Objective:To evaluate the role of hippocampal prostaglandin-endoperoxide synthase 2 (PTGS2) in baicalin-induced reduction of cognitive dysfunction after cerebral ischemia-reperfusion injury (CIRI) in mice.Methods:Thirty healthy male C57BL/6 mice, aged 16 weeks, weighing 20-25 g, were divided into 5 groups ( n=6 each) using a random number table method: control group (C group), CIRI group, baicalin+ CIRI group (B+ CIRI group), overexpression of PTGS2+ CIRI group (PTGS2+ CIRI group), and overexpression of PTGS2+ baicalin+ CIRI group (PTGS2+ B+ CIRI). In B+ CIRI group and PTGS2+ B+ CIRI group, baicalin-liposome 0.2 ml was injected through the tail vein, and the CIRI model was established 1 week later. In PTGS2+ CIRI group and PTGS2+ B+ CIRI group, PTGS2-overexpressed adeno-associated virus 1.2 μl was injected into the hippocampus, and the CIRI model was established 4 weeks later. CIRI model was established by using the transient (50 min) bilateral common carotid artery occlusion/reperfusion. On the 12th day after developing the model, the spatial learning and memory ability was evaluated using Morris water maze test. The expression of PTGS2 in the hippocampus was detected by Western blot, and the expression of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), IL-6, Iba-1 and CD68 mRNA in the hippocampus was detected by quantitative real-time polymerase chain reaction. Results:Compared with C group, the escape latency was significantly prolonged, the time spent in the target quadrant was shortened, the number of crossing the original platform was reduced, and the expression of PTGS2 and expression of Iba-1, CD68, TNF-α, IL-1β and IL-6 mRNA in the hippocampus was up-regulated in CIRI group ( P<0.05). Compared with CIRI group, the escape latency was significantly shortened, the time spent in the target quadrant was prolonged, the number of crossing the original platform was increased, and the expression of PTGS2 and expression of Iba-1, CD68, TNF-α, IL-1β and IL-6 mRNA in the hippocampus was down-regulated in B+ CIRI group, and the escape latency was significantly prolonged, the time spent in the target quadrant was shortened, the number of crossing the original platform was reduced, and the expression of PTGS2 and expression of Iba-1, CD68, TNF-α, IL-1β and IL-6 mRNA in the hippocampus was up-regulated in PTGS2+ CIRI group ( P<0.05). Compared with B+ CIRI group, the escape latency was significantly prolonged, the time spent in the target quadrant was shortened, the number of crossing the original platform was reduced, and the expression of PTGS2 and expression of Iba-1, CD68, TNF-α, IL-1β and IL-6 mRNA in the hippocampus was up-regulated in PTGS2+ B+ CIRI group ( P<0.05). Conclusions:The mechanism by which baicalin attenuates cognitive dysfunction after CIRI is related to down-regulation of hippocampal PTGS2 expression and inhibition of neuroinflammation in mice.

OBJECTIVE To study the effects of Zigui yichong formula on premature ovarian insufficiency （POI） in mice through glycolysis metabolic pathway. METHODS Eighty SPF C57BL/6N female mice were divided into normal group， model group， Zigui yichong formula group （14.175 g/kg）， Zigui yichong formula+2-deoxy-D-arabino-hexose （2-DG） group （Zigui yichong formula 14.175 g/kg + glycolysis inhibitor 2-DG 100 mg/kg）， with 20 mice in each group. Except for the normal group， POI model mice were induced by intraperitoneal administration of cyclophosphamide in the other groups. After the model was successfully established， each group was given corresponding drugs. HE staining was employed to observe the pathomorphological changes in ovarian tissue and to count follicles at all developmental stages； radioimmunoassay was conducted to measure the serum levels of estradiol （E2）， anti-Müllerian hormone （AMH）， and follicle-stimulating hormone （FSH）； TUNEL assay was employed to detect apoptosis in ovarian granulosa cells of mice； the activities of hexokinase （HK）， pyruvate kinase （PK） and lactate dehydrogenase （LDH） were detected by colorimetry； Western blot and real-time fluorescence quantitative PCR were employed to analyze the protein and mRNA expressions of B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， caspase-3， HK2， pyruvate kinase M2 （PKM2）， and lactate dehydrogenase A （LDHA）. RESULTS Compared with model group， the number of primordial follicles， growing follicles， antral follicles and granulosa cells were increased significantly（P＜0.05）， and granulosa cells arranged neatly， but the number of atretic follicles and granulosa cells apoptosis were decreased significantly in Zigui yichong formula group （P＜0.05）； the serum levels of E2 and AMH， the activities of HK， PK and LDH， protein and mRNA expressions of Bcl-2， HK2， PKM2 and LDHA were increased significantly （P＜0.05）； the serum levels of FSH， the protein and mRNA expressions of Bax and caspase-3， Bax/Bcl-2 ratio were decreased significantly （P＜0.05）. 2-DG could reverse the improvement effects of Zigui yichong formula on the above indexes of POI model mice. CONCLUSIONS Zigui yichong formula may inhibit the apoptosis of ovarian granulosa cells， reduce follicle atresia and improve ovarian reserve function by promoting glycolysis levels in POI model mice.

Objective To investigate the effects of 0.5 Gy 60Co γ-ray irradiation on intestinal tissue injury and intestinal microflora in mice.Methods C57BL/6N mice were irradiated with 0.5 Gy 60Co γ-ray at 1 d,3 d,7 d and 14 d after irradiation.Jejunum tissues were fixed and frozen,and feces were frozen.Hematoxylin-eosin staining was used to observe the pathological injury to jejunum after irradiation,ki67 immunohistochemical staining was adopted to detect the proliferation of jejunum crypt cells,and TdT-mediated dUTP nick end labeling was employed to detect the apoptosis of jejunum crypt cells.The expressions of TNF-α,IL-1β,IL-6 and IL-10 cytokines in small intestines were detected via radioimmunoassay.The changes of intestinal flora in mice after irradiation were analyzed by metagenomic sequencing,and LEfSe analysis and ROC analysis were used to screen the bacteria with significant differences.Results After 0.5 Gy 60Co γ-ray irradiation,the proliferative cells of the jejunal crypt were significantly decreased at 1 d after irradiation(P＜0.05),while the apoptotic cells were significantly increased at 1 and 3 d after irradiation(P＜0.01).The expression of TNF-α at 7 and 14 d after irradiation,that of IL-1 β at 1,3,7 and 14 d after irradiation and that of IL-6 at 3,7 and 14 d after irradiation were significantly increased(P＜0.05),while the expression of IL-10 at 7 and 14 d after irradiation was significantly decreased(P＜0.05).After 0.5 Gy 60Co γ-ray irradiation,intestinal flora composition changed significantly at phylum,genus and species levels,and Lactobacillus murinus,Lactobacillus johnsonii,Alistipes-unclassified,Mucispirillum schaedleri underwent the most significant changes and had higher LDA scores.Conclusion The whole body irradiation of 0.5 Gy 60Co γ-ray can cause intestinal tissue damage and change the composition of intestinal flora in mice.

Objective:To explore the effectiveness of limb motor rehabilitation program based on patient health engagement (PHE) model in patients with hemorrhagic stroke, and to provide reference for the limb motor rehabilitation management of hemorrhagic stroke patients.Methods:Through literature review and Delphi expert correspondence, a limb motor rehabilitation program for hemorrhagic stroke patients based on the PHE model was constructed. A non-contemporaneous controlled study was conducted, 45 hemorrhagic stroke patients hospitalized in the Department of Neurosurgery of Shanxi Bethune Hospital from March to August 2022 were selected by convenience sampling method as the control group, and routine exercise rehabilitation measure was given, 45 hemorrhagic stroke patients from September 2022 to February 2023 were selected as the intervention group, a limb motor rehabilitation program based on PHE model was implemented on the basis of control group. The functional exercise compliance, limb motor function, daily activity ability, emotional and social dysfunction of patients in the two groups were observed before intervention, 1 and 3 months after intervention respectively.Results:A total of 85 patients with hemorrhagic stroke were included. There were 42 patients in the intervention group, 25 males and 17 females, aged (52.07 ± 9.91) years old, and 43 patients in the control group, 21 males and 22 females, aged (53.93 ± 10.52) years old. There were no significant differences in the functional exercise compliance, limb motor function, daily activity ability, emotional and social dysfunction of patients before intervention between the two groups. At 3 months after intervention, the functional exercise compliance score in the intervention group was (40.83 ± 7.92) points, higher than that in the control group (37.14 ± 6.44) points, and the difference was statistically significant ( t = 2.36, P<0.05). At 1 and 3 months after intervention, the scores of limb motor function and daily activity ability in the intervention group were (27.12 ± 6.74), (33.67 ± 6.54) points and (61.31 ± 6.72), (74.40 ± 8.71) points, which were higher than (24.91 ± 6.03), (27.02 ± 6.59) points and (52.33 ± 9.78), (60.12 ± 10.03) points of the control group, the differences were statistically significant ( t values were 2.06-7.01, all P<0.05), the scores of emotional and social dysfunction were (75.52 ± 22.09) and (58.33 ± 18.88) points, which were lower than (86.02 ± 23.04), (78.51 ± 21.67) points of the control group, and the differences were statistically significant ( t = - 2.14, - 4.57, both P<0.05). Conclusions:The limb motor rehabilitation program based on the PHE model could improve the exercise compliance of patients with hemorrhagic stroke, improve the limb motor function and daily activity ability of patients, alleviate negative emotions, and reduce the level of social dysfunction.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.

Cognitive frailty, as one of the hotspots in the field of geriatric medicine research, is a disease state where physical frailty and cognitive impairment coexist. Cognitive frailty is related to sociodemographic factors, nutritional status, geriatric syndrome, physical and cognitive activities, comorbidities, etc., but the underlying mechanisms are not yet clear. Cognitive frailty not only increases the risk of adverse health outcomes such as falls, disability, and hospitalization in the elderly, but also exacerbates the burden on families and public healthcare systems. This article reviews the recent progress on the cognitive frailty in the elderly, focusing on the awareness of cognitive frailty, the related mechanisms and influencing factors, the assessment methods and non-pharmaceutical interventions to provide reference for clinical application.

Objective To compare the consistency between the estimated values of nine common resting energy expenditure estimation equations and the measured values among the elderly population in pension institutions. Methods A total of 181 elderly individuals from Henan Guangda Ouan Leling Nursing Center were recruited as study objects through cluster sampling. The differences between the estimated values of nine common equations and the measured values obtained by indirect calorimetry were compared, and subgroup analyses were conducted to compare their consistency across different subgroups. Results Among the nine equations, the Cunningham equation and the Owen equation showed relatively small deviations from the measured values, with no significant differences (deviation rates of -1.9% and -2.0%, root mean square errors of 222.7 kcal/d and 239.4 kcal/d, and coincidence rates of 48.4% and 47.5%, respectively). In subgroups stratified by gender and body mass index (BMI), the Cunningham equation showed no significant difference compared with the measured values. The Owen equation showed no significant difference compared with the measured values only in some subgroups [males with BMI of 20~ < 27 kg/m² and ≥27 kg/m², and females with BMI < 20 kg/m²]. Conclusion The Cunningham equation, which utilizes body composition data, can assess the resting energy expenditure of the elderly in pension institutions with relatively high accuracy and speed, demonstrating strong applicability in this population.

BACKGROUND: In light of the significant clinical benefits of antibody-drug conjugates in clinical trials, the human epidermal growth factor receptor 2 (HER2)-low category in breast cancers has gained increasing attention. Therefore, we studied the clinicopathological characteristics of Chinese patients with hormone receptor (HR)-positive/HER2-low early-stage breast cancer and developed a recurrence risk prediction model. METHODS: Female patients with HR-positive/HER2-low early-stage breast cancer treated in 29 hospitals of the Chinese Society of Breast Surgery (CSBrS) from Jan 2015 to Dec 2016 were enrolled. Their clinicopathological data and prognostic information were collected, and machine learning methods were used to analyze the prognostic factors. RESULTS: In total, 25,096 patients were diagnosed with breast cancer in 29 hospitals of CSBrS from Jan 2015 to Dec 2016, and clinicopathological data for 6486 patients with HER2-low early-stage breast cancer were collected. Among them, 5629 patients (86.79%) were HR-positive. The median follow-up time was 57 months (4, 76 months); the 5-year disease-free survival (DFS) rate was 92.7%, and the 5-year overall survival (OS) rate was 97.7%. In total, 412 cases (7.31%) of metastasis were observed, and 124 (2.20%) patients died. Multivariate Cox regression analysis revealed that T stage, N stage, lymphovascular thrombosis, Ki-67 index, and prognostic stage were associated with recurrence and metastasis ( P <0.05). A recurrence risk prediction model was established using the random forest method and exhibited a sensitivity of 81.1%, specificity of 71.7%, positive predictive value of 74.1%, and negative predictive value of 79.2%. CONCLUSION: Most of patients with HER2-low early-stage breast cancer were HR-positive, and patients had favorable outcome; tumor N stage, lymphovascular thrombosis, Ki-67 index, and tumor prognostic stage were prognostic factors. The HR-positive/HER2-low early-stage breast cancer recurrence prediction model established based on the random forest method has a good reference value for predicting 5-year recurrence events. REGISTRITATION ChiCTR.org.cn, ChiCTR2100046766.
Humans ; Female ; Breast Neoplasms/diagnosis* ; Ki-67 Antigen ; Receptor, ErbB-2 ; Prognosis ; Thrombosis ; Receptors, Progesterone

Pain after burns is a very common problem in children. Severe pain will not only hinder treatment, but also damage children's mental health if not handled in time. Therefore, pain management is very important in treating children with burns. As a safe, effective, and convenient non-drug therapy, music therapy has great advantages in relieving pain and is widely used in a variety of clinical fields. This paper focused on music therapy and its mechanism of pain relief, the current status of research on pain management of pediatric burns, the application and prospect of music therapy in pain management of pediatric burns, etc., to provide reference for clinical application.

Objective:To retrospect the blood transfusion status of patients with extensive burns in multiple centers and analyze its influencing factors.Methods:A retrospective case series study was conducted. Clinical data of 455 patients with extensive burns who met the inclusion criteria and were admitted to the burn centers of 3 hospitals from January 2016 to June 2022 were collected, including 202 patients from the First Affiliated Hospital of Nanchang University, 179 patients from the Second Affiliated Hospital of Zhejiang University School of Medicine, and 74 patients from the First Affiliated Hospital of Anhui Medical University. The following data were collected from patients during their hospitalization, including infusion of red blood cells, plasma, and platelets during hospitalization; age, gender, body mass index, combined underlying diseases, cause of injury, time of admission after injury, type of admission, total burn area, full-thickness burn area, combination of inhalation injury, combination of other trauma, and combination of pulmonary edema; the blood lactic acid, serum creatinine, total bilirubin, and albumin values within 24 h of admission; combination of bloodstream, wound, lung, and urinary tract infection, and combination of sepsis; the number of escharectomy or tangential excision and skin grafting surgery (hereinafter referred to as surgery) and total surgical blood loss volume; occurrence of hemoglobin<70 g/L, admission to intensive care unit (ICU), conduction of mechanical ventilation and continuous renal replacement therapy (CRRT), length of hospital stay, and prognosis were recorded. In 602 surgeries of patients within 14 days after injury, data including area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and surgical blood loss volume per surgery, operation site, and use of tourniquet and wound graft were collected. Data were statistically analyzed with Mann-Whitney U test, Kruskal-Wallis H test, and Spearman correlation analysis. Combined with the results of single factor analysis and clinical significance, multiple linear regression analysis was performed to screen the independent influencing factors of red blood cell infusion volume and plasma infusion volume, as well as blood loss volume per surgery. Results:During the whole hospitalization period, 437 (96.0%) patients received blood transfusion therapy, including 435 (95.6%) patients, 410 (90.1%) patients, and 73 (16.0%) patients who received transfusion of plasma, red blood cells, and platelets, respectively. The patients were mainly male, aged 18 to 92 years. There were statistically significant differences in the plasma infusion volume among patients with different combination of underlying disease, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.06, -4.67, -2.11, -6.13, -9.56, -4.93, -8.08, -4.78, -9.12, -6.55, -9.37, -11.46, and -7.17, respectively, P<0.05). The total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, albumin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the plasma infusion volume of patients (with r values of 0.39, 0.51, 0.14, 0.28, -0.13, 0.47, and 0.56, respectively, P<0.05).There were statistically significant differences in the red blood cell infusion volume among patients with different gender, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.00, -4.34, -3.10, -4.22, -8.24, -7.66, -8.62, -4.75, -7.42, -9.36, -6.12, and -8.31, -6.64, respectively, P<0.05). The age, total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, total bilirubin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the red blood cell infusion volume of patients (with r values of 0.12, 0.22, 0.49, 0.09, 0.18, 0.13, -0.15, 0.69, and 0.77, respectively, P<0.05). Combined underlying diseases, full-thickness burn area, combined pulmonary edema, serum creatinine value within 24 h of admission, combined sepsis, conduction of CRRT, number of surgeries, and total surgical blood loss volume were the independent influencing factors for plasma infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.09, 0.16, 0.12, 0.07, 0.11, 0.15, 0.31, and 0.26, respectively, P<0.05). Female, full-thickness burn area, serum creatinine value within 24 h of admission, combined sepsis, occurrence of hemoglobin value <70 g/L, conduction of CRRT, and total surgical blood loss volume were the independent influencing factors for red blood cell infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.10, 0.12, 0.10, 0.11, 0.05, 0.19, and 0.54, respectively, P<0.05). There were statistically significant differences in blood loss volume per surgery of patients with different surgical site and wound graft (with Z values of -2.54 and -2.27, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting and duration of operation were correlated with the blood loss volume per surgery of patients (with r values of 0.40 and 0.21, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts were the independent influencing factors for blood loss volume per surgery of patients with extensive burns (with standardized regression coefficients of 0.41, 0.16, and 0.12, respectively, P<0.05). Conclusions:The major factors influencing blood transfusion status in patients with extensive burns are female, combined underlying diseases, full-thickness burn area, serum creatinine value within 24 h of admission, combined pulmonary edema, occurrence of hemoglobin value <70 g/L, combined sepsis, conduction of CRRT, number of surgery, and total surgical blood loss volume. In addition, the area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts indirectly affect the patient's blood transfusion status by affecting the blood loss volume per surgery.