OBJECTIVES: Neuropathic pain (NP) is one of the most common forms of chronic pain, yet current treatment options are limited in effectiveness. Peripheral nerve injury activates spinal microglia, altering their inflammatory response and phagocytic functions, which contributes to the progression of NP. Most current research on NP focuses on microglial inflammation, with relatively little attention to their phagocytic function. Early growth response factor 2 (EGR2) has been shown to regulate microglial phagocytosis, but its specific role in NP remains unclear. This study aims to investigate how EGR2 modulates microglial phagocytosis and its involvement in NP, with the goal of identifying potential therapeutic targets. METHODS: Adult male Sprague-Dawley (SD) rats were used to establish a chronic constriction injury (CCI) model of the sciatic nerve. Pain behaviors were assessed on days 1, 3, 7, 10, and 14 post-surgery to confirm successful model induction. The temporal and spatial expression of EGR2 in the spinal cord was examined using real-time quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. Adeno-associated virus (AAV) was used to overexpress EGR2 in the spinal cord, and behavioral assessments were performed to evaluate the effects of EGR2 modulation of NP. CCI and lipopolysaccharide (LPS) models were established in animals and microglial cell lines, respectively, and changes in phagocytic activity were measured using RT-qPCR and fluorescent latex bead uptake assays. After confirming the involvement of microglial phagocytosis in NP, AAV was used to overexpress EGR2 in both in vivo and in vitro models, and phagocytic activity was further evaluated. Finally, eukaryotic transcriptome sequencing was conducted to screen differentially expressed mRNAs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses to identify potential downstream effectors of EGR2. RESULTS: The CCI model successfully induced NP. Following CCI, EGR2 expression in the spinal cord was upregulated in parallel with NP development. Overexpression of EGR2 via spinal AAV injection enhanced microglial phagocytic activity and increased pain hypersensitivity in rats. Both animal and cellular models showed that CCI or LPS stimulation enhanced microglial phagocytosis, which was further amplified by EGR2 overexpression. Transcriptomic analysis of spinal cord tissues from CCI rats overexpressing EGR2 revealed upregulation of numerous genes associated with microglial phagocytosis and pain regulation. Among them, Lag3 emerged as a potential downstream target of EGR2. CONCLUSIONS EGR2 contributes to the maintenance of NP by enhancing microglial phagocytosis in the spinal dorsal horn.
Animals ; Microglia/metabolism* ; Phagocytosis/physiology* ; Rats, Sprague-Dawley ; Neuralgia/physiopathology* ; Early Growth Response Protein 2/metabolism* ; Male ; Rats ; Spinal Cord/metabolism* ; Sciatic Nerve/injuries*

The plant AT-rich sequence and zinc-binding protein (PLATZ) family is composed of plant-specific zinc finger-like transcription factors, which play important roles in plant growth, development, and stress tolerance. In this study, to gain a better understanding of the PLATZ gene in C. sinensis and elucidate its response under drought and high temperature conditions, the PLATZ gene family of the C. sinensis cultivar 'Tieguanyin' was systematically identified, and a total of 12 CsPLATZ family members were identified. Expasy online and other bioinformatics tools were used to analyze the members of the PLATZ gene family in terms of protein physicochemical properties, phylogenetic relationships, cis-acting elements, gene structures, and intra- and inter-species collinearity. The results of phylogenetic analysis classified the CsPLATZ family members into 2 subfamilies. The conserved domains and gene structures of PLATZ family members within the same subfamily had a high degree of consistency, whereas a certain degree of diversity was observed among the subfamilies. Twelve PLATZ genes were unevenly distributed across 7 chromosomes of C. sinensis and the promoter regions of these genes had multiple cis-acting elements related to hormone and stress responses. The collinearity analysis showed that there were 4 pairs of duplication events in the CsPLATZ gene family, all of which were segmental duplications. Based on this gene family, C. sinensis had a closer evolutionary relationship with A. thaliana than with O. sativa. The transcriptome analysis showed that the expression levels of CsPLATZ family members varied in different tissue samples of C. sinensis. 6 genes (CsPLATZ-1, CsPLATZ-2, CsPLATZ-3, CsPLATZ-4, CsPLATZ-6, and CsPLATZ-8) with high expression in shoots, young leaves, and roots were selected for high temperature and drought stress treatments, and their expression was quantified by qRT-PCR. The results indicated that the six genes might play important roles in the response to drought stress. In addition, CsPLATZ-2 and CsPLATZ-8 might have important functions in the response to high temperature stress. The results of this study will contribute to a better understanding of the biological functions of PLATZ genes and their possible roles in the growth, development, and stress responses of C. sinensis.
Droughts ; Camellia sinensis/physiology* ; Phylogeny ; Gene Expression Regulation, Plant ; Plant Proteins/genetics* ; Stress, Physiological/genetics* ; Multigene Family ; Transcription Factors/genetics* ; Hot Temperature ; Genes, Plant

Objective To establish the drug use evaluation(DUE)criteria for aspirin enteric-coated tablets and provide a reference for the rationally clinical application of aspirin enteric-coated tablets.Methods DUE criteria for aspirin enteric-coated tablets were established from three aspects of indications,medications and medication results with reference to drug instructions of aspirin enteric-coated tablets,related guidelines,expert consensus and literature,and through Delphi method.A retrospective analysis was conducted to evaluate the medical records of patients who took aspirin enteric-coated tablets from January 2021 to June 2022 in Fuqing Hospital affiliated to Fujian Medical University.Results A total of 1 071 medical records were included.683 cases fully met the DUE criteria,with a rational rate of 63.77％.Irrational drug use mainly included inappropriate indications(6.26％),off-label drug use without approval(28.48％),contraindications(1.03％),inappropriate usage and dosage(1.68％),drug interactions with potential clinical significance(0.65％)and other inappropriate drug use(2.71％).Conclusion The established DUE standard for aspirin enteric-coated tablets has strong scientific practicability and feasibility.The irrational rate of aspirin enteric-coated tablets in this hospital is high.Corresponding intervention measures should be formulated to ensure the safety of clinical medication.

Objective:To analyze the self-evaluation and training needs of standardized parents from pediatric nurses after participating in the standardized residency training of pediatrics, and to explore the feasibility of pediatric nurses as standardized parents and the methods of training and management.Methods:A self-made questionnaire was used to investigate the self-evaluation, the influencing factors, the needs of training content and training form of standardized parents of pediatric nurses. Data analysis was made by SPSS 24.0 statistical software.Results:A total of 37 questionnaires were collected from the standardized parents of nurses. Among them, 36 nurses (97.30%) thought they were very competent for the work of standardized parent; 36 ones (97.30%) thought the most satisfied with their own was responsibility and fairness; 26 ones (70.27%) thought the least satisfied with their own was performance ability; 23 ones (62.16%) thought that the assessment of non-professional diseases would affect their performance in the assessment process; 34 people (91.89%) had the highest demand for training in the contents and skills of consultation; 16 ones (43.24%) thought that "teaching" and "giving cases to doctors and standardized parents for assessment simulation exercise" were the better training methods. Nurses used their own time to participate in training and assessment, and were willing to participate in the certification assessment of standardized parents.Conclusions:In the training of standardized parents of pediatric nurses, it is need to strengthen the training of various abilities, further improve the training contents and forms, reasonably arrange the training and assessment time, and increase policy support to make the standardized parent management of nurses more standardized.

Objective:To analyze the evaluation of the application effect and deficiency of nurses acting as standardized parents in the graduation examination of standardized residency training of pediatrics and further improve and promote the level of standardized parents.Methods:A questionnaire survey was used to collect the scores of nurse standardized parents by students and examiners who took part in the graduation examination of standardized residency training of pediatrics in 2021. And the self-evaluation scores of standardized parents were collected. Counting data were represented by the number of cases and composition ratio. A Chi-square test was used to compare the rates.Results:A total of 125 questionnaires from students and 37 questionnaires from nurse standardized parents were collected, and the overall satisfaction (very satisfied + satisfied) of standardized parents reached 121 (96.80%). In the three dimensions of simulation ability, compliance with question-and-answer rules, and simulated attitude, students believed that the consistency between standardized parents and actual parents in simulated altitude was lower than that in the simulation ability and compliance with question-and-answer rules ( P=0.007, P=0.001). The overall satisfaction of standardized parents (very satisfied + satisfied) reached 87.38% (388/444). There were 26 (70.27%) nurse standardized parents who had the lowest satisfaction with their own performance ability, followed by 28 (75.68%) cases of imitation ability and 30 (81.08%) cases of adaptability. Conclusions:It is feasible to adopt nurse standardized parents in the assessment of standardized residency training of pediatrics, and both students and examiners have higher satisfaction. The next step is to improve the training of nurses standardized parents in the attitude of simulation and, at the same time, enhance the training of imitation ability and adaptability, so as to further expand the construction of standardized parents.

Objective:To investigate Helicobacter pylori (Hp) infection status, strain typing, and their correlations with gastric mucosal lesions in chronic gastritis. Methods:A retrospective analysis was conducted on the medical records of 11 500 patients with chronic gastritis who received treatment at Xi'an International Medical Center Hospital, People's Hospital of Wuhai, and People's Hospital of Tongchuan from January to July 2022. Hp test results, strain typing, and the basic characteristics and gastric mucosal lesions of Hp-infected patients were determined. Pearson correlation analysis was performed to assess the correlation between strain types and gastric mucosal lesions. Logistic regression analysis was performed to identify factors influencing Hp infection in patients with chronic gastritis.Results:A total of 7 549 cases of Hp infection were identified (65.65%). Patients with more than three family members, farmers and workers, those who frequently drank raw water, consumed pickled foods, did not drink tea, were aged 50 years or older, or had a disease duration of 2 years or more had a higher Hp-positive rate compared with those with fewer than three family members, government officials, those who infrequently drank raw water, did not consume pickled foods, drank tea, were younger than 50 years, or had a disease duration of less than 2 years (all P < 0.05). The majority of infected patients harbored the highly virulent type I Hp strains (55.65%). The numbers of cases of non-epithelial neoplasia, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, and gastric infiltrating carcinoma were significantly different among different strain types (χ2 = 40.33, 7.65, 11.39, 54.89, all P < 0.05). Conclusion:A higher number of family members, being a farmer or a worker, frequently drinking raw water, and consuming pickled foods are associated with an increased rate of Hp infection, while drinking tea is linked to a reduced infection rate. Patients with chronic gastritis are often infected with highly virulent type I Hp strain. There is a positive correlation between non-epithelial neoplasia and strain type. Age ≥ 50 years and disease duration ≥ 2 years are independent factors influencing Hp infection in chronic gastritis.

Objective:To retrieve and summarize the best evidence for nursing of hematopoietic stem cell reinfusion in children.Methods:Clinical decisions, guidelines, recommended practices, evidence summaries, systematic reviews, and expert consensuses on nursing of hematopoietic stem cell reinfusion in children were searched in Chinese and English databases as well as related websites such as British Medical Journal (BMJ) Best Practice, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, UpToDate, CINAHL, Embase, PubMed, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to March 2023. Two researchers independently conducted literature quality evaluation, identified the included literature, extracted evidence item by item, and translated, organized and summarized the evidence.Results:A total of nine articles were included, including two clinical decisions, two expert consensuses, four guidelines, and one evidence summary. 24 pieces of evidence were summarized from six aspects, consisting of child preparation, stem cell preparation, item preparation, nursing during reinfusion, nursing after reinfusion, and evaluation and education.Conclusions:The best evidence for nursing of hematopoietic stem cell reinfusion in children involves a wide range of aspects. Managers, clinical medical and nursing staff should apply evidence based on specific medical situations in order to safely and reasonably perform hematopoietic stem cell reinfusion.

Objective:To summarize the best evidence of medication adherence interventions for patients with multiple chronic conditions.Methods:According to the "6S" evidence model, literature on medication adherence in patients with multiple chronic conditions was retrieved from BMJ Best Clinical Practice, UpToDate, Medlive, National Institute for Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang data and so on. The search period was from establishing the database to August 30, 2023.Results:A total of 16 articles were included, including three guidelines, four expert consensus, seven systematic reviews, and two meta-analyses. Twenty-seven pieces of evidence were summarized from six aspects of compliance assessment, educational intervention, behavioral intervention, optimized treatment program, technical reminder intervention, and social-psychological-emotional intervention.Conclusions:The best evidence of medication adherence interventions for patients with multiple chronic conditions summarized provides a reference for medical and nursing staff to develop medication adherence interventions.

Objective·To explore the effect of online courses combined with the teach-back method among patients with laryngectomy and their family caregivers.Methods·Convenience sampling was used to select patients with laryngectomy treated in the Department of Otolaryngology,Shanghai Changhai Hospital from July 2022 to June 2023 and their family caregivers.The participants were divided into a control group and an observation group using the random number table method.The intervention was conducted in two different wards.General information of the two groups of patients and caregivers was collected.After admission,the control group watched offline videos recorded by the department.The videos introduced laryngocarcinoma-related knowledge and standard procedures of airway stoma care,suctioning,nasal feeding,etc.,which were divided into 4 sessions with 30 min each.The patients watched one session per week.The observation group watched the same videos(8 lessons)online on their own after admission,while the nursing staff used the teach-back method for health education,consolidating 2 lessons once a week,45 min/session for 4 weeks.The effectiveness of the intervention was evaluated by using Caregiver Preparedness Scale(CPS),Family Caregiver Task Inventory(FCTI),and Chinese Quality of Life Instruments for Cancer Patients-Head and Neck Cancer(QLICP-HN)at baseline(1st week),before discharge(4th week),and one month after discharge(8th week),as well as the incidence of adverse events during home care.Results·The study included a total of 120 pairs of patients and caregivers,with 60 pairs in each group.Five pairs in each group were excluded due to various reasons,leaving a total of 55 pairs in each group.There were no statistically significant differences between the two groups in terms of general information of the patients and the caregivers,QLICP-HN scores of the patients,and CPS and FCTI scores of the caregivers at baseline(P＞0.05).Before discharge and 1 month after discharge,the CPS scores of the caregivers and the QLICP-HN scores of the patients in the observation group were significantly higher than those in the control group,and the FCTI scores were significantly lower(lower scores indicating better nursing care),with statistically significant differences(P＜0.05).Within 1 month after discharge,the incidence of adverse home care events in the observation group was lower than that in the control group(5.5%vs 29.1%),and the difference was statistically significant(P＜0.05).Conclusion·The online courses combined with the teach-back method help improve the readiness to care and caregiving competence of family caregivers of post-laryngectomy patients,improve patients'quality of life,and reduce the incidence of adverse events during home care.

Objective:To explore the distribution and hematological characteristics of rare thalassemia-associated mutations in Chenzhou region of Hunan Province with an aim to provide a basis for genetic counseling and effective prevention.Methods:A total of 37 370 individuals enrolled from January 2015 to December 2021 were screened by routine blood test and hemoglobin electrophoresis. The genotypes were determined with high-throughput sequencing.Results:A total of 8 455 thalassemia mutations (including 185 rare ones) were detected, which had involved 27 mutational types. Rare type α-Thalassemia --THAI and CD31 (AGG>AAG) have the typical microcytic hypochromic hematological features, whilst SEA-HPFH, CD14 (CTG>-TG), CD37 (TGG>TAG), -90(C>T), Codon 15 (G>A), IVS-Ⅰ-128 (T>G), CD86 (GCC>GC-) and Chinese Gγ+ (Aγδβ)0 had typical microcytic hypochromic and β-thalassemia-associated hematological features of elevated HbA2 or HbF. In addition, the -50(G>A)heterozygotes of β-thalassemia had normal or slightly decreased MCV and MCH without an increase in HbA2.Conclusion:Various forms of thalassemia-associated mutations have been identified in the Chenzhou region of Hunan Province. Above finding has facilitated development of preventive and control strategies for thalassemia as well as birth health programs.