Objective To investigate the clinical predictive value of rheumatoid factor (RF), anti-keratin antibodies (AKA), anti-cyclic citrullinated peptide (anti-CCP) antibody and anti-perinuclear factor (APF) in the transition from undifferentiated arthritis (UA) to rheumatoid arthritis (RA), and to analyze the clinical relevant factors. Methods 271 patients with UA who were followed up for a year were enrolled into the investigation. RF was measured by the rate scatting immunity method. APF and AKA were detected by immuniofluorescence method(IFA). Anti-CCP was measured by ELISA. Erythrocyte sedimentation rate (ESR) was analyzed by Wilcoxon method. The duration of morning stiffness, the numbers of swelling and tender joints, tender joints involved and DAS28 score were recorded and analyzed. Results 99% patients who had four-antibody-positive finally convetted from UA to RA. The conversation rate for those who had two or more than two antibody-positive was 83.0% and 65.9% respectively. The sensitivity and specificity of RF and anti-CCP antibody-positive in those who converted from UA to RA was 77.8% and 80.5% respectively. The percentage of polyarticular swelling in antibody-negative, one-antibody-positive, two-antibody-positive, three-antibody- positive and four-antibody-positive was 48%, 57%, 59%, 70% and 70% respectively. Meanwhile, the percentage of multi-small-joint involvement was 71%, 71%, 72%, 76% and 83% respectively. The proportion of elbow involvement in antibody-negative patients was 72%, which was the highest among all joint area involvement. The conversion differences of the group with more than 3 swelling joints or more than 3 small joints involvement ranked the first and second in frequency. Conclusion The combined detection of these autoantibodies could increase the specificity of early diagnosis of RA. The more positive antibodies present, the more likely the concersion form UA to RA. The sensitivity and specificity of RF and anti-CCP-positive is high, so the latter is expected to become one of the diagnostic criteria. The polyarticular swelling and multi-small-joint involvement are valuable in predicting the transformation from UA to RA.

Objective To explore the reaction pattern rules of mouse retinal ganglion cells potential under different wavelengths of light stimulation. Methods Thirty SPF grade 3.week.old C57BL/6 mice were used for ex vivo whole mount retina preparation. The cells firing activities were recorded on patch clamp system with on cell touch mode under stimulation of 400 nm,580 nm and white light,respectively. According to different reactions to different light stimulation, the cells were classified into 400 nm sensitive RGC, 580 nm sensitive RGC and color vision insensitive RGC. Then the cells were further classified according to light ON type,light ON/OFF type or light OFF type. The RGC's baseline firing pattern ( baseline firing frequency,burst firing frequency) and light activation firing pattern (response pattern,light response firing frequency,light response firing amplification) were compared among different RGC classifications. Results Eighty.two RGCs were recorded in total. The frequency of spontaneous firing activity ranged from 0. 00 Hz to 32. 33 Hz among different RGCs. 400 nm sensitive RGCs were 52(63. 41％),580 nm sensitive RGCs were 29(35. 37％) and color vision insensitive RGC was 1(1. 22％). OFF type RGC was the main cell type in 400 nm sensitive group (36. 29％),and ON/OFF type RGC was the main cell type in 580 nm sensitive group (34. 48％). The firing amplification in 580 nm sensitive RGC was (22. 93±10. 23)Hz,which was significantly higher than (14. 44±10. 11)Hz in 400 nm sensitive RGC (t=4. 060,P=0. 044). The firing amplification in 580 nm sensitive ON type RGC was (24. 17±8. 98)Hz,which was significantly higher than (11. 12±10. 35)Hz in 400 nm sensitive ON type RGC (t=5. 373,P=0. 021). Conclusions There is no specific firing pattern rules among different light sensitive RGCs. In the future, artificial color vision may be achieved through personalized electric stimulation and learning feedback strategy.

Objective To explore the reaction pattern rules of mouse retinal ganglion cells potential under different wavelengths of light stimulation.Methods Thirty SPF grade 3-week-old C57BL/6 mice were used for ex vivo whole mount retina preparation.The cells firing activities were recorded on patch clamp system with on cell touch mode under stimulation of 400 nm,580 nm and white light,respectively.According to different reactions to different light stimulation,the cells were classified into 400 nm sensitive RGC,580 nm sensitive RGC and color vision insensitive RGC.Then the cells were further classified according to light ON type,light ON/OFF type or light OFF type.The RGC's baseline firing pattern (baseline firing frequency,burst firing frequency) and light activation firing pattern (response pattern,light response firing frequency,light response firing amplification) were compared among different RGC classifications.Results Eighty-two RGCs were recorded in total.The frequency of spontaneous firing activity ranged from 0.00 Hz to 32.33 Hz among different RGCs.400 nm sensitive RGCs were 52 (63.41％),580 nm sensitive RGCs were 29(35.37％) and color vision insensitive RGC was 1 (1.22％).OFF type RGC was the main cell type in 400 nm sensitive group (36.29％),and ON/OFF type RGC was the main cell type in 580 nm sensitive group (34.48％).The firing amplification in 580 nm sensitive RGC was (22.93±10.23) Hz,which was significantly higher than (14.44± 10.11) Hz in 400 nm sensitive RGC (t =4.060,P =0.044).The firing amplification in 580 nm sensitive ON type RGC was (24.17±8.98)Hz,which was significantly higher than (11.12±10.35)Hz in 400 nm sensitive ON type RGC (t =5.373,P =0.021).Conclusions There is no specific firing pattern rules among different light sensitive RGCs.In the future,artificial color vision may be achieved through personalized electric stimulation and learning feedback strategy.

Objective:To construct a scientific and practical ovarian tumor nursing quality sensitive indicator system so as to provide a reference for evaluating the quality of nursing care for patients with ovarian tumors.Methods:Based on Donabedian's three-dimensional theoretical model of structure-process-outcome quality management, we used literature review and Delphi expert correspondence consultation to construct a nursing quality sensitive indicator system for ovarian tumor patients. From February to April 2019, we selected 20 experts from 16 ClassⅢ Grade A general hospitals and 2 higher nursing institutions from 7 provinces/municipalities in Shandong Province, Jiangsu Province, Beijing, Jilin Province, Shanghai, Guangdong Province and Sichuan Province for consultation.Results:Among two rounds of consultation, valid recovery rates were 90.00% and 94.44% respectively; authority coefficients were all 0.92; familiarity coefficients were 0.89 and 0.91 respectively; judgment coefficients were 0.94 and 0.92 respectively; Kendall harmony coefficients were 0.204 and 0.426 respectively; the differences were all statistically significant ( P<0.05) . The final nursing quality sensitive indicator system for ovarian tumor patients included 3 first-level indicators, 12 second-level indicators and 23 third-level indicators. Conclusions:The nursing quality sensitive indicator system for ovarian tumor patients is highly scientific and practical which can be used to standardize clinical nursing care for patients with ovarian tumors by gynecological nurses and improve the nursing quality.

Objective To analyze the current status and quality of existing obstetrics and gynecology enhanced recovery after surgery(ERAS)guidelines/consensus,understand the evidence-based practices in this field,and provide a basis for clinical decision-making.Methods A systematic search of PubMed,CNKI,and other databases,as well as NGC,SIGN,and websites of anesthesia societies domestically and internationally was conducted to obtain relevant guidelines and consensus on ERAS for gynecological surgery.The search was conducted from inception to July 1,2023,and the AGREE Ⅱ and RIGHT tools were used to analyze the current status and quality of the included guidelines/consensus,as well as to conduct a summary of the recommendations.Results A total of 5 guidelines and 10 consensus statements were included.The publication years were from 2018 to 2023,originating from the United States,China,Canada,and the United Kingdom.In the 6 areas evaluated using AGREEⅡ,clarity(66.06％)scored highest,followed by scope and purpose(56.67％),involvement of stakeholders(42.02％),and editorial independence(37.64％)with scores above 30％.The scores for rigor of development(26.88％)and applicability(4.17％)were relatively low.The same items among different evaluators indicated good consistency.The results of the scores in each area were as follows:A-level 2,B-level 13,and no C-level.Two high-quality guidelines were selected.The average RIGHT reporting rate was 44.38％.Subgroup analysis showed that guidelines were higher than consensus statements in the areas of rigor of development and applicability(P＜0.05),and that using GRADE was higher than not using(P＜0.05).The areas of rigor of development and clarity were higher in foreign guidelines than domestic guidelines(P＜0.05),and using evidence grading tools was higher than not using(P＜0.05).The summary of the recommendations showed that the quality of the evidence supporting the recommendations was uneven,and some recommendations were not specific enough.Conclusion The quality of the 15 included ERAS guidelines/consensus in obstetrics and gynecology is uneven,and 2 of them can be used as high-quality guidelines for clinical reference.The quality of evidence-based guidelines in foreign countries is higher,and the use rate of GRADE in foreign guidelines is high,most of which can provide clear recommendation strength and evidence level.Chinese guidelines/consensus are of lower quality compared to overseas,and methodology and report quality need further improvement.Overall,it is still necessary to strengthen the formulation of methods and reporting standards,improve the quality of evidence,and refine specific recommendations.

Objective To explore the regional differences in nursing human resource allocation and the dynamic evolution in the western region,in order to provide a scientific and effective basis for the balanced allocation of nursing human resources.Methods Dagum's Gini coefficient,kernel density estimation method and Markov chain were employed to analyze the regional differences,dynamic evolution and trend prediction of nursing human resource allocation in 12 provinces(autonomous regions and municipalities)in western China from 2011 to 2020.Results From the point of view of regional differences,the overall regional differences in the allocation of nursing human resources are on a downward trend and stem mainly from intra-regional differences;the overall regional differences between urban and rural areas stem mainly from inter-regional differences.From the perspective of dynamic evolution,nursing human resources have been continuously upgraded and the absolute difference in the allocation level has gradually increased.From the perspective of trend prediction,the transferring probability between different types of nursing human resource allocation in the west is low,and spatial factors have a polarizing effect on it.Conclusion The level of nursing human resources allocation in the western region has gradually increased,and the overall development goes towards the level of equalization,and the level of nursing human resources allocation in each type is stable and significantly affected by spatial factors.The government should establish regional,urban,and county nursing specialty alliances as well as innovative information-based nursing service models,and implement nursing talent training mechanisms to improve the balanced allocation of nursing human resources in the western region.

Pyroptosis is a newly discovered programmed cell death that can lead to inflammatory response, its occurrence depends on the sequential activation of inflammatory bodies and caspase, and then the pore-forming generated by the fragmentation of gasdermin D and its cell membrane polymerization. Pyroptosis is mainly comprised of the pathway that depends on caspase-1 activated by flammasomes and the non-classical pathway that depends on caspase-4/5/11 activated by cytoplasmic lipopolysaccharide. As an important mechanism mediating the inflammatory response of the body, pyroptosis plays an irreplaceable role in the body's response to noxious stimuli, which is closely related to many diseases such as nervous system diseases, cardiovascular system diseases and tumors. Recent studies have found that pyroptosis also plays a key role in the occurrence of intestinal ischemia-reperfusion (II/RI). This paper reviews the molecular characteristics, mechanism of pyroptosis and its relationship with II/RI in recent years, in order to provide theoretical basis for the prevention and treatment of II/RI.

With the increasingly wide application of herbal medicines and dietary supplements worldwide,herb-induced liver injury(HILI)has become an important etiology of drug-induced liver injury.Due to the diverse manifestations of HILI,the difficulty in medical history collection,and the lack of specific biomarkers,how to identify suspected patients and make a correct diagnosis has become a major challenge in practice.Causality assessment is commonly used in the diagnosis of HILI,but there is still a lack of prospective cohort studies with a large sample size.In addition,further studies are needed to search for the specific biomarkers for the diagnosis of HILI.The diagnosis and differential diagnosis of HILI are challenging,and currently there is still no universally accepted uniform and standard method for the diagnosis of all-cause HILI.

【Objective】 To detect the anti-SARS-CoV-2 antibody levels in blood donors in Guangzhou, so as to provide laboratory data support for the collection and clinical use of convalescent plasma. 【Methods】 Anti-SARS-CoV-2 antibodies were measured by ELISA in qualified donors. Among them, 326 donors who gave blood in February 2023 were tested for IgG antibodies, 444 donors were tested for neutralizing antibodies. In July 2023, 398 donors were tested for IgG and IgM. 【Results】 399 of 724 blood samples diluted with normal saline (1∶160) were IgG reactive, with a reactive rate of 55.11%. Chi-square test showed that there was a significant difference in the reactive rate of IgG among samples collected at different times (25.46% in February vs 79.40% in July, χ²=210.74, P<0.01, 95%CI: 7.97, 15.98), but there was no significant difference in the reactive rate between different genders and different age groups. IgM was detected in 5 of 398 blood samples, with a reactive rate of 1.26%. The IgG test results of these five blood donors were all reactive, whereas the nucleic acid test results were negative. Neutralizing antibody was detected in 440 of 444 blood samples, with a reactive rate of 99.10%, and 71.59% of the reactive donors had a neutralizing antibody level of 10 μg/mL or more. 【Conclusion】 Blood donors in Guangzhou have a high level of SARS-CoV-2 antibody, which is sufficient to provide convalescent plasma for clinical treatment.

Guided bone regeneration technology applied in alveolar bone defect regeneration is based on the barrier function and space maintenance of the barrier membrane. Therefore, traditional development strategies for barrier membranes focus on their physical barrier function, degradation characteristics and biocompatibility to avoid immunogenicity. However, not only does the barrier membrane passively block connective tissue, it is recognized as a “foreign body”that triggers a persistent host immune response, known as a foreign body reaction. The theories of osteoimmunology reveal a close relationship between the immune system and bone system and emphasize the role of immune cells in bone tissue-related pathophysiological processes. Based on these findings, we propose a novel development strategy for barrier membranes based on immune microenvironment regulation: by manipulating mechanical properties, surface properties and physiochemical properties, barrier membranes are endowed with an improved immunomodulation ability, which helps to regulate immune cell reactions to induce a favorable local immune microenvironment, thus coordinating osteogenesis and osteoclastogenesis as well as barrier membrane degradation to increase the efficiency of barrier membranes in GBR applications. In this paper, we review the development of barrier membranes and their close relationship to the immune microenvironment concerning bone regeneration and membrane degradation. Additionally, the outcomes of research on barrier membranes based on the regulation of the immune microenvironment have been summarized to improve the osteogenesis efficiency of barrier membranes and solve the problem of the regeneration and repair of bone defects, especially alveolar bone defects.