Objective To explore the neuroprotective effect of dexmedetomidine ( Dex) in rats ex-posed to focal cerebral ischemia/reperfusion ( I/R) induced by middle cerebral artery occlusion ( MCAO) and the possible mechansims.Methods Adult male Sprague-Dawley rats were subjected to MCAO for 90 min followed by reperfusion for 24 h and Dex ( 15μg? kg-1 ) was infused through the left femoral vein im-mediately after the onset of MCAO.The PI3K inhibitor LY294002 ( LY,10 mM,10 μl) or eNOS inhibitor L-NIO ( 1 mg? kg-1 ,10μl) was intracerebroventricular administered before ischemia using a microinjecton. The neurological deficit score,brain edema,cerebral infarct volume,and neuron survivals were evaluated after 24 h of reperfusion.The expression of p-Akt ( Ser473) and p-eNOS ( Ser1177) in the ischemic hemicere-brum was detected by Western Blot.Results Compared with I/R group,the neurological deficit score,cere-bral infarct volume,and the degree of brain edema were significantly reduced in the rats treated with Dex ((2.3±0.4) vs (3.9±0.6),(19.3±3.5)%vs (40.5±5.4)%,(61.8±8.1)%vs (76.3±8.5)%,all P<0.05)re-spectively,and the number of survival neuron in the hippocampal CA1 and cortex was significantly increased ((136.5±15.8)/mm vs (53.5±7.9)/mm,(253.8±26.4)/mm3vs (112.5±14.6)/mm3,all P<0.01) respec-tively.The neuroprotection in DEX group was significantly inhibited by LY and L-NIO ( P<0.05) .In addi-tion,the expression of p-Akt and p-eNOS in the ischemic hemicerebrum was markly reduced in LY group compared with that in DEX group ((3.94±0.45) vs (0.85±0.21),(2.14±0.25) vs (0.79±0.29),all P<0.01) ,while there was no significant difference in the expression of p-Akt in the ischemic hemicerebrum be-tween L-NIO group and DEX group ((3.76±0.33) vs (3.94±0.45), P>0.05).Conclusion Dex can reduce cerebral injury in rats exposed to focal I/R,which is mediated by the activation of PI3K/Akt-eNOS pathway.

ObjectiveToinvestigatethecharacteristicsofsinglelacunarinfarct(SLI)andipsilateral multiple lacunar infarction (MLI), and the differences of risk factors and and pathologies betw een them. Methods The clinical data of al patients w ith cerebral infarction in acute internal carotid artery territory from August 1, 2008 to December 13, 2014 w ere analyzed retrospectively. Lacunar infarctions w ere screened according to the clinical manifestations and imaging findings. The patients w ere divided into a SLI, a unilateral MLI in the same blood supply area (MLI 1) and a unilateral MLI in the different blood supply area (MLI 2) group according to the number and location of the lesions show ed on diffusion w eighted imaging. Multivariate logistic regression analysis w as used to identify potential independent risk factors. Results The incidences of ipsilateral carotid plaque (73.33%vs.48.67%; χ2 =5.801, P=0.016), ipsilateral unstable carotid plaque ( 70.0%vs.42.5%; χ2 =7.192, P= 0.007 ), and ipsilateral carotid stenosis ≥50%(16.67%vs.1.77%; χ2 =8.327, P=0.004) of the MLI 1 group w ere significantly higher than those of the SLI group; the incidence of atrial fibril ation of the MLI 2 group w as significantly higher than that of the SLI group (40.0%vs.0.88%; χ2=15.887, P<0.001); there w ere no significant differences in the remaining risk factors among each group. Multivariate logistic regression analysis showed that atrial fibrilation (odds ratio [OR] 14.452, 95% confidence interval [CI] 1.558-134.011; P=0.019) and ipsilateral carotid stenosis ≥50% (OR 11.483, 95%CI 2.202-59.891; P=0.011) w ere the independent risk factors for MLI. Conclusions MLI may have different risk factors and pathogeneses w ith SLI. Atherosclerotic lesions and embolism are the important pathogeneses of MLI, w hile SLI is not.

Objective To explore the nursing essentials of complicated incision infection and embedding syndrome after percutaneous endoscopy gastrojejunostomy(PEGJ). Methods Comprehensive treatment and care including improved nursing methods, negative pressure suction, the dressing strengthening, and enteral nutrition. Results The swelling of the incision gradually subsided. On the 18th day, there was slight redness around the tube, no exudate, no fever, and the incision healed well. On the 20th day, family members were taught with routine maintenance method of the PEG/J tube, and the patient was discharged from hospital with the tube home for continue treatment. Conclusion Comprehensive nursing methods according to cause analysis can improve the curative effect of complications after PEGJ implantation.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

Objective This article reviews the curriculum framework, teaching content, teaching method and application effects of stimulation teaching of hospice care for nursing undergraduates and reveals its inspirations to China, in order to provide a reference for the further development of China's hospice education.

Objective:To analyze the clinical characteristics of bone tumors in children, so as to improve the understanding and diagnosis of bone tumors in children.Methods:The clinical data of bone tumors in children hospitalized in the Affiliated Hospital of Zunyi Medical University from January 2009 to December 2018 were collected, with the age ≤ 14 years old.All children′s gender, age, tumor type, location, number of lesions and first symptoms were counted, and the clinical characteristics of bone tumors in children in this area were analyzed.Results:Totally 548 children with bone tumor were collected, with 344 males and 204 females, and the ratio of males to females was 1.69∶1.00, with 462 single cases and 86 multiple cases.Among the multiple cases (86 cases), 82 cases (95.35%) were benign bone tumors.The total number of cases increased with age.The age of different tumors has its own characteristics.Tibia was the most common tumor location (223 in total), followed by femur (177 in total) and humerus (82 in total). According to the classification of tumor nature, there were 478 cases (87.22%) of benign bone tumors, 43 cases (7.85%) of intermediate bone tumors and 27 cases (4.93%) of malignant bone tumors.The incidence of benign bone tumors was significantly higher than that of intermediate and malignant bone tumors, with statistically significant differences ( χ2=72.604, P<0.05). Among the benign bone tumors (478 cases), osteochondroma was the most common (265 cases), accounting for 55.44%; among the intermediate bone tumors (43 cases), aneurysmal bone cyst was the most common (20 cases), occupying 46.51%; among the malignant bone tumors(27 cases), osteosarcoma was the most common (16 cases), accounting for 59.26%.Among the initial symptoms, 268 cases were local masses, and 166 cases were pain, which were significantly higher than that of 79 without symptoms, with 28 lameness, 4 deformity and 3 dysfunction, and the differences were statistically significant( χ2=71.422, P<0.05). Conclusions:The majority of bone tumors patients in children were male, and the incidence increased with age.Benign and solitary are common, and the multiple cases were mainly benign.The most common locations are tibia and femur.The initial symptoms were mainly local mass and pain.Most importantly, the clinical characteristics of different tumors are slightly different.

Objective:To explore the relative concentration changes of oxygenated hemoglobin (Oxy Hb) in the prefrontal cortex (PFC) and brain region activation during emotional face recognition tasks in women with perimenopausal depression.Methods:From February to April 2023, forty perimenopausal women were recruited, including 20 women with perimenopausal depression (experimental group) and 20 women with non-perimenopausal depression (control group). All participants were evaluated by the modified Kupperman score, 24-item Hamilton depression scale (HAMD-24), and patient health questionnaire (PHQ-9). Functional near-infrared spectroscopy (fNIRS) equipment was used to measure the relative concentration of Oxy-Hb in the PFC in two groups under the emotional face recognition task. Statistical analysis was performed by SPSS 26.0 software. Data were analyzed by a t-test, rank sum test, and Pearson correlation. Results:There were statistically significant differences in the results of the modified Kupperman score((23.20±3.66), (18.10±1.28)), HAMD-24((15.95±5.47), (3.35±1.84)), and PHQ-9(7.00(5.00, 10.75), 1.50(1.00, 3.00)) scales between the the experimental group and control group ( P<0.05). There was a positive correlation between the modified Kupperman score and the HAMD-24 score in the experimental group ( r=0.685, P=0.01). The reaction time of the experimental group in identifying negative and neutral emotional faces was statistically significant compared to the control group( t=4.01, 4.80, both P<0.05). Compared with identifying neutral emotions, PFC activation was stronger in the experimental group and control group when identifying negative emotions ( P<0.05). The PFC activation in the experimental group was stronger than that in the control group when identifying negative emotions ( P<0.05). There was no statistically significant difference in the activation level between the two groups when identifying neutral emotions ( P>0.05). Conclusion:Women with perimenopausal depression exhibit specificity in emotional processing, with increased PFC activation when identifying negative emotions, impaired emotional processing function of PFC, and dysfunction of aerobic metabolism.

Objective:To explore the application effect of coaching technique in respiratory function exercise of patients with chronic obstructive pulmonary disease (COPD) in stable stage.Methods:Using the convenient sampling method, a total of 40 COPD patients in stable stage who were treated in Geriatric and Respiratory Departments of 3 provincial hospitals in Hangzhou were selected as the research objects from August 2018 to June 2019. They were given a six-month breathing intervention based on coaching techniques by trained health coaches. COPD Self-Efficacy Scale (CSES) and COPD Assessment Test (CAT) were used to evaluate self-efficacy and quality of life of patients before and after intervention. The awareness and implementation of respiratory function exercise were compared before and after intervention.Results:After6 months of intervention, compared with those before intervention, the score of awareness and implementation of respiratory function exercise of patients increased, and the differences were statistically significant ( P<0.05) . After the intervention, the score of CSES increased and the scores of CAT decreased, and the differences were statistically significant compared with those before the intervention ( P<0.05) . Conclusions:The application of coaching technique in the respiratory function exercise of COPD patients in stable period has a certain effect, which can improve the awareness and implementation of patients with respiratory function exercise and improve their sense of self-efficacy and quality of life.

Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin's lymphoma. A total of 10%‒15% of DLBCL cases are associated with myelocytomatosis viral oncogene homolog(MYC) and/or B-cell lymphoma-2 (BCL2) translocation or amplification. BCL2 inhibitors have potent anti-tumor effects in DLBCL; however, resistance can be acquired through up-regulation of alternative anti-apoptotic proteins. The histone deacetylase (HDAC) inhibitor chidamide can induce BIM expression, leading to apoptosis of lymphoma cells with good efficacy in refractory recurrent DLBCL. In this study, the synergistic mechanism of chidamide and venetoclax in DLBCL was determined through in vitro and in vivo models. We found that combination therapy significantly reduced the protein levels of MYC, TP53, and BCL2 in activated apoptotic-related pathways in DLBCL cells by increasing BIM levels and inducing cell apoptosis. Moreover, combination therapy regulated expression of multiple transcriptomes in DLBCL cells, involving apoptosis, cell cycle, phosphorylation, and other biological processes, and significantly inhibited tumor growth in DLBCL-bearing xenograft mice. Taken together, these findings verify the in vivo therapeutic potential of chidamide and venetoclax combination therapy in DLBCL, warranting pre-clinical trials for patients with DLBCL.
Aminopyridines ; Animals ; Benzamides ; Biological Phenomena ; Bridged Bicyclo Compounds, Heterocyclic ; Down-Regulation ; Histone Deacetylase Inhibitors/therapeutic use* ; Humans ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Mice ; Neoplasm Recurrence, Local ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Proto-Oncogene Proteins c-myc/therapeutic use* ; Sulfonamides ; Tumor Suppressor Protein p53/metabolism*