Mild encephalitis/ encephalopathy with a reversible splenial lesion (MERS)in the corpus callosum is a clinical - radiological syndrome with typical imaging characteristics,which can be divided into 2 types (MERS Ⅰand MERS Ⅱ)according to the affected parts. The main cause is infection in children. Patients can be presented with symptoms that are common for acute mild encephalitis or encephalopathy such as disturbance of consciousness,hea-dache,vomiting,seizure. Brain magnetic resonance imaging(MRI)indicates lesions in the splenium of the corpus callo-sum. The symptoms and brain MRI lesions disappear almost within 1 month,and the prognosis is usually good. Early recognition is necessary and excessive treatment should be avoided.

Objective:To summarize the best evidence for weight management in patients with knee osteoarthritis.Methods:Clinical decisions, guidelines, expert consensus, and systematic reviews regarding the weight management in patients with knee osteoarthritis were searched in databases such as British Medical Journal (BMJ) Best Practice, UpToDate, Cochrane Library, CINAHL, PubMed, and Embase. The search period was from database establishment to March 31, 2023. Two researchers conducted quality evaluations, extracted evidence, and recommended evidence levels for the included literature.Results:A total of 13 articles were included, including five guidelines, three expert consensus, and five systematic reviews. Thirty pieces of evidence were summarized from five aspects, namely the principles of weight management, weight management goals, exercise management strategies, dietary management strategies, and health education.Conclusions:The best evidence for weight management in patients with knee osteoarthritis can provide a basis for medical staff.

Background and Purpose:Prostate cancer is one of the most common cancers and the second leading cause of cancer-related death in Europan and North American males.The incidence of prostate cancer has also been increasing during the past few decades in China.It is widely accepted that this heterogeneity,which results from the tumor progression driven largely by genomic instability(genetic and/or epigenetic alterations)of tumor cells in primary tumor,endows specific populations of tumor cells with the unique character needed for invasion,migration,and metastasis colony formation in other organs and only these subpopulations possessing thost character can survive the potentially destructive journey from the primary tumor to the sites of metastases.The purpose of the present study was to explore the genes associated with invasion and metastasis of human prostate cancer cell line PC-3M in nude mice.Methods:After PC-3M cells were inoculated into orthotopic site(prostate) in a male nude mouse for two months,tumor cells were isolated from the primary tumor and lymph node metastasis,separately.Cell invasion and adhesion ability in vitro were first compared between two cells.Then metastasis-related genes differentially expressed between them were analyzed by utilizing cDNA microarray technique.Results:The in vitro cell invasion and adhesion potential of tumor cells from lymph node metastasis was significantly higher than those from primary tumor by 2.5 fold and 1.5 fold,respectively.Metastasis-related genes differentially expressed between those two sublines were identified,all of them were up-regulated in the tumor cells from lymph node metastasis and could be categorilized: 1.genes encoding cellular matrix-degrading proteolytic enzyme including cathepsin and MMP.2.genes encoding transcription factors.3.genes related to heterotypic adhesion of tumor cells.4.genes encoding cell surface receptors.Conclusions:There are significant differences in invasion and adhesion potential between cells from primary tumor and those from lymph node metastasis.Some differentially expressed molecules might be playing pivotal roles in promoting tumor cells to migrate from primary tumors to distant metastases,which may be helpful to elucidate the possible mechanism of metastasis in prostate cancer.

Objective? To explore the competitive attitude of clinical nurses of Infectious Disease Department and its influencing factors so as to provide a basis for improving nursing management strategies of infectious disease further. Methods? From April 2017 to June 2017, we selected 454 clinical nurses of Infectious Disease Department from 8 Class Ⅲ hospitals in Nantong City as subjects by convenience sampling. The Competitive Attitude Scale (CAS) was used to investigate the score of competitive attitude of clinical nurses of infectious disease department and multiple linear regression was used to analyze its influencing factors. Results? Among 454 clinical nurses of Infectious Disease Department in Nantong City, the scores of benign competition attitude and excessive competition were (45.13±8.17) and (29.57±5.51) respectively. There were statistical differences in the scores of excessive competition among clinical nurses of infectious disease department with different work lives and professional titles (F=3.147,3.556; P＜ 0.05). Multiple linear regression showed that the influencing factors of excessive competition included work lives and professional titles (P＜0.01). Conclusions? Clinical nurses of Infectious Disease Department have the low score of competitive attitude. The work lives and professional titles are the influencing factors of excessive competition. Nursing managers of infectious disease department should establish a reasonable competitive mechanism to allow full paly to benign competition, avoid excessive competition and improve whole competitiveness.

Objective:To explore the effect of physical activity trajectories on cognitive function in middle-aged and older adults.Methods:Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, 809 participants aged ≥45 were selected. General data, physical activity levels, and cognitive function were collected. The group-based trajectory model (GBTM) was used to establish the physical activity trajectory model, and multiple linear regression was applied to investigate factors affecting cognitive function in middle-aged and older adults and to analyze the relationship between physical activity trajectories and cognitive function.Results:The cognitive function score for the 809 middle-aged and older adults was (11.71±4.60), and the logarithmic metabolic equivalent of physical activity was (8.38±1.06). Based on GBTM, four physical activity trajectories were identified: stable group, slow-increase group, rapid-decrease group, and stable-decrease group. Multiple linear regression analysis showed that the stable and slow-increase activity trajectories, gender, age, marital status, and retirement status were significant factors influencing cognitive function in middle-aged and older adults ( P<0.01) . Conclusions:Physical activity trajectories are associated with cognitive function in middle-aged and older adults. Maintaining stable or slowly increasing physical activity is beneficial for cognitive health. Nurses should design targeted interventions based on factors influencing cognitive function.

Lung transplantation is the only effective treatment of end-stage lung diseases. Nevertheless, shortage of donor lungs has become increasingly prominent worldwide. A large quantity of patients died while waiting for lung transplantation. Urgent lung transplantation is a prioritized allocation strategy for donor lung transplantation according to the urgency of diseases, aiming to shorten the waiting time for donor lungs and reduce the fatality of patients on the waiting list for lung transplantation. However, no consensus has been reached worldwide on the definition, criteria and application of the terminology of urgent lung transplantation. In addition, the survival and net benefits of lung transplant recipients based on this allocation system are still controversial. On the basis of previous clinical research on urgent lung transplantation, the definition criteria, risk factors, survival outcomes, limitations and optimization measures were explicitly elucidated in this article, aiming to provide theoretical reference for comprehensive evaluation of the feasibility of urgent lung transplantation and further optimizing the allocation system of donor lungs.

Lung transplantation has become the most effective treatment of end-stage lung diseases. Along with persistent optimization of lung transplantation technique and perioperative management, the short-term clinical efficacy after lung transplantation has been significantly improved, whereas the long-term clinical prognosis remains unoptimistic. Besides chronic lung allograft dysfunction, postoperative malignant tumors also threaten the long-term survival of the recipients. Common malignant tumors following lung transplantation include nonmelanoma skin cancer, posttransplant lymphoproliferative disease and lung cancer. After solid organ transplantation, a large majority of the recipients require lifelong immunosuppressive therapy. The intensity of immunosuppressive therapy for the lung transplant recipients is generally higher than other organ transplant recipients. Immunosuppression is the main factor which leads to the impairment of anti-tumor immune monitoring function and promotes the incidence and development of malignant tumors. In this article, the risk factors, prevention and treatment of the most common malignant tumors after lung transplantation were reviewed, aiming to provide reference for comprehensive diagnosis and treatment of malignant tumors following lung transplantation.

Objective:To analyze the differential expression of breast milk-derived extracellular vesicles (BM-EV) from mothers of preterm and term infants .Methods:Breast milk samples were collected from preterm and term delivery (three cases in each) at the Women's Hospital of Nanjing Medical University in 2019. BM-EV was extracted using ultracentrifugation. After preliminary identification of the characteristics of BM-EV, liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used for protein quantification. Significantly up-regulated differential proteins (fold change≥1.5 and P<0.05) in the preterm group were screened. GO and KEGG were performed to predict the differentially expressed proteins' functional annotation and determine associated signaling pathways. Mann-Whitney U test and Fisher's exact test were used for intergroup comparisons. Pearson's correlation test describes the correlation of protein quantification values between samples. The differences in protein abundance were compared between the two groups using a t-test, followed by multiple corrections. Additionally, significantly enriched GO terms and KEGG pathways of the differentially expressed proteins were screened based on the hypergeometric distribution. Results:(1) There were three primiparae in the preterm group and one in the term group. Marker proteins CD9, CD81, and HSP70 were enriched in the BM-EV of both groups. (2) Six samples were comparable between groups and showed high reproducibility within groups. The correlation of protein quantification values between samples was up to 0.99. Furthermore, the coefficient of variation was 11.21% for preterm samples and 19.72% for term, and the data values in the preterm group were relative. (3) A total of 945 proteins were identified, and 156 were differentially expressed between preterm and term BM-EV, with 83 significantly up-regulated in preterm BM-EV. In the up-regulated proteins, the top three high-abundance proteins were complemented C4a, fatty acid synthase, and sclerostin domain-containing protein-1. (4) The biological processes or cellular components with the highest enrichment in GO functional prediction were mainly involved in hemoglobin and glycogen biosynthesis, immunological synapse formation, and phagocytosis mediated by the Fc γ receptor signaling pathway. The most relevant KEGG pathways were ribosome-related, complement and coagulation cascades, neutrophil extracellular trap formation, and Fc γ receptor-mediated phagocytosis.Conclusion:The significantly up-regulated differential proteins in BM-EV may play a protective role by regulating immunity, gastrointestinal function, and energy metabolism in preterm infants.

Objective: Endometrial cancer (EC) is a common gynecological malignant tumor. CircRNAs play crucial roles in cancer progression and metastasis. However, the biological functions of circRNAs in EC remain largely unknown. Methods: CircSMAD2, miR-1277-5p, MFGE8 and relative maker protein expression in EC tissues or cell lines were analyzed by quantitative real-time polymerase chain reaction and Western blot. In vitro and in vivo functional assays, including EDU, CCK8, colony formation, transwell, tube formation and tumor xenograft assays, were conduct to explore the effects of circSMAD2 on EC. Mechanism assays were conducted to confirm the binding between miR-1277-5p and circSMAD2 or MFGE8 expression. Results: Upregulation of circSMAD2 was uncovered in both EC tissues and cell lines. Functionally, silencing of circSMAD2 apparently inhibited the proliferation, migration, invasion and angiogenesis of EC cell lines in vitro. Mechanistically, circSMAD2 sponged miR-1277-5p to upregulate MFGE8 expression. The decrease of miR-1277-5p and increase of MFGE8 were observed both in EC tissues and cell lines. Then MFGE8 knockdown or miR-1277-5p upregulation suppressed EC cell oncogenic biological behavior. Rescue experiments showed that miR-1277-5p mimics countervailed the anticancer effects of circSMAD2 silencing on EC. Besides that, MFGE8 overexpression also attenuated the inhibitory action of miR-1277-5p mimic in EC. Moreover, knockdown of circSMAD2 inhibited EC growth in vivo. Conclusion CircSMAD2 functions as an oncogene in promoting the progression of EC through miR-1277-5p/MFGE8 axis.

Necrotizing enterocolitis(NEC)is an acute intestinal inflammation characterized by mucosal edema, epithelial ischemic necrosis, and crypt destruction.The intestinal organoid 3D culture system derived from intestinal stem cells has been developed as a valuable research model for studying NEC in vitro.To fully understand the progression of NEC, it is crucial to comprehend the changes that take place in the intestinal stem cell niche, as well as the interactions among different cell types in the intestinal crypt.On the other hand, intestinal organoids can also be used directly for the treatment of NEC, and for screening of specific drugs or nutrients for NEC in vitro .This article provides a review of intestinal organoids and their recent advancements in NEC research.