Objective The pathogenesis of intractable epilepsy was explored by examining the expression of the P-gp , GST-Pi as well as MDR1 in peripheral blood of the patients with intractable epilepsy. The potential of the above mentioned three genes as the biomarkers for treatment of intractable epilepsy was investigated. Methods Thirty-one sub?jects with refractory epilepsy, 33 subjects under good circumstances by antiepileptic drugs, and 37 healthy subjects were included in the present study. fluorescence quantitative polymerase chain reaction and flow cytometry were used to detect mRNA levels of MDR1 and GST-Pi and P-gp of MDR1 in the peripheral blood of the patients, respectively. Results The expression levels of MDR1 and GST-Pi were significantly higher in the AEDs intractable group(1.36±0.14,0.585±0.257) than in the treatment group(0.82±0.15,0.309±0.217, P<0.05)The expression levels of MDR1 and GST-Pi were signifi?cantly higher in the AEDs treatment group than in the normal group(0.27±0.07,0.134±0.223,P<0.05). The expression levels of P-gp were significantly higher in the AEDs of the intractable group(0.104±0.084)than in the treatment group (0.063 ± 0.030, P<0.05). The GST-Pi gene expression levels were significantly higher in three(0.535 ± 0.256)or two (0.425±0.254)kinds of antiepileptic drugs combination therapy than in single drug treatment(0.267±0.265, P<0.05). Leucocyte P-gp levels were significantly higher in combination therapy of three kinds of antiepileptic drugs(0.141 ± 0.096)than in combination therapy of two kinds of antiepileptic drugs(0.071±0.020)or in monotherapy(0.050±0.020, P<0.05). Conclusion MDR1 and GST-Pi gene expression levels of peripheral blood can be used as the reference in?dex for treatment of intractable epilepsy and the resistant index of combination treatment for intractable epilepsy.

Objective:To assess the preventive and therapeutic effects and primary mechanisms of Danshen injections in the treat-ment of hepatic encephalopathy ( HE) . Methods:The acute ammonia poisoning model induced by ammonium chloride was established in mice, and HE model with liver injury induced by carbon tetrachlorie and high blood ammonia induced by thioacetamide was made in rats. The time of death was detected in the first model, and the histamine levels in blood and brain, liver function and liver pathologi-cal histology changes were detected respectively in the other model. Results:In the acute ammonia poisoning experiment, the time of death in Danshen injections group was longer than that in the control group. Furthermore, Danshen injections could notably decrease the histamine levels in blood and brain, reduce the levels of ALT, AST, ALP and Tbil in serum and improve the function of liver to show the preventive and therapeutic effects on HE. Conclusion:Danshen injections exhibit promising preventive and therapeutic effects on HE, which may be related to decreasing histamine levels in blood and brain.

Objective:To explore the expression of type 2 complement receptor (CR2) in mesangial cells of the renal tissue in IgA nephropathy (IgAN) and its possible mechanism involved in complement C3 deposition.Methods:The demographic data, samples of plasma and renal tissues of primary IgAN patients diagnosed by renal biopsy in the Guangdong Provincial People's Hospital from August 2021 to May 2022 were collected. According to the fluorescent intensity of mesangial complement C3 deposition, the patients were divided into complement C3 deposition ≥2+ group and complement C3 deposition <2+ group. The circulating IgA and complement C3 levels were detected by enzyme linked immunosorbent assay (ELISA). The influencing factors of kidney prognosis, plasma IgA and complement C3 levels were compared between the two groups. Immunofluorescence was used to detect the expression of IgA, complement C3 and CR2 in the renal mesangial cells of IgAN patients and normal renal tissues around renal carcinoma. Human mesangial cells were cultured in vitro and randomly divided into control group and experimental group. The experimental group was incubated with IgA protein (2 g/L) for 8 hours. The expressions of CR2 protein and mRNA were measured by Western blotting and real-time fluorescence quantitative PCR. The biological function of differential genes was analyzed by gene ontology (GO) and Kyto encyclopedia of genes and genomes (KEGG) enrichment analysis. Results:A total of 75 patients with IgAN were included in this study, including 50 patients in the complement C3 deposition ≥2+ group and 25 patients in the complement C3 deposition <2+ group. The proportions of patients with urine red blood cell count negative, 1+, 2+ and 3+-4+ in the complement C3 deposition ≥2+ group were 2.0%, 8.0%, 18.0% 72.0%, respectively, which were more serious than those in the complement C3 deposition <2+ group (4.0%, 4.0%, 52.0%, 40.0%) ( Z=-2.320, P=0.020). Meanwhile, the proportion of S1 in Oxford pathological classification in the complement C3 deposition ≥2+ group was higher than that in the complement C3 deposition <2+ group (68.0% vs. 40.0%, χ2=5.389, P=0.020), and there were no statistically significant differences in gender, age, 24-hour urinary protein, serum creatinine, other indicators of Oxford pathological classification between the two groups. ELISA results showed that plasma IgA concentration in the complement C3 deposition ≥2+ group was higher than that in the complement C3 deposition <2+ group [3.62 (2.95, 5.53) g/L vs. 2.72 (2.15, 4.24) g/L, Z=2.405, P=0.016], and the plasma complement C3 concentration was lower than that in the complement C3 deposition <2+ group [199.6 (116.0, 328.0) mg/L vs. 319.2 (158.3, 454.5) mg/L, Z=-2.383, P=0.017]. Spearman correlation analysis showed that the complement C3 deposition intensity was positively correlated with IgA deposition intensity in mesangial area ( rs=0.441, P<0.001). Immunofluorescence results showed that there was colocalization of IgA and complement C3 in the glomeruli of IgAN patients. The expression of CR2 in the kidney was consistent with complement C3 deposition, and CR2 was colocalization with complement C3. In vitro experiments, the expression of CR2 in IgA protein group was higher than that in the control group ( P<0.05). GO and KEGG enrichment analysis found that IgA protein induced active changes in various pathways of mesangial cells. Conclusion:IgA protein induces mesangial cells to express CR2 and participates in complement C3 deposition, which may be an important mechanism of complement C3 activation in IgAN.

Physical pain is a common uncomfortable symptom for pregnant women , and doing exercise for improving pain experience during pregnancy has been approved by national and international people .Exercise during pregnancy has various forms , and the exercise interventions of pain to different parts of the body have been carried out at domestic and abroad with favorable effect .Affected by the Chinese traditional recognition , the Chinese women′s acceptance of the exercise during pregnancy is low .This paper will summarize the exercise development during pregnancy of domestic and international , types of exercise for cutting pain , efficacy and safety of safeguard measures , and advocate nursing staff to carry out multi-specialty cooperation for investigation , promote the implementation and promotion of exercise during pregnancy so as to improve the service quality of pregnancy and delivery .

Objective To analyze the research hotspots and trends of early mobilization in ICU patients with mechanical ventilation.Methods The literature on early mobilization of ICU patients with mechanical ventilation included in the China National Knowledge Infrastructure(CNKI)and Web of Science databases from 2000 to 2023 was searched.CiteSpace visualization software was used for literature analysis,and the publication volume and keywords of the literature were displayed in the form of maps.The research hotspots and problems in this field were analyzed.Results A total of 116 Chinese articles and 145 English articles related to early mobilization in ICU patients with me-chanical ventilation were retrieved.The number of English articles increased with fluctuations,while the number of Chinese articles showed a steady growth trend overall,both of which fell slightly in 2020.The research focused on early mobilization,mechanical ventilation,ICU-acquired weakness and delirium.Chinese articles formed 11 clusters such as early mobilization,mechanical ventilation,nursing,review and muscle strength;English articles formed 10 clusters such as critical care,deliri-um and pilot study.The high-frequency keyword in 2023 was goal-directed.Conclusion Domestic and foreign scholars pay high attention to the early mobilization of ICU patients with mechanical venti-lation,focusing on the impact of early mobilization on diseases and the evaluation of its effects.The research content in this field is rich,but there are few evidence-based practical studies.

Objective To analyze the research hotspots and trends of early mobilization in ICU patients with mechanical ventilation.Methods The literature on early mobilization of ICU patients with mechanical ventilation included in the China National Knowledge Infrastructure(CNKI)and Web of Science databases from 2000 to 2023 was searched.CiteSpace visualization software was used for literature analysis,and the publication volume and keywords of the literature were displayed in the form of maps.The research hotspots and problems in this field were analyzed.Results A total of 116 Chinese articles and 145 English articles related to early mobilization in ICU patients with me-chanical ventilation were retrieved.The number of English articles increased with fluctuations,while the number of Chinese articles showed a steady growth trend overall,both of which fell slightly in 2020.The research focused on early mobilization,mechanical ventilation,ICU-acquired weakness and delirium.Chinese articles formed 11 clusters such as early mobilization,mechanical ventilation,nursing,review and muscle strength;English articles formed 10 clusters such as critical care,deliri-um and pilot study.The high-frequency keyword in 2023 was goal-directed.Conclusion Domestic and foreign scholars pay high attention to the early mobilization of ICU patients with mechanical venti-lation,focusing on the impact of early mobilization on diseases and the evaluation of its effects.The research content in this field is rich,but there are few evidence-based practical studies.

Objective:To investigate the effects and mechanism of gut metabolite sodium butyrate on the proliferation and apoptosis of steatosis HepG2 cells in vitro. Methods:The in vitro steatosis hepatocyte model was established with human liver cell line HepG2 and free fatty acid (FFA; the concentration ratio of oleic acid to palmitic acid was 2∶1). Normal control group, model group and intervention groups with different concentration (1, 2, 5, 10, 20 and 50 mmol/L) of sodium butyrate were set up. The inhibition of sodium butyrate on the proliferation of steatosis HepG2 cells was detected by cell counting kit (CCK-8). The proportion of apoptotic cells of normal control group, model group and sodium butyrate 5 mmol/L (sodium butyrate intervention) group was detected by flow cytometry. Normal control group, model group, intervention group with different concentration (1, 2, 5 and 10 mmol/L) of sodium butyrate, negative small interfering RNA (siRNA) control group, G protein-coupled receptor (GPR) 43-siRNA group, GPR109a-siRNA group, GPR43+ GPR109 a double knockout group were set up. The change of the levels of phosphorylated protein kinase B (p-AKT) and phosphorylated mammalian target of rapamycin (p-mTOR) before and after transfection were detected by Western blotting. One-way analysis of varivance, SNK- q test and logistic regression analysis were used for statistical analysis. Results:The results of CCK-8 test indicated that sodium butyrate inhibited the proliferation of steatosis HepG2 cells in a dose-dependent and time-dependent manner. The results of flow cytometry showed that the proportion of apoptotic cells of the sodium butyrate intervention group was higher than that of the model group and normal control group ((3.400±0.100)% vs. (1.800±0.400)% and(1.067±0.451)%), and the differences were statistically significant ( t=6.721 and 8.705, both P<0.01). There was no significant difference in the proportion of apoptotic cells between the model group and the normal control group ( P>0.05). Before transfection, the expressions of p-AKT and p-mTOR at protein level of the model group were both higher than those of the normal control group (2.300±0.058 vs. 1.000±0.012, 2.160±0.125 vs. 1.000±0.052), and the differences were statistically significant ( t=22.080 and 8.575, both P<0.05). The expressions of p-AKT and p-mTOR at protein level of sodium butyrate intervention groups at 1, 2, 5 and 10 mmol/L were all lower than those of the model group (1.530±0.085, 1.407±0.096, 1.032±0.035 and 1.036±0.099 vs. 2.300±0.058; 1.483±0.073, 1.297±0.048, 1.067±0.035 and 0.970±0.072 vs. 2.160±0.125), and the differences were statistically significant ( t=7.491, 7.997, 19.790, and 11.020; 4.683, 6.445, 8.424, and 8.245; all P<0.05). After transfection, the expressions of p-AKT and p-mTOR at protein level of GPR43-siRNA group, GPR109a-siRNA group and GPR43/ GPR109 a double knockout group were all higher than those of the negative siRNA control group and 5 mmol/L sodium butyrate group (1.474±0.045, 1.471±0.058 and 2.067±0.120 vs. 1.158±0.030 and 1.139±0.031; 1.850±0.082, 1.683±0.058 and 2.160±0.091 vs. 1.469±0.037 and 1.490±0.116), and the differences were statistically significant ( tp-AKT=5.807, 4.816, 7.322, 6.109, 5.080 and 7.463; tp-mTOR=4.235, 3.113, 7.044, 2.542, 1.497 and 4.562; all P<0.05). Conclusions:The effect of sodium butyrate on the proliferation and apoptosis of steatosis HepG2 cells is associated with the GPR43/GPR109a-pAKT-mTOR signaling pathway.

[Objective]To explore the diagnostic value of dual-energy computed tomography(DECT)for left atrial appendage thrombosis/spontaneous echocardiographic contrast(LAAT/SEC).[Methods]A retrospective analysis was done on 64 non-valvular atrial fibrillation patients who planned to undergo radiofrequency ablation between November 2020 and November 2021.All patients underwent DECT and transesophageal echocardiography(TEE),and then were divided into LAAT/SEC group and non-LAAT/SEC group based on the TEE results.The clinical data and imaging parameters of the two groups were compared and analyzed.Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for LAAT/SEC,and a prediction model was constructed.[Results]A total of 64 patients with atrial fibrillation were enrolled in this study,including 42 non-LAAT/SEC patients and 22 LAAT/SEC patients.There was no statistically significant difference in gender and body mass index(BMI)between the two groups(P>0.05).CHA2DS2-VASc score and left atrial diameter were higher in the LAAT/SEC group than in the non-LAAT/SEC group(P=0.047;P<0.001).Significant differences(P<0.001)were observed in the ratio of Hounsfield unit of LAA and ascending aorta(LAA/AA HU ratio)at the first phase of DECT and quantitative parameters such as Zeff,Rho,λHu,and nIC.Multivariate logistic regression showed that Zeff and Rho were the independent factors for the diagnosis of LAAT/SEC.A Zeff-Rho based model predicting LAAT/SEC was subsequently developed,with Area Under the Curve(AUC)of 0.96(95%CI:0.92,1.00)and the accuracy of 0.92(95%CI:0.83,0.97).[Conclusions]The two quantitative parameters Zeff and Rho are independent risk factors for the diagnosis of LAAT/SEC.The DECT derived Zeff and Rho may have better diagnostic performance than single parameter and conventional CT in detecting LAAT/SEC.

Objective:To develop the Suicide Outcomes Scale for Undergraduates with Suicidal Ideation(SO-SUSI)and test its validity and reliability.Methods:Based on semi-structured interview,literature review and expert discussion,main aspects and indicator system were defined.The initial version of SOSUSI was formed,and items were either modified from existing scales targeting the relevant constructs,or compiled according to previous inter-view results.A total of 607 undergraduates with suicidal ideation were enrolled.The sample was randomly divided in half,one half(n=317)was used for item analysis and exploratory factor analysis,and another half(n=290)for confirmatory factor analysis.All data were used for reliability analysis.The Self-rating Depression Scale(SDS)and Suicidal Intent(SI)were used for criterion validity.Results:The SOSUSI included 39 items in 4 dimensions(nega-tive reinforcement of suicide,negative consequences of suicide,loss of suicide,and positive reinforcement of sui-cide)which explained 50.10％of the total variance.Confirmatory factor analysis showed that the four-factor struc-ture model fitted well(x2/df=3.27,CFI=0.92,TLI=0.91,IFI=0.92,SRMR=0.09).The scores of negative re-inforcement and positive reinforcement of suicide were positively correlated with the SDS and SI scores(ICC=0.15-0.33,Ps＜0.05),while the scores of negative consequences and loss of suicide were negatively correlated with the SI scores(ICC=-0.42--0.56,Ps＜0.05).The Cronbach's α coefficients of each dimension ranged from 0.79 to 0.91.Conclusion:The Suicide Outcomes Scale for Undergraduates with Suicidal Ideation(SOSUSI)has good validity and internal consistency reliability.

OBJECTIVETo understand the dietary consumption of residents in Xiamen and the content of phthalic acid esters (PAEs) in food, and to assess the plasticizer exposure risk of diet in Xiamen.

METHODSThe survey was conducted by stratified cluster random sampling method in Xiamen from September to October in 2010. According to the Xiamen administrative division, six neighborhood communities were selected as sampling units, then 25 families were randomly chosen from each sampling units.From the above 150 families, the permanent residents over the age of six were permitted to our study. The survey included 495 residents totally. These participants' information, such as basic personal information, physical activity levels, meal frequency and the average consumption of 33 kinds of food in 13 categories were collected using questionnaires. Thirteen categories included cereal and tubers, beans, vegetables, fungi and algae, fruits, dairy products, meat, seafood, eggs, snacks, beverages, cooking oil and spices. The height and weight of residents were measured and the average daily dietary intake was calculated. Thirty-three kinds of food in 13 categories were collected in supermarkets in Xiamen. According to the annual sales ranking, the top three-five brands of each kinds of food were selected and numbered, then two or three brands were chosen by random number table method from them; three completely individual packed samples in the same batch of each brand were detected; 243 samples were included in our study.100-500 g solid samples or 100-500 ml liquid samples were collected. The content of diethyl phthalate (DEP), dibutyl phthalate (DBP), di (2-ethylhexyl) phthalate (DEHP) in food were detected by liquid chromatography mass spectrometry, which expressed by median (minimum-maximum). The exposure dose, contribution rate and risk index of PAEs were calculated by point estimation method.

RESULTSAccording to the average daily dietary intake of residents in Xiamen, the top three ones in 13 categories of food were cereal and tubers (337.16 g/d, 18.21%), vegetables (309.12 g/d, 16.69%) and fruits (213.20 g/d, 11.51%). The content of DEP, DBP or DEHP among different categories of food was significantly different (χ² values were 58.05, 50.19 and 102.10, P < 0.01). Among 13 categories of food, seafood contained the most DEP (0.090 (0.000-0.324)mg/kg); cooking oil had the most DBP (0.700(0.000-2.980) mg/kg) and DEHP (5.115(0.000-24.160) mg/kg). DEP, DBP and DEHP exposure(0.19, 4.20, 18.10 µg × kg⁻¹ ×d ⁻¹)in dietary food in Xiamen were less than the reference dose(RfD) (800, 100, 20 µg × kg⁻¹ × d⁻¹) proposed by the United States Environmental Protection Agency (EPA), and the risk indexes were 0.02%, 4.20% and 90.50%, respectively. Among 13 categories of foods, seafood was the main source of DEP dietary exposure. The exposure dose and contribution rate of DEP in seafood were 0.18 µg × kg⁻¹ × d⁻¹ and 94.74%, respectively.Vegetables were the main source of DBP and DEHP dietary exposure. The exposure dose and contribution rate of DBP and DEHP were 1.48 µg × kg⁻¹ × d⁻¹, 35.24% and 6.07 µg × kg⁻¹ × d⁻¹, 33.54%, respectively.

CONCLUSIONThe food consumed by residents in Xiamen was overall in a safe state, but to some extent, there still exists DEHP exposure risk in foods.

China ; Dibutyl Phthalate ; Diet ; Diethylhexyl Phthalate ; Food Contamination ; Humans ; Phthalic Acids ; Plasticizers ; Risk Assessment ; Seafood ; United States ; Vegetables