Autoimmune hepatitis （AIH） is an inflammatory disease caused by immune dysfunction， and its pathogenic mechanism remains unclear. In recent years， a large number of studies have shown that iron homeostasis imbalance and ferroptosis are closely associated with the pathogenesis and progression of AIH. This article reviews the pathological mechanism and impact of iron overload and ferroptosis in AIH， in order to provide new insights and theoretical bases for research on the mechanism and clinical treatment of AIH.

Objective:To understand the real experience and needs of early exercise rehabilitation in elderly patients with total hip arthroplasty (THA), so as to provide a preliminary basis for intervention research to meet the needs of patients.Methods:Using the purposive sampling method, a total of 12 elderly patients with THA from the First Affiliated Hospital of Naval Medical University from June to September 2021 were selected as the research objects for semi-structured in-depth interviews. Colaizzi 7-step method was used to analyze, summarize and extract the data.Results:The early exercise rehabilitation experience and needs of elderly THA patients could be summarized into four themes such as postoperative exercise being a difficult journey, the need for professional support, the need for external support and internally driven needs and 14 sub themes.Conclusions:There are various problems and needs for early exercise rehabilitation in elderly patients undergoing THA. It is necessary to strengthen communication among doctors, nurses and patients, understand their true feelings and provide personalized care and rehabilitation guidance to improve their treatment experience and enhance their satisfaction.

Objective To observe the value of Zero-Shot Noise2Noise(ZS-N2N)based on Z-axis correlation for reducing noise of low dose CT(LDCT)images.Methods CT data of the cancer imaging archive were enrolled,including normal dose CT(NDCT)images and LDCT images,with 3 sets of chest and 3 sets of abdominal images.Noise on LDCT images were reduced with ZS-N2N method based on Z-axis correlation,and the peak signal-to-noise ratio(PSNR),structural similarity(SSIM)and time-consuming of reducing noise were compared with those of Self2Self,simple ZS-N2N and traditional Block-matching and 3D filtering(BM3D).Results After reducing noise,noise on Self2Self denoised images remained significant,the structure edges on BM3D denoised images were blurry with some details lost,while simple ZS-N2N and ZS-N2N based on Z-axis correlation denoised images preserved more details and had better quality.PSNR and SSIM of Self2Self denoised images were poor and the time-consuming were longer.PSNR,SSIM and time-consuming of the other 3 methods were similar,among which PSNR of ZS-N2N based on Z-axis correlation were slightly higher than BM3D and simple ZS-N2N,but the time-consuming were also slightly longer.Conclusion ZS-N2N based on Z-axis correlation had high value for reducing noise of LDCT images.

Acetaminophen (APAP) overdose is a major cause of liver injury. Neural precursor cell expressed developmentally downregulated 4-1 (NEDD4-1) is an E3 ubiquitin ligase that has been implicated in the pathogenesis of numerous liver diseases; however, its role in APAP-induced liver injury (AILI) is unclear. Thus, this study aimed to investigate the role of NEDD4-1 in the pathogenesis of AILI. We found that NEDD4-1 was dramatically downregulated in response to APAP treatment in mouse livers and isolated mouse hepatocytes. Hepatocyte-specific NEDD4-1 knockout exacerbated APAP-induced mitochondrial damage and the resultant hepatocyte necrosis and liver injury, while hepatocyte-specific NEDD4-1 overexpression mitigated these pathological events both in vivo and in vitro. Additionally, hepatocyte NEDD4-1 deficiency led to marked accumulation of voltage-dependent anion channel 1 (VDAC1) and increased VDAC1 oligomerization. Furthermore, VDAC1 knockdown alleviated AILI and weakened the exacerbation of AILI caused by hepatocyte NEDD4-1 deficiency. Mechanistically, NEDD4-1 was found to interact with the PPTY motif of VDAC1 through its WW domain and regulate K48-linked ubiquitination and degradation of VDAC1. Our present study indicates that NEDD4-1 is a suppressor of AILI and functions by regulating the degradation of VDAC1.

Objective: To observe the effects of tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder on pain and shoulder joint function in subacromial impingement syndrome (SIS). Methods: Eighty patients with SIS were recruited and divided into a control group and a treatment group by the random number table method, with 40 cases in each group. The control group was given JIN's three-needle therapy for the shoulder, and the treatment group received additional tendon-regulating and stretching manipulation. The visual analog scale (VAS) score and constant-Murley score (CMS) were observed before and after the intervention, and the total effective rate was also observed. Results: The total effective rate was 92.5％ in the treatment group versus 70.0％ in the control group, and the difference was statistically significant (P<0.05). The VAS score and CMS changed notably after treatment in both groups (P<0.05), and the improvements were markedly greater in the treatment group than in the control group (P<0.05). Conclusion: Tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder can facilitate the relief of pain and the improvement of shoulder joint function in SIS patients.

Objective:To investigate the effect of Asarinin on the survival time of transplanted heart after allogeneic heterotopic heart transplantation and to further verify the anti-immune rejection effect of Asarinin in spleen and peripheral blood.Methods:Using 64 Wistar rats as donors, 64 SD rats as recipients to establish the allogeneic heterotopic heart transplantation model in rats.After successful transplantation, 64 rats were use simple randomization divided into control group, cyclosporine A(CsA) group, Asarinin group and half CsA + half Asarinin group with 16 rats in each group.CsA group was given 5 mg/kg by gavage; Asarinin group was given 25 mg/kg; half dose group was given CsA 2.5 mg/kg+ Asarinin 12.5 mg/kg and the control group was given the same volume of normal saline by gavage.After administration for 1 week, half of them were used to observe the survival time.The other half of the rats were fully anesthetized with chloral hydrate, spleen and peripheral blood were taken.Half of the spleen was taken to observe the slices under the microscope.The other half of spleen was used RT-PCR to detect the relative expression of IFN-γ and IL-4.The expression of co-stimulatory molecules CD80, CD86 and CD40 in peripheral blood were detected by flow cytometry.Results:Survival time of transplanted heart was control group (8.4±0.9), CsA group (30.5±8.3), Asarinin group (16.5±4.3) and half-dose group (26.1±5.2) days.Compared with control group, survival time of heart transplantation became prolonged in all groups and the difference was statistically significant ( P<0.05). HE staining of splenic tissue showed that, as compared with control group, the injury of each group was alleviated.The relative expression of IFN-γ in spleen was control group (1.055±0.083), CsA group (0.396±0.038), Asarinin group (0.833±0.094) and half-dose group (0.862±0.104). The last three groups were lower than control group and the difference was statistically significant ( P<0.05). The relative expression of IL-4 in spleen was control group (1.429±0.234), CsA group (3.808±0.729), Asarinin group (2.209±0.306) and half-dose group (2.323±0.321). The last three groups all spiked as compared with control group and the difference was statistically significant ( P<0.05). The expressions of CD80, CD86 and CD40 in peripheral blood were control group (98.21±0.54), (85.78±0.89) and (96.36±0.66), CsA group (89.26±0.36), (56.86±2.32) and (88.11±1.61), Asarinin group (94.19±0.47), (79.01±1.12) and (87.86±1.67) and half-dose group (94.87±0.74), (80.81±0.98) and (89.71±0.97) respectively.The last three groups were lower than control group and the difference was statistically significant ( P<0.05). Conclusions:Asarinin can prolong the survival time of transplanted heart after allogeneic heterotopic heart transplantation in rats, inhibit the immune injury of spleen after allogeneic heterotopic heart transplantation in rats, decrease IFN-γ in spleen, increase IL-4 in spleen and inhibit the expression of peripheral blood costimulatory molecules CD80, CD86 and CD40.

Objective:To retrieve the qualitative research on real experience of multidisciplinary medical and nursing staff on early mobilization of Intensive Care Unit (ICU) patients, and conduct a Meta-synthesis.Methods:The qualitative research on the cognition and experience of multidisciplinary medical and nursing staff on the early mobilization of ICU patients was searched by computer in Web of Science, PubMed, CINAHL, Embase, the Cochrane Library, PsycINFO, Ovid, Medline, China National Knowledge Infrastructure (CNKI) , WanFang Data, VIP and China Biology Medicine disc. The search time limit was from the establishment of the database to April 2021. After evaluating the quality of the studies, the results were integrated using the collective synthesis method in the Meta-synthesis of the Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia.Results:A total of 14 studies were included, and54 main results, 13 new categories, and 3 synthesis results were extracted. The results of the synthesis were the perception of the importance of early mobilization, the obstacles to the implementation of early mobilization, and the facilitating factors for the implementation of early mobilization.Conclusions:Multidisciplinary medical and nursing staff collaboration plays an important role in the implementation of early mobilization for ICU patients, but it is currently facing many obstacles in clinical practice. In the future, multidisciplinary collaboration strategies should be explored based on the actual situation and characteristics of domestic ICU, and the clinical development and continuous implementation of early mobilization should be actively promoted to effectively improve the prognosis of patients.

Total hip arthroplasty (THA) is the first choice for the treatment of end-stage hip diseases in elderly patients. Exercise therapy, as an effective intervention for the rehabilitation of elderly patients after THA, can optimize the physical conditions patients. However, there are no guidelines for exercise rehabilitation treatment in elderly adults with THA. This article reviews the concept, necessity, risk assessment, exercise plan and strategies to improve the effect of exercise therapy in elderly patients with THA after surgery and makes a prospect for the shortcomings, aiming to provide a reference for clinical nurses to choose safe and effective sports rehabilitation methods for elderly THA patients.

Objective:To explore the nursing effect of health education guided by trans-theoretical model combined with therapeutic communication in patients with vitiligo.Methods:A total of 120 patients with vitiligo who were admitted to Department of Dermatology in the First Affiliated Hospital of Zhengzhou University from February 2017 to June 2020 were selected and they were divided into the study group and the control group according to simple random number table method, with 60 cases in each group. Patients in both groups received conventional treatment. The control group was given therapeutic communication, while the study group was given trans-theoretical model-guided health education combined with therapeutic communication. Symptom Check List-90 (SCL-90) , Herth Hope Index (HHI) and The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were used to investigate patients of the two groups before and after the intervention.Results:After intervention, the depression factors and anxiety factors of the SCL-90 scale in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the total score of the HHI scale and the score of each dimension of SF-36 scale of the study group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education guided by trans-theoretical model combined with therapeutic communication can effectively improve the mental state of patients with vitiligo and improve their treatment compliance, hope level and quality of life.

The influence of circadian rhythm disorder on nonalcoholic fatty liver disease (NAFLD) has attracted more and more attention in recent years, and studies in China and globally have shown that individuals who work in shifts at night or often stay up late have a higher incidence rate of NAFLD-related hepatocellular carcinoma (NAFLD-HCC) than those with regular work and rest. This article summarizes the research advances in the effect of circadian rhythm system on the pathogenesis of NAFLD-HCC by regulating lipid metabolism, glucose metabolism, and intestinal flora, and it is pointed out that restoration of normal circadian rhythm has potential clinical significance in delaying the development and progression of disease.