis via the p38/MMP13 pathway

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Acta Pharmaceutica Sinica B 2024年第8期14卷 3528-3542页

作者： Xiang Li Ya Zhou Xuefeng Chen Hongjun Wang Shuang Yang Jun Yang Yunfeng Song Zhehui Zhao Haijing Zhang Lianqiu Wu State Key Laboratory of Digestive Health Institute of Materia MedicaChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100050China Tide Pharmaceutical Co. Ltd.Beijing 100176China Camford royal School Beijing 100093China

Osteoarthritis(OA)is an aging-associated disease characterized by joint stiffness pain and destroyed articular *** treatments for OA are limited to alleviating various OA *** is a lack of drugs available in clinical practice that can truly repair cartilage ***,we developed the chondroitin sulfate analog CS-semi5,semi-synthesized from chondroitin sulfate *** vivo,CS-semi5 alleviated inflammation,provided analgesic effects,and protected cartilage in the modified Hulth OA rat model and papain-induced OA rat model.A bioinformatics analysis was performed on samples from OA patients and an exosome analysis on papain-induced OA rats,revealing miR-122-5p as the key regulator associated with CS-semi5 in OA *** prediction revealed that miR-122-5p acted on the 30-untranslated region of p38 mitogen-activated protein kinase,which was related to MMP13 *** in vitro experiments revealed that CS-semi5 effectively reduced cartilage degeneration and maintained matrix homeostasis by inhibiting matrix breakdown through the miR-122-5p/p38/MMP13 axis,which was further validated in the articular cartilage of OA *** is the first study to investigate the semi-synthesized chondroitin sulfate CS-semi5,revealing its cartilageprotecting,anti-inflammatory,and analgesic properties that show promising therapeutic effects in OA via the miR-122-5p/p38/MMP13 pathway.

关键词： Chondroitin sulfate Cartilage Osteoarthritis Extracellular matrix Inflammation miRNA p38 MMP13

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Balancing Exploration–Exploitation of Multi-verse Optimizer for Parameter Extraction on Photovoltaic Models

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Journal of Bionic Engineering 2024年第2期21卷 1022-1054页

作者： Yan Han Weibin Chen Ali Asghar Heidari Huiling Chen Xin Zhang college of Computer Science and Artificial Intelligence Wenzhou UniversityWenzhou325035China School of Surveying and Geospatial Engineering College of EngineeringUniversity of TehranTehranIran School of Biomedical Engineering National Engineering Research Center of Ophthalmology and OptometryEye HospitalWenzhou Medical UniversityWenzhou325027China Key Lab of Biohealth Materials and Chemistry of Wenzhou Wenzhou UniversityWenzhouChina Key Laboratory of Intelligent Informatics for Safety&emergency of Zhejiang Province Wenzhou UniversityWenzhouChina

Extracting photovoltaic(PV)model parameters based on the measured voltage and current information is crucial in the simulation and management of PV *** accurately and reliably extract the unknown parameters of different PV models,this paper proposes an improved multi-verse optimizer that integrates an iterative chaos map and the Nelder–Mead simplex method,*** experiments verified that the proposed INMVO fueled by both mechanisms has more affluent populations and a more reasonable balance between exploration and ***,to verify the feasibility and competitiveness of the proposal,this paper employed INMVO to extract the unknown parameters on single-diode,double-diode,three-diode,and PV module four well-known PV models,and the high-performance techniques are selected for *** addition,the Wilcoxon signed-rank and Friedman tests were employed to test the experimental results *** evaluation metrics,such as root means square error,relative error,absolute error,and statistical test,demonstrate that the proposed INMVO works effectively and accurately to extract the unknown parameters on different PV models compared to other *** addition,the capability of INMVO to stably and accurately extract unknown parameters was also verified on three commercial PV modules under different irradiance and *** conclusion,the proposal in this paper can be implemented as an advanced and reliable tool for extracting the unknown parameters of different PV *** that the source code of INMVO is available at https://***/woniuzuioupao/INMVO.

关键词： Photovoltaic models Multi-verse optimizer Nelder-Mead simplex Iterative chaos map

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