Objective:To investigate the effect and molecular mechanism of miR-15a-5p regulation Wnt signaling pathway in PQ-induced pulmonary fibrosis.Methods:The PQ-induced 16HBE cell model was constructed, high-throughput miRNA chip and RT-qPCR were used to screen for miR-15a-5p with significant differences. The experimental groups were as follows: NC group (normal control);no special treatment; PQ group: 50 μmol/L PQ treated cells for 72 h; miR-15a-5p group: 16HBE stable cell lines transfected with miR-15a-5p overexpressing lentivirus; miR-15a-5p+PQ group: Stable cell lines were treated with 50 μmol/L PQ for 72 h. The expression of Wnt pathway-related genes Wnt3α and β-catenin, fibroblast marker genes Collagen I, Vimentin and α SMA, epithelial marker genes Occludin and CK18 were detected by RT-qPCR and Western blot. The mice model of PQ-induced pulmonary fibrosis was constructed, and the protein expression and lung tissue injury were detected by Western blot, HE staining and immunohistochemistry. Data were expressed as mean ± standard deviation, and independent sample t-test was used to analyze the data between the two groups. Results:The expressions of Wnt3α, β-catenin, fibroblast marker genes Collagen I, Vimentin and α SMA significantly up-regulated in cell injury models ( P<0.05), the epithelial cell marker genes Occludin and CK18 significantly down-regulated ( P<0.05), overexpression of miR-15a-5p could inhibit the expression of Wnt3α and alleviated the EMT induced by PQ. In animal models, Wnt3α, β-catenin, fibroblast marker genes Collagen I, Vimentin and α SMA significantly increased ( P<0.01), the structure of lung tissue was disordered and fibrosis occurred, overexpression of miR-15a-5p inhibited the expression of Wnt3α protein ( P<0.05) and ameliorated lung tissue injury. Conclusions:miR-15a-5p ameliorates PQ-induced lung injury by modulating the Wnt3α/β-catenin signaling pathway, thereby inhibiting the development of pulmonary fibrosis.

Objective:To explore the protective mechanism of Xuebijing injection (referred to as Xuebijing) on sepsis-associated acute respiratory distress syndrome (ARDS).Methods:① Animal experiments: 100 mice were randomly(random number) divided into 4 groups, including sham operation (Sham) group, cecal ligation and puncture (CLP) group, CLP+low-dose Xuebijing (L-XBJ) group, and CLP+high-dose Xuebijing (H-XBJ) group. The survival rate, lung histological changes, lung wet/dry (W/D) ratio, cell count and protein concentration in bronchoalveolar lavage fluids (BALF), inflammatory factors levels in serum, oxidative stress indicators, cell apoptosis, and key proteins of HIF-1α/p38 MAPK/NF-κB signaling pathway were measured. ② Cell experiments: Mouse alveolar macrophages (MH-S) were cultured in vitro and divided into 6 groups, including control (Con) group, lipopolysaccharide (LPS) group, LPS+L-XBJ group, and LPS+H-XBJ group, LPS+H-XBJ+ dimethyloxallyl glycine (DMOG, HIF-1α activator) group, LPS+H-XBJ+ 2-methoxyestradiol (2ME2, HIF-1α inhibitor) group. The effects of Xuebijing on inflammatory factors, oxidative stress, and cell apoptosis and their relationship with HIF-1α/p38 MAPK/NF-κB signaling pathway were detected.Results:Xuebijing increased the survival rate of mice with sepsis-associated ARDS, relieved lung tissue damage [lung injury score: CLP group (8.778±0.588), CLP+L-XBJ group (5.833±0.310), and CLP+H-XBJ group (4.750±0.246)], alleviated lung W/D ratio, and decreased pneumonia cell infiltration and protein exudation (all P<0.05). Additionally, Xuebijing treatment also diminished the expression of inflammatory factors (TNF-α, IL-1β, and IL-6), intracellular reactive oxygen species (ROS) accumulation, malondialdehyde (MDA) formation, superoxide dismutase (SOD) depletion, and cell apoptosis in LPS-induced MH-S cells and CLP-induced sepsis-associated ARDS mice (all P<0.05). Furthermore, mechanistic investigation further clarified the effects of Xuebijing on inflammation, oxidative stress, and cell apoptosis through the HIF-1α/p38 MAPK/NF-κB signaling pathway. Conclusions:Xuebijing can exert anti-inflammatory, anti-oxidative, and anti-apoptotic effects by suppressing the HIF-1α/p38 MAPK/NF-κB signaling pathway, thereby conferring protection against sepsis-associated ARDS.

Purpose/Significance To build an evaluation index system of hospital intelligence in line with China's national conditions,so as to provide references for the quantitative evaluation of the degree of hospital intelligence,and to help the orderly development of hospi-tal intelligence construction.Method/Process Based on the review of the existing evaluation standard system of hospital informatization con-struction,Delphi method and analytic hierarchy process are used to discuss the construction process of hospital intelligence evaluation index system from four processes:construction of an evaluation index system,selection of experts in letter consultation,evaluation of indicator im-portance and verification of letter consultation results,and determination of the evaluation index weight.Result/Conclusion The construc-tion of hospital intelligence evaluation index system,which includes 3 first-level indexes,8 second-level indexes and 33 third-level in-dexes,is complementary to the existing evaluation system of smart hospitals,can reflect the construction foundation and development goals of the current intelligent hospitals,and has certain applicability and guidance for the future construction of smart hospitals.

Purpose/Significance To construct the conceptual model of hospital intelligence index,so as to lay the foundation for the quantitative evaluation of hospital intelligence degree,and help the intelligent construction of hospital.Method/Process The paper intro-duces the connotation of intelligence,expounds the evaluation standard system of hospital informatization construction,and considers the application of intelligence in hospital from the perspective of structure-function-effect.Result/Conclusion The conceptual model of hospital intelligence index is built.That conceptual model includes 3 first-level indicators,8 second-level indicators and 33 third-level indicators of intelligence basis,intelligence capacity and intelligence effect.As a tool for continuous improvement of medical serv-ices,regular assessment of hospital intelligence level can promote the improvement of medical quality and patient experience,and help the high-quality development of hospitals.

Objective:To investigate the characteristics of neointimal hyperplasia (NIH) in patients with in-stent restenosis (ISR) over 5 years post-drug-eluting stent (DES) implantation based on optical coherence tomography (OCT).Methods:In this cross-sectional study, patients with DES-ISR who underwent OCT examination at PLA General Hospital between March 2010 and March 2022 were retrospectively included. All patients were divided into≤5 years DES-ISR group and>5 years DES-ISR group according to the time interval after DES implantation. Quantitative and qualitative analyses were conducted on OCT images to compare the clinical data and lesion characteristics of two patient groups. Furthermore, the independent clinical predictive factors of in-stent neoatherosclerosis (ISNA) were analyzed by multivariable logistic regression.Results:A total of 230 DES-ISR patients with 249 lesions were included, with an age of (63.1±10.4) years and 188 males (81.7%). The median interval after DES implantation was 6 (2, 9) years. There were 117 patients (122 ISR lesions) in the≤5 years DES-ISR group, and 113 patients (127 ISR lesions) in the>5 years DES-ISR group. Compared with≤5 years DES-ISR,>5 years DES-ISR showed more heterogeneous patterns (65.4% (83/127) vs. 48.4% (59/122), P=0.007), diffuse patterns (46.5% (59/127) vs. 31.2% (38/122), P=0.013), macrophage accumulations (44.1% (56/127) vs. 31.2% (38/122), P=0.035) in NIH and higher prevalence of ISNA (83.5% (106/127) vs. 72.1% (88/122), P=0.031). According to multivariable logistic regression, the independent predictive factor for ISNA was female ( OR=0.44, 95% CI 0.21-0.90, P=0.026). Female ( OR=0.48, 95% CI 0.23-0.99, P=0.046) and low-density lipoprotein cholesterol level ( OR=1.62, 95% CI 1.01-2.59, P=0.046) were independent predictive factors, respectively, for lipid ISNA. Calcified ISNA was independently associated with time interval of post-DES implantation ( OR=1.18, 95% CI 1.07-1.29, P=0.001). Conclusion:DES-ISR patients with a time interval of>5 years after stent implantation have a higher prevalence of ISNA and more complex lesions. Gender, the level of low-density lipoprotein cholesterol, and the time interval post-DES implantation are independently correlated with ISNA, lipid ISNA, and calcified ISNA.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Objective:To investigate the clinical effects of free posterior interosseous artery perforator flap on reconstruction of the soft tissue defects of multiple fingers in one hand.Methods:Clinical data of 9 patients with soft tissue defect of multiple fingers in one hand admitted to the Department of Hand Surgery, Yongkang Orthopedic Hospital between January 2021 and August 2023 were retrospectively studied. The patients were 7 males and 2 females, aged between 19 and 55 years old. The soft tissue defects of 2 patients with 3 fingers injury and 7 patients with 2 fingers injury were reconstructed with free posterior interosseous artery perforator flaps. The size of defects in single finger was 1.5 cm×2.5 cm-3.0 cm×4.5 cm. The size of flap was 2.5 cm×7.0 cm-3.5 cm×13.0 cm. The posterior cutaneous nerve of the forearm were sutured to the intrinsic nerve of palmar side of the 14 fingers. Donor sites in forearm were directly sutured. After discharge, regular follow-up at outpatient clinic and through WeChat interviews were conducted to observe the appearance and texture of the flaps, finger fullness, donor site function and appearance, as well as patient satisfaction. For the flaps with anastomosis of cutaneous nerve, the recovery of TPD of the flap was tested. Sensory recovery was assessed according to the British Medical Research Council (BMRC) sensory function assessment criteria. Hand functions were evaluated using the Total Active Movement (TAM) of fingers of the Hand Surgery of the Chinese Medical Association.Results:All of the 20 flaps survived and were evaluated through follow-up visits, which ranged from 6 to 25 months with an average of 13 months. The flaps were soft, unbloated and without obvious pigmentation. The protective sensations were recovered with an average static TPD of 14 flaps anastomosed with cutaneous nerve was of 9.7 (7-13) mm. Among them, S 3+ 10 fingers, S 3 4 fingers; 6 fingers of flap without sutured cutaneous nerve, S 2 5 fingers, S 1 1 finger. According to the TAM of Hand Surgery of Chinese Medical Association, the results were excellent for 15 fingers and good for 5 fingers. There was no scar contracture in the forearm donor sites and motor function was not affected. Conclusion:Posterior interosseous artery perforator flap has the advantages of thin flap, similar texture to the hand, good recovery in sensory, and minimal damage to the donor site. Therefore, it is a good option in reconstruction of soft tissue defects of multiple fingers in one hand.

OBJECTIVE: To improve the classical 4-vessel occlusion (4VO) model established by Pulsinelli and Brierley. METHODS: Thirty-two male SD rats were randomized into sham operation group, I4VO-Con10 group, I4VO-Int10 group and I4VO-Int15 group. The sham surgery group underwent exposure of the bilateral vertebral arteries and carotid arteries without occlusion to block blood flow. The I4VO-Con10 group experienced continuous ischemia by occluding the bilateral vertebral arteries and carotid arteries for 10 minutes followed by reperfusion for 24 hours. The I4VO-Int10 and I4VO-Int15 groups were subjected to intermittent ischemia. The I4VO- Int10 group underwent 5 minutes of ischemia, followed by 5 minutes of reperfusion and another 5 minutes of ischemia, and then reperfusion for 24 hours. The I4VO-Int15 group experienced 5 minutes of ischemia followed by two cycles of 5 minutes of reperfusion and 5 minutes of ischemia, and then reperfusion for 24 hours. The regional cerebral blood flow (rCBF) was monitored with laser Doppler scanning, and survival of the rats was observed. HE staining was used to observe hippocampal pathologies to determine the optimal method for modeling. Another 48 rats were randomized into 6 groups, including a sham operation group and 5 model groups established using the optimal method. The 5 I4VO model groups were further divided based on the reperfusion time points (1, 3, 7, 14, and 28 days) into I4VO-D1, I4VO-D3, I4VO-D7, I4VO- D14, and I4VO- D28 groups. Body weight changes and survival of the rats were recorded. HE staining was used to observe morphological changes in the hippocampal, retinal and optic tract tissues. The Y-maze test and light/dark box test were used to evaluate cognitive and visual functions of the rats in I4VO-D28 group. RESULTS: Occlusion for 5 min for 3 times at the interval of 5 min was the optimal method for 4VO modeling. In the latter 48 rats, the body weight was significantly lower than that of the sham-operated rats at 1, 3, 7, 14 and 28 days after modeling without significant difference in survival rate among the groups. The rats with intermittent vessel occlusion exhibited progressive deterioration of hippocampal neuronal injury and neuronal loss. Cognitive impairment was observed in the rats in I4VO-D28 group, but no obvious ischemic injury of the retina or the optic tract was detected. CONCLUSION The improved 4VO model can successfully mimic the main pathological processes of global cerebral ischemia-reperfusion injury without causing visual impairment in rats.
Rats ; Male ; Animals ; Rats, Sprague-Dawley ; Brain Ischemia ; Cerebral Infarction ; Reperfusion Injury ; Body Weight

Objective:To evaluate the reliability and validity of the information needs assessment scales for breast cancer patients, so as to recommend an appropriate information needs assessment scale for breast cancer patients.Methods:Researches on the information needs assessment tools for breast cancer patients were retrieved by computer in PubMed, Embase, PsycINFO, EBSCOhost, WOS Core Collection, China National Knowledge Infrastructure (CNKI) , WanFang Data, and China Biomedical Literature Database. The inclusion criteria included that the research content was the breast cancer patient information needs scale/tumor patient information needs scale and the original research sample included breast cancer patients, and outcome indicators included reliability and validity. Exclusion criteria included assessment of information needs of family members/caregivers of breast cancer patients, assessment of unmet information needs, languages other than Chinese and English, comments, reviews, qualitative studies, systematic reviews, and Meta-analyses. The measurement characteristics of the scale were evaluated using the measurement characteristics evaluation criteria in the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) evaluation manual.Results:A total of 1 293 articles were retrieved, and 13 articles were finally included. The 13 scales had no hypothesis test of construct validity, cross-cultural validity, criterion validity and reactivity index. 11 of the scales were recommended as Grade B, and 2 were recommended as Grade C. Combined with the methodological quality evaluation results and measurement characteristics evaluation results, and the consistency between the research and development population and the user population, the Psychological Needs of Cancer Patient Scale and the Comprehensive Needs Assessment Tool in cancer (CNAT) are the optimal scales.Conclusions:There are currently no recommended scales according to the COSMIN guidelines. Considering the methodological quality, the evaluation results of measurement characteristics, and the consistency between the research and development population and the user population, the Psychological Needs of Cancer Patient Scale and the CNAT are the optimal scales.

Objective:To explore the establishment and effect of short-term training path for prenatal ultrasound diagnosticians in primary hospitals.Methods:A total of 105 trainees from in total 5 batches of the "prenatal ultrasound screening training base" in Chongqing were selected as the research objects, and a combination of multiple teaching methods was used to carry out specialized training for primary prenatal ultrasound screening doctors before and after training. Theoretical examinations and practical operation assessments were performed, and after training, remote image quality control and continuous improvement methods were established for trainees to assess training effectiveness. SPSS 21.0 was used for t test, Wilcoxon test and chi-square test. Results:After training, the results of the theoretical examinations and practical operation examinations of the trainees were higher than those before the training ( P<0.05), and after the completion of the training, the number of trainees who returned to their original units to carry out prenatal ultrasound examination, the average number of prenatal ultrasound examinations per month and the number of referrals to higher prenatal diagnosis centers of each trainee increased significantly ( P<0.05). Conclusion:The establishment of short-term training path for prenatal ultrasound diagnosis can effectively improve the professional theoretical knowledge and practical operation level of prenatal ultrasound doctors in primary hospitals, and greatly solve the problem of technical promotion under the shortage of grassroots hospitals.