Objective To observe the effect of intrathecal p38 MAPK inhibitor(SB203580) treatment on neuropathic pain and the expression of p38 MAPK and BDNF in dorsal horn of spinal cord in rats with chronic constriction injury(CCI),So as to investigate the possible mechanisms of neuropathic pain.Methods Totally 30 SD rats were evenly randomized into 3 groups(n=10) :sham group receiving intrathecal injection of sodium chloride,control group receiving intrathecal injection of sodium chloride and CCI surgery,and SB203580 group receiving intrathecal injection of SB203580 and CCI surgery.SB203580(0.1 ml/kg) was administered 0.5 h before and 1-14 d after CCI surgery.The mechanical thresholds were tested 24 h before and 4-14 d after CCI surgery.p38 MAPK expression and BDNF release in the dorsal horn were determined using immunohistochemistry method 14 d after CCI surgery.Results The mechanical thresholds in the control and SB203580 groups were significantly lower after CCI surgery compared with that before CCI surgery(P0.05).Compared with the sham operation group,the mechanical thresholds were significantly lower in the other two groups after CCI surgery(P

Objective To investigate the changing characteristics and rules of the different period of articular cartilage in rats after dorsal rhizotomy, and to verify the partial sensory disturbance can cause articular cartilage injury. Methods Thirty-three ten-month-old SPF male Wistar rats were randomly divided into experimental group ( n=18 ) and control group ( n=15) .The rats in the experimental group were sectioned the L3、L4 dorsal roots in the right.The rats in the control group were only incised the skin and paravertebral muscles.To observe the behavior changes in rats.At 2, 6 and 10 weeks, the specimens of the right hind lower end of femur were drawn out to make paraffin sections, then HE staining and Safranin O/Fast Green staining.The changes and characteristics of the morphology of the articular cartilage was observed.Results With the prolonging of period, the right hind limb of the experimental rats through the change process of transient paralysis, coordination of movement disorders and active movement.In the experimental group, the patellar surface of right hind femur gradually became shallow and wide.The articular cartilage underwent rough, cells disorganizated, cells decreased, and duplicated drifted and interrupted tide line. The ratios of ACC/TAC of the experimental group were gradually high(t=5.25~8.13,P <0.05).Conclusion Dorsal rhizotomy can cause injury and degenerative changes in articular cartilage.

Objective:To explore the influence of head nurse empowerment on nurses′ voice behavior and the mediating and moderating effects of nurses′ job crafting and proactive personality.Methods:A total of 805 nurses from the 4 grade A hospitals in Shandong province from February to March 2022 were selected by convenience sampling method, the Nurse Managers′ Empowering Behavioral Scale For Staff Nurses, Job Crafting Scale, Voice Behavior Scale and Proactive Personality Scale were used for cross-sectional survey. The mediating effect was analyzed by SPSS 26.0 and Process 3.4 macro.Results:The total score of nurses′ perception of head nurse empowerment was (4.01 ± 0.57) points, the total score of nurses′ job crafting was (4.19 ± 0.66) points, the total score of nurses′ voice behavior was (4.12 ± 0.62) points, and the total score of nurses′ proactive personality was (6.07 ± 0.90) points. Head nurse empowerment, nurse job crafting, voice behavior and proactive personality were positively correlated with each other ( r values were 0.483-0.824, all P<0.01). The mediating effect of job crafting was 0.541, accounting for 86.4% of the total effect; proactive personality had a positive moderating effect on the first half path of the mediation model ( ? R 2=0.163, P<0.01). Conclusions:Head nurse empowerment influenced voice behavior of nurses directly and indirectly through the mediating role of job crafting, proactive personality can moderate the effect of head nurse empowerment on nurse job crafting. It is suggested that the head nurse appropriately delegate power to the nurses and actively authorize them, identify nurses with high proactive personality, stimulate their job remodeling and voice behavior, and improve the quality of nursing work.

OBJECTIVE:To provide reference for promoting the rational use of Dexamethasone sodium phosphate injection in the clinic. METHODS:Special comment criteria and evaluation rules was formulated,medical records of 1273 inpatients receiving Dexamethasone sodium phosphate injection were collected from our hospital during Jul. 2014-Jun. 2015. Rationality of drug use was evaluated and analyzed retrospectively. RESULTS:The most use amount and case number of Dexamethasone sodium phosphate injection were in the departments of blood/oncology,obstetrics,emergency minimally invasive surgery,gastrointestinal surgery,emergency trauma of orthopedics and thyroid breast surgery;while much less were in departments of new pediatrics, infection and rehabilitation. There were 138 cases of irrational use of Dexamethasone sodium phosphate injection found in special comment, and the total irrational use rate was 10.84％ . The types of irrational use included inappropriate indication (contraindication,59.42％),inappropriate drug combination(18.84％),inappropriate drug selection (15.94％),inappropriate usage and dosage(3.62％)and inappropriate drug dosage forms or drug delivery methods(2.17％),etc. The irrational use rate of Dexamethasone sodium phosphate injection monthly declined steadily by month from 30.35％ in Jul. 2014 to 7.81％ in Jun. 2015 through the special comment;then a consensus of 5 points for the drug use formed in our hospital. CONCLUSIONS:There are irrational situations in the clinical use of Dexamethasone sodium phosphate injection in our hospital,especially in the cases of inappropriate indications. The rationality of the drug can be improved by the development of the special comment. This work should continue to be carried out in the future and perfected.

Multiple sclerosis (MS) is an idiopathic inflammatory demyelinating diseases of the central nervous system, the underlying cause of which has not been cleared. Previous studies have shown that the pathogenesis of MS is related to the destruction of blood brain barrier, furthermore the drugs used to treat MS have a certain protective effect on the function of blood brain barrier. Therefore, this review combines the research progress at home and abroad to clarify the relationship between the blood brain barrier and MS in pathogenesis and treatment, proposing possible orientation of development.

Objective:Assess the relationship between elevated antiphospholipid antibodies and thrombosis in hospitalized patients.Methods:Case control study. A total of 385 patients (149 males and 236 females, aged from 1 to 105 years, with a median age of 37 years) who were hospitalized in Peking University First Hospital from January 2015 to December 2019 and tested positive for any one of the anti-phospholipid antibodies were included in the study. All subjects were divided into thrombotic group and non-thrombotic group according to whether thrombus was detected by imaging examination during hospitalization. In thrombosis group, there were 66 males and 36 females, aged from 3 to 105 years, with a median age of 58 years. In non-thrombosis group, there were 83 males and 200 females, aged from 1 to 94 years, with a median age of 31 years. Clinical data and laboratory data of patients were recorded. ACL-IgM/IgG and anti-β2GPI-IgM/IgG were detected by ELISA and LA was detected by dRVVT and SCT on automatic coagulation analyzer. The rates of age, gender, smoking, obesity, hypertension, hyperlipidemia, diabetes and the median level of antiphospholipid antibodies were compared between two groups. Logistic multivariate regression analysis was used to determine the risk factors for thrombotic events. The mid-to-high titer value of aCL was established by the χ 2-trend test and verified by logistic regression. Results:The median age (58 years) and the rates of male (64.7%), smoking (16.7%), hypertension (63.7%) and diabetes (28.4%) in thrombus group were significantly higher than those in non-thrombus group ( Z=7.685, χ2=38.077, 16.312, 37.769, 24.749 respectively; P<0.01). The positive rate of anti-β2GPI-IgG and dRVVT in thrombosis group (11.8% and 78.4%) was significantly higher than that in non-thrombosis group (5.3% and 60.1%), as well as the median level of dRVVT (1.29 RU/ml vs 1.23 RU/ml) (χ2=3.864 and 10.309, Z=3.539; P<0.05). The median level of aCL-IgM was higher in non-thrombosis group (2.3 MPL vs 2.0 MPL). The positive rate of aCL-IgG was slightly higher in thrombosis group (18.6% vs 10.6%). Logistic regression analysis showed that men, hypertension, diabetes, advanced age, elevated dRVVT, and elevated anti-β2GPI-IgG are risk factors for thrombosis. Taking 36 GPL as the medium-to-high titer value of aCL-IgG, the risk of thrombosis increased by 2.45 times. Conclusions:In the anti-phospholipid antibody profile, LA detected by dRVVT method, anti-β2GPI-IgG and aCL-IgG may be valuable laboratory indicators for inpatient thrombotic events. The mid-to-high titer value of aCL-IgG is set at 36 GPL to distinguish the risk of thrombosis.

Objective:Assess the relationship between elevated antiphospholipid antibodies and thrombosis in hospitalized patients.Methods:Case control study. A total of 385 patients (149 males and 236 females, aged from 1 to 105 years, with a median age of 37 years) who were hospitalized in Peking University First Hospital from January 2015 to December 2019 and tested positive for any one of the anti-phospholipid antibodies were included in the study. All subjects were divided into thrombotic group and non-thrombotic group according to whether thrombus was detected by imaging examination during hospitalization. In thrombosis group, there were 66 males and 36 females, aged from 3 to 105 years, with a median age of 58 years. In non-thrombosis group, there were 83 males and 200 females, aged from 1 to 94 years, with a median age of 31 years. Clinical data and laboratory data of patients were recorded. ACL-IgM/IgG and anti-β2GPI-IgM/IgG were detected by ELISA and LA was detected by dRVVT and SCT on automatic coagulation analyzer. The rates of age, gender, smoking, obesity, hypertension, hyperlipidemia, diabetes and the median level of antiphospholipid antibodies were compared between two groups. Logistic multivariate regression analysis was used to determine the risk factors for thrombotic events. The mid-to-high titer value of aCL was established by the χ 2-trend test and verified by logistic regression. Results:The median age (58 years) and the rates of male (64.7%), smoking (16.7%), hypertension (63.7%) and diabetes (28.4%) in thrombus group were significantly higher than those in non-thrombus group ( Z=7.685, χ2=38.077, 16.312, 37.769, 24.749 respectively; P<0.01). The positive rate of anti-β2GPI-IgG and dRVVT in thrombosis group (11.8% and 78.4%) was significantly higher than that in non-thrombosis group (5.3% and 60.1%), as well as the median level of dRVVT (1.29 RU/ml vs 1.23 RU/ml) (χ2=3.864 and 10.309, Z=3.539; P<0.05). The median level of aCL-IgM was higher in non-thrombosis group (2.3 MPL vs 2.0 MPL). The positive rate of aCL-IgG was slightly higher in thrombosis group (18.6% vs 10.6%). Logistic regression analysis showed that men, hypertension, diabetes, advanced age, elevated dRVVT, and elevated anti-β2GPI-IgG are risk factors for thrombosis. Taking 36 GPL as the medium-to-high titer value of aCL-IgG, the risk of thrombosis increased by 2.45 times. Conclusions:In the anti-phospholipid antibody profile, LA detected by dRVVT method, anti-β2GPI-IgG and aCL-IgG may be valuable laboratory indicators for inpatient thrombotic events. The mid-to-high titer value of aCL-IgG is set at 36 GPL to distinguish the risk of thrombosis.

Objective To investigate the risk factors for secondary infection in patients with acute ischemic stroke(AIS)undergoing intravenous thrombolysis,and to construct a nomogram model.Methods A retrospective analysis was performed for the clinical data of 391 patients with AIS who underwent intravenous thrombolysis in Nanjing Drum Tower Hospital retrospectively from December 2016 to December 2021,and according to the presence of absence of secondary in-fection,they were divided into infection group with 75 patients and non-infection group with 316 patients.Results Age[odds ratio(OR)=1.049,95%confidence interval(CI)1.017-1.082],history of renal insufficiency(OR=3.76,95%CI 1.382-9.966),history of antihypertensive drugs(OR=0.298,95%CI 0.144-0.562),hemorrhagic transforma-tion after thrombolysis(OR=2.851,95%CI 1.05-7.36),white blood cell count(WBC)on admission(OR=1.17,95%CI 1.045-1.313),prothrombin time(PT)on admission(OR=1.585,95%CI 1.206-2.167),and dysphagia(OR=8.309,95%CI 4.091-17.269)were independent risk factors for secondary infection.The nomogram predictive model based on these risk factors had an area under the ROC curve of 0.867 and a cutoff value of 0.180,suggesting that the model had good discriminatory ability and calibration.According to the cutoff value of the nomogram,the patients were di-vided into high-risk and low-risk groups based on the risk of secondary infection,and the low-risk group had a significantly higher cumulative survival rate than the high-risk group(P<0.000 1).Conclusion Age,history of renal insufficiency,his-tory of antihypertensive drugs,hemorrhagic transformation after thrombolysis,WBC on admission,PT on admission,and dysphagia on admission are risk factors for secondary infection in AIS patients after intravenous thrombolysis,and the nomo-gram predictive model constructed based on the above risk factors has a good value in predicting secondary infection and 90-day survival.

Objective:To prospectively investigate the prevalence of heparin-induced thrombocytopenia (HIT) in critically ill children during extracorporeal membrane oxygenation(ECMO) and explore the clinical characteristics and prognosis of HIT during ECMO.Methods:A total of 22 critically ill children, who had received ECMO support for more than 96 hours in the Intensive Care Unit at the Children′s Hospital of Fudan University from March 2019 to December 2020, were enrolled.According to the 4T score and the heparin/platelet factor 4(PF4) antibody, children whose 4T scores were not less than 6 and heparin/ PF4 antibodies were positive, were classified into HIT group ( n=6), and non-HIT group ( n=16). The clinical outcomes and the incidence of thrombotic events were compared between two groups. Results:The incidence of HIT during ECMO in critically ill children was 27% in this study.The incidence of thrombosis in the ECMO circuit in the HIT group was higher (100% vs.63%, P=0.133), and the average time to the first thrombosis in ECMO circuit in the HIT group was shorter than that in the non-HIT group (3.70 d vs.5.44 d, P=0.06). During the first 14 days of ECMO, the proportion of children with thrombotic events no less than twice was higher in the HIT group (67% vs.19%, P=0.054). There was no significant difference regarding the survival rate at 28 days after ECMO withdrawal between two groups (33% vs.50%, P=0.664). Conclusion:The prevalence of HIT during ECMO in critically ill children is high.Thrombosis events tend to occur earlier and more extensively in children with HIT during ECMO.No significant effect of HIT on the survival rate of children during ECMO is found.Whether HIT has effect on the survival rate of children with ECMO requires a prospective and large clinical study.

Objective:To identify new prognostic markers and therapeutic targets for gastric adenocarcinoma.Methods:The public datasets of gastric adenocarcinoma collected from GEO database (GSE33335 and GSE63089) were downloaded for analysis. There were 70 GC tissues and paired normal tissues in the two profile datasets. Differentially expressed genes (DEGs) between GC tissues and normal stomach tissues were selected by the R software. Protein-protein interaction (PPI) of these DEGs were visualized by the Search Tool for the Retrieval of Interacting Genes (STRING). The key gene sets were analyzed by Cytoscape and Molecular Complex Detection (MCODE). The mRNA and protein expression levels of prognosis related genes identified by public database were confirmed by using GC tissues and paired normal tissues collected from July 2019 to September 2019 in Affiliated Hospital of Nantong University.Results:DEGs were identified in the two datasets by using R software. A total of 128 DEGs were detected, including 85 up-regulated genes ( log2FC>1.2 and FDR<0.01) and 43 down-regulated genes ( log2FC<-1.2 and FDR<0.01) in the GC tissues. PPI network model and MCODE model were established by using the Online String tool and Cytoscape software, and 27 key genes were obtained, including 25 genes related with prognosis of GC patients ( P<0.05). We identified 14 significant DEGs in GC tissues, including cyclin B1 (CCNB1), polo-like kinase 1 (PLK1) and pituitary-tumor transforming gene (PTTG1), which were significantly enriched in the cell cycle pathway through KEGG pathway enrichment analysis. The positive expression rate of PTTG1 in GC tissues was 68.8% (22/32), significantly higher than 18.8% (6/32) in normal gastric tissues ( P<0.05). Conclusions:The expression of PTTG1 is different in GC and gastric tissues, implicates it is the key gene in gastric carcinogenesis. The prognoses of GC patients with higher PTTG1 expression are worse. PTTG1 might participate in the development of gastric adenocarcinoma by regulating cell cycle.