OBJECTIVE To construct a clinical model of motion sickness(MS),provide a relatively objective diagnostic model for MS research,and provide a basis for further clinical intervention of the disease.METHODS A total of 60 subjects were included and divided into experimental group and control group according to the presence or absence of MS.The MS clinical model was established using SRM-IV rotating chair.Peripheral blood was collected before and after acceleration exposure,and the contents of adrenocorticotropic hormone(ACTH),growth hormone(GH),prolactin(PRL),follicle stimulating hormone(FSH),luteinizing hormone(LH),thyroid stimulating hormone(TRH)and gastrin-17(G-17),acetylcholine(ACH)and 5-hydroxytryptamine(5-HT)were detected,Graybiel scale was used to evaluate the severity of MS.The correlation between MS symptoms and signs and peripheral blood indexes was analyzed by multiple linear regression,and the diagnostic model was established.construct a clinical model of MS and a diagnostic model based on blood parameters,so as to provide a reliable clinical model and an objective diagnostic model for MS research,and to provide a basis for further clinical intervention of the disease.RESULTS After acceleration exposure,the Graybiel scores,ACH,5-HT,ACTH,GH and PRL levels in peripheral blood of the experimental group were higher than those before exposure,and were significantly different from those of the control group(P<0.001).There was no significant difference in FSH,LH,TRH and G-17 between the two groups before and after acceleration exposure(P>0.05).Multi-index combined diagnostic model:Graybiel scores=-9.32+0.131×ACTH+0.055×ACH+0.041×5-HT.CONCLUSION The levels of ACH,5-HT,ACTH,GH and PRL increased during the onset of MS.The multi-index combined diagnosis model can provide a certain basis for the objective diagnosis of MS in clinical practice.

Objective To observe the effect of muscone in regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway on cardiomyocyte apoptosis in rats with diabetic car-diomyopathy(DCM),and explore the mechanism of Chen Shuquan's theory of"warming and clear-ing collaterals"in treating DCM.Methods SD rats were divided into blank group,DCM group,low-dose muscone group(0.68 mg/kg muscone),high-dose muscone group(2.72 mg/kg muscone),met-formin group(140 mg/kg metformin),and high-dose muscone+recombinant human FasL protein(rh-FasL)group(2.72 mg/kg muscone+0.017 mg/kg rh-FasL),with 12 rats in each group.Except for the blank group,rats in all other groups were fed with high-fat feed combined with intraperitoneal injection of streptozotocin to construct a DCM rat model.After successful modeling,the rats were administered once a day for 6 weeks.After the last treatment,the changes in fasting blood glucose,left ventricular ejection fraction(LVEF),and left ventricular short axis shortening rate(LVFS)in rats were detected;Hematoxylin-eosin(HE)staining and Masson staining were applied to detect pathological damage and fibrosis degree of myocardial tissue,respectively.Spectrophotometry was applied to detect the activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)in myocardial tissue;TUNEL staining was applied to observe myocardial cell apoptosis;and Western blot was applied to detect the expression of cleaved aspartate specific cysteine protease-3(cleaved-caspase-3),Bcl-2 associated X protein(Bax),Fas,and FasL proteins in myocardial tis-sue.Results Compared with the blank group,the pathological damage to the myocardial tissue of rats in the DCM group was severe,the fasting blood glucose,MDA content,myocardial collagen ar-ea fraction and apoptosis rate of myocardial cell,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,while the LVEF,LVFS,and activity of SOD decreased(P＜0.05);compared with DCM group,pathological damage of myocardial tissue was reduced in the low-dose muscone group,the high-dose muscone group and the metformin group,and fasting blood glucose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate and cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and the activities of LVEF,LVFS and SOD were increased(P＜0.05).Compared with low-dose muscone group,pathological damage of myocar-dial tissue was relieved in the high-dose muscone group and the metformin group,fasting blood glu-cose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate,cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and LVEF,LVFS and SOD activities were in-creased(P＜0.05).Compared with the high-dose muscone group,the pathological damage to the myocardial tissue of rats in the high-dose muscone+rh-FasL group was intensified,the fasting blood glucose,MDA content,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,the LVEF,LVFS,and activity of SOD decreased(P＜0.05).Conclusion Muscone may inhibit oxidative stress and cardiomyocyte apoptosis in DCM rats by inhibiting the Fas/FasL pathway.

Objective To observe the effect of muscone in regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway on cardiomyocyte apoptosis in rats with diabetic car-diomyopathy(DCM),and explore the mechanism of Chen Shuquan's theory of"warming and clear-ing collaterals"in treating DCM.Methods SD rats were divided into blank group,DCM group,low-dose muscone group(0.68 mg/kg muscone),high-dose muscone group(2.72 mg/kg muscone),met-formin group(140 mg/kg metformin),and high-dose muscone+recombinant human FasL protein(rh-FasL)group(2.72 mg/kg muscone+0.017 mg/kg rh-FasL),with 12 rats in each group.Except for the blank group,rats in all other groups were fed with high-fat feed combined with intraperitoneal injection of streptozotocin to construct a DCM rat model.After successful modeling,the rats were administered once a day for 6 weeks.After the last treatment,the changes in fasting blood glucose,left ventricular ejection fraction(LVEF),and left ventricular short axis shortening rate(LVFS)in rats were detected;Hematoxylin-eosin(HE)staining and Masson staining were applied to detect pathological damage and fibrosis degree of myocardial tissue,respectively.Spectrophotometry was applied to detect the activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)in myocardial tissue;TUNEL staining was applied to observe myocardial cell apoptosis;and Western blot was applied to detect the expression of cleaved aspartate specific cysteine protease-3(cleaved-caspase-3),Bcl-2 associated X protein(Bax),Fas,and FasL proteins in myocardial tis-sue.Results Compared with the blank group,the pathological damage to the myocardial tissue of rats in the DCM group was severe,the fasting blood glucose,MDA content,myocardial collagen ar-ea fraction and apoptosis rate of myocardial cell,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,while the LVEF,LVFS,and activity of SOD decreased(P＜0.05);compared with DCM group,pathological damage of myocardial tissue was reduced in the low-dose muscone group,the high-dose muscone group and the metformin group,and fasting blood glucose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate and cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and the activities of LVEF,LVFS and SOD were increased(P＜0.05).Compared with low-dose muscone group,pathological damage of myocar-dial tissue was relieved in the high-dose muscone group and the metformin group,fasting blood glu-cose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate,cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and LVEF,LVFS and SOD activities were in-creased(P＜0.05).Compared with the high-dose muscone group,the pathological damage to the myocardial tissue of rats in the high-dose muscone+rh-FasL group was intensified,the fasting blood glucose,MDA content,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,the LVEF,LVFS,and activity of SOD decreased(P＜0.05).Conclusion Muscone may inhibit oxidative stress and cardiomyocyte apoptosis in DCM rats by inhibiting the Fas/FasL pathway.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*

Objective To investigate the epidemic characteristics of pulmonary tuberculosis (TB) in Minhang District of Shanghai, and to provide a scientific basis for TB prevention and control. Methods Data from active TB patients registered in Minhang District of Shanghai from 2009 to 2019 was collected and analyzed using descriptive epidemiological method. Results From 2009 to 2019 the registration rates of TB patients in Minhang district of Shanghai showed a downward trend, with an average annual registration rate of 32.35/100 000, including 3 611 (41.08%) patients who were registered permanent residents of Shanghai and 5 179 (58.92%) patients who were non-permanent residents. The ratio of men to women was 2.04:1. Workers accounted for more cases (22.77%) than other occupations among patients without registered permanent residence, while retirees accounted for the majority of cases (38.60%) among patients with registered permanent residence. Among the TB patients without registered residence, the highest proportion (45.86%) was in the 20-29 years old group, while the highest proportion in permanent residents was in the 50-59 years old group (19.47%). The peak incidence occurred in May in patients without registered permanent residence, while the peak incidence was in June in patients with registered permanent residence. Conclusion It is necessary to strengthen the prevention and control of TB in people without registered permanent residence of Shanghai, and at the same time, to strengthen the prevention and control of TB in old people and students with registered permanent residence of Shanghai.

Objective To investigate the etilolgy of failed pyeloplasty in children and to study the feasibility of redo laparoscopic surgery for recurrent nreterupelvic junction obstruction.Methods The clinical data of 39 patients with recurrent ureteropelvic junction obstruction after the primary pyeloplasty underwent redo laparoscopic surgery were analyzed retrospectively between September 2009 and June 2016 in our institution.There were 31 males and 8 females with a mean age of 66 months,ranged from 4 to 204 months.28 patients had left obstructions and 11 had fight obstructions,who were diagnosed by ultrasonography,MRU,and MAG3 renal scan et a1.Under general anesthesia,we identified that two patients (5.1％) had renal calices strictures,four patients (10.3％) had unsolved disease ureter and anastomotic strictures,two patients (5.1％) had adhesion band and anastomotic strictures,one patient had adhesion band,high ureteropelvic anastomosis and ureter torsion,and 30 (76.9％) patients had anastomotic strictures.Thirty-three patients underwent cdismembered pyeloplasty,five patients underwent onlay appendiculoureteroplasty and one patient underwent ureterocalicostomy.Results All surgeries were successfully completed without conversion.No intraoperative complication was encountered.One patient had persistent,frequent and intolerable flank pain with severe hydronephrosis after surgery,he subsequently underwent nephrectomy.One patient had persistent severe hydronephrosis which was repaired with on-lay appendiculoureteroplasty.One patient had anastomotic adhesion and balloon dilatation was performed with no further obstruction in follow up imaging.The rest of the patients got complete clinical or radiologic resolution.The successive rate was 36 of 39 (92.3％) at a mean follow up of 25 months (ranging 3-60 months).Conclusions Unsolved ureteric pathologies,anastomotic stricture,renal calices stricture,adhesion band,torsion of ureter and high ureteropelvic anastomosis all contribute to recurrent obstruction after the primary pyeloplasty.Laparoscopic redo pyeloplasty is safe and feasible for skilled surgeons.

Aim To investigate the inhibitory effect of Bupleurum chinense-Scutellaria baicalensis decoction(CQ)on activation of rat HSC induced by CCl4 and the mechanism.Methods Cells in logarithmic growth phase were cultured in culture medium without FBS for 24 h.After disassociated using 0.25％EDTA-trypsin,the cells were seeded into respective plates at the density of 1.5×109· L-1 and cultured overnight.The cells were divided into the following groups:control group(no treatment),model group(treated with 6 mmol·L-1 CCl4 for 24 h),CQ groups(pretreated with 6 mmol·L-1 CCl4 for 24 h and 400,500,600 mg·L-1 CQ for 24 h).Concentrations of hyaluronidase(HA),laminin(LN),procollagen Ⅲ(PCⅢ),collagen type Ⅳ(Ⅳ-C)were assayed by ELISA kits.Gene expressions of Toll-like receptor 4(TLR4)and NF-κB were examined by RT-PCR analysis.Protein expression of TLR4 and NF-κB was examined by Western blot.Results CQ could significantly inhibit cell proliferation induced by CCl4.Furthermore,CQ at 600 mg·L-1 significantly downregulated gene and protein expressions of TLR4 and NF-κB.And CQ reduced the secretion of HA,LN,PCⅢ,Ⅳ-C.Further studies disclosed that the TLR4 inhibitor TAK-242 and NF-κB inhibitor BAY 11-7082 could significantly inhibit the gene and protein expressions of NF-κB,but could not change gene and protein expression of TLR4,and reduced the secretion of HA,LN,PCⅢ,Ⅳ-C.Conclusion CQ could inhibit inflammatory responses in HSC induced by CCl4 probably by inhibiting the transcription activity and protein expression of TLR4-NF-κB,which indicates its possible therapeutic effect on liver fibrosis.

A sensitive, rapid, simple and economical ultra-performance liquid chromatography–tandem mass spectro-metric method (UPLC–MS/MS) was developed and validated for simultaneous determination of imatinib, dasatinib and nilotinib in human plasma using gliquidone as internal standard (IS). Liquid-liquid extraction method with ethyl acetate was used for sample pre-treatment. The separation was performed on an Xtimate Phenyl column using isocratic mobile phase consisting of A (aqueous phase: 0.15% formic acid and 0.05% ammonium acetate)and B(organic phase:acetonitrile)(A:B=40:60,v/v).The flow rate was 0.25 mL/min and the total run time was 6 min. The multiple reaction monitoring (MRM) transitions, m/z 494.5→394.5 for imatinib, 488.7→401.5 for dasatinib, 530.7→289.5 for nilotinib and 528.5→403.4 for IS, were chosen to achieve high selectivity in the simultaneous analyses. The method exhibited great improvement in sensitivity and good linearity over the concentration range of 2.6–5250.0 ng/mL for imatinib, 2.0–490.0 ng/mL for dasatinib,and 2.4–4700.0 ng/mL for nilotinib.The method showed acceptable results on sensitivity,specificity, recovery, precision, accuracy and stability tests. This UPLC–MS/MS assay was successfully used for human plasma samples analysis and no significant differences were found in imatinib steady-state trough concentra-tions among the SLC22A5?1889T>C or SLCO1B3 699G>A genotypes(P>0.05).This validated method can provide support for clinical therapeutic drug monitoring and pharmacokinetic investigations of these three tyrosine kinase inhibitors(TKIs).

Objective To establish the list of head nurses′ activities in China,in order to provide basis for work environment,propose the knowledge,skill and ability standard in head nurses.Methods A list of total 86 activities in 11 dimensions of head nurses′ was assembled by literature analysis and SMEs′ consultation. Convenient sampling method was used. Through a questionnaire to 395 head nurses,the frequency and importance of the activities were compared in 230 head nurses from level three hospitals,131 head nurses from level two hospitals,and 34 head nurses from special hospitals. Cronbach′s alpha coefficient was also calculated to test the reliability of the survey.Results The Cronbach′s alpha coefficient was beyond 0.9 and the result was reliable. The work in clinical practice involved multiple aspects in 395 head nurses and the top 5 frequencies of work included daily nursing work evaluation (4.60±0.67) score,patients encouragement and reassurance (4.31±0.84),regulations implementation of disinfection and isolation (4.27±0.83),to know patients′ condition (4.20±0.93),and ward environment (4.06±1.04). The top 5 important job for head nurses were regulations implementation of disinfection and isolation,critical patient′s management,medication management,rescue of critical patients,and daily nursing work evaluation.Conclusions Among all dimensions of head nurses′ activities,"nurse care quality and security management" is the most frequent activity of head nurses,which is also the most important activity.

Objective:To detect the change of composition of immune cells in the spleen of miR-126 knockdown(miR-126KD) mice and preliminarily explore its significance .Methods: The expression level of miR-126 in spleens of miR-126KD mice was deter-mined by Realtime PCR.And the total number of splenocytes was calculated.The pathologic morphology change of the spleen was observed by HE staining.And the changes on proportion of DCs ,macrophages cells ,γδ T cells and NK T cells,CD3+T cells and its subgroup ,as well as CD19+B cells in spleens of miR-126KD mice were analyzed by Flow cytometry and calculated respectively.The level of phosphorylated AKt and NF-κB was analyzed by Western blot assay.Results:Compared with those of WT mice ,the expression level of miR-126 decreased obviously ( P<0.05 ) and the total number of cells increased obviously in spleen of miR-126 KD mice ( P<0.05).Moreover,the pathologic morphology of miR-126KD mice was significantly changed.The proportion and number of NK T cells in the inherent cells were significantly increased ( P<0.05 ) , but the proportion of Mφcells were significantly decreased ( P<0.05 ) . Meanwhile,the proportion and number of CD3+T cells and CD4+T cells in the adaptive immune cells were significantly increased (P<0.05),while the total number of CD19+B cells were significantly decreased (P<0.05).Last,the level of phosphorylation Akt and NF-κB increased obviously in spleen of miRNA-126 knockdown mice.Conclusion: Change obviously on the composition of immune cells subsets in the spleen of miRNA-126 knockdown mice ,which it may be related to the altered level of phosphorylated AKt and NF-κB and provides a preliminary experimental basis for the further exploring the roles of miR -126 in immune response.