Objective:To explore the protective effect of emodin on D-galactosamine (D-GalN)/lipopolysaccharide (LPS)-induced acute liver injury and its mechanism.Methods:A total of 40 male BALB/c mice were randomly (random number) divided into 5 groups ( n=8 in each group): the control group, the emodin group, the D-GalN/LPS group, the emodin+D-GalN/LPS group and the 3-MA+emodin+D-GalN/LPS group. D-GalN (700 mg/kg) and LPS (10 μg/kg) were intraperitoneally injected to induce acute liver injury in mice. Autophagy inhibitor 3-MA (15 mg/kg) and/or emodin (20 mg/kg) were intraperitoneally injected 30 min before the liver injury model. The animals were sacrificed under anaesthesia 6 h after D-GalN/LPS challenge, blood samples and liver tissues were collected. The levels of alanineaminotransferase (ALT) and aspartateaminotransferase (AST) in serum, and myeloperoxidase (MPO) activity of liver tissues were determined by colorimetric quantitative method; the levels of tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured by ELISA; the expression of LC3-II and Beclin 1 in the liver tissues were evaluated by Western blot; the pathological changes of liver was evaluated by HE staining. Animal survival rate was also analyzed. The one-way ANOVA was use to compare quantitative data, SNK- q test was used for pairwise comparison between two groups, and Games-Howell test was used when homogeneity of variance were not met. Results:Compared with the control group, the levels of ALT, AST, TNF-α, IL-6 and MPO activity [(2 476.80 ± 263.14) U/L, (271.71 ± 47.15) U/L, (537.92 ± 89.35) pg/mL, (169.74 ± 25.52) pg/mL, and (1.37 ± 0.22) U/mg] were obviously increased in the D-GalN/LPS group ( P<0.05). Compared with the D-GalN/LPS group, the levels of ALT, AST, TNF-α, IL-6 and MPO activity [(1 248.01 ± 380.70) U/L, (142.59 ± 34.63) U/L, (288.91 ± 67.21) pg/mL, (61.83 ± 13.64) pg/mL, and (0.80 ± 0.21) U/mg] were obviously decreased in the emodin+ D-GalN/LPS group ( P<0.05). Compared with the D-GalN/LPS group, the histopathological abnormalities in liver tissue were significantly alleviated and the survival rate of mice was improved in the emodin+ D-GalN/LPS group. Compared with the control group, the expression of LC3-II and Beclin1 was decreased in the liver tissue in the D-GalN/LPS group, while compared with the D-GalN/LPS group, the expression of LC3-II and Beclin1 was increased in the emodin+ D-GalN/LPS group. With co-administration of 3-MA, the protective effects of emodin in acute liver injury were reversed, the levels of AST, ALT, TNF-α, IL-6, and MPO [(2 398.78 ± 233.57) U/L, (242.79 ± 43.46) U/L, (505.07 ± 67.89) pg/mL, (151.46 ± 14.11) pg/mL, and (1.27 ± 0.15) U/mg] were increased, and the pathological damage of liver tissue was aggravated. Conclusions:Emodin alleviates D-GalN/LPS-induced acute liver injury in mice, which may be related to the activation of protein LC3-II, Beclin1 and restored autophagy.

Objective:To understand the attitude, practice status and influencing factors of obstetric medical staff on sexual health care during pregnancy, and to provide reference for carrying out sexual education and training during pregnancy.Methods:A self-designed questionnaire on attitude and practice of obstetric medical staff towards sexual health care during pregnancy was used to investigate 462 obstetric medical staff in Guangdong Province from July to August, 2021,and the influencing factors were analyzed.Results:The attitude score of sexual health care during pregnancy among obstetric medical staff was (29.87 ± 5.96) points, and the practice score was (13.61 ± 1.23) points. Profession and hospital level affected obstetric medical staff′s attitude towards sexual health care during pregnancy ( P<0.05); profession, title and hospital level affected obstetric medical staff′s practice in providing pregnancy sexual health care ( P<0.05). Conclusions:Obstetric medical staff have a negative attitude towards sexual health care during pregnancy, and their active sexual health care behaviors need to be improved. Medical schools and work units need to strengthen the training and management of obstetric-related and reproductive health knowledge and skills to promote the effectiveness of pregnancy sexual education implementation and promotion.

Objective:To evaluate the safety and clinical efficacy of primary suturing of dog bite injuries on the head and face.Methods:A total of 42 cases with the dog bite injuries of Grade Ⅲ rabies exposure on the head and face(20 females and 22 males, aged from 1 to 81) were enrolled from October 2015 to October 2018 at the Department of Plastic Surgery, The Second People’s Hospital of Gansu Province. The primary suturing was performed after meticulous wound debridement and sufficient irrigation, the patients who were under 11 years old only received rabies vaccine for the rabies post-exposure prophylaxis, whereas the others were reinforced with tetanus antitoxin (1 500 IU) and human rabies immunoglobulin (20 IU/kg) around the wound, followed by Dermatix anti-scarring treatment for at least one year. Post-operative observation included wound healing and potential complications. All patients were followed up for facial deformities and bilateral symmetry, and the scars were assessed using the Vancouver Scar Scale (VSS).Results:Among the 42 cases, 38 cases (90.4%) were Class-A healed, 2 cases (4.8%) were Class-B healed (one of the two cases had a mandibular wound deep in the muscular layer. A deep abscess appeared in the neck 10 days after surgery, and was cured after puncture and drainage), and 2 cases (4.8%) were Class-C healed. Thirty-two patients had fever to different extent 2 to 5 days after surgery, and their body temperatures were below 38.5 ℃. The body temperature returned to normal after 1 to 2 days. During 6-24 months of follow-up, no tetanus and rabies occurred in all cases. During 1 to 2 years of follow-up, 1 of 42 cases had asymmetrical cheek 1 year post-operation. 1 case had scars on the upper eyelid 1 year after operation, and both eyes were asymmetric when eyes were open. Other 40 cases were recovered with bilateral symmetry without dysfunction of opening and closing the mouth and eyes. Facial contour recovery was cosmetically satisfactory with VSS score 1-3.Conclusions:Primary suturing of dog bite injuries on the head and face, according to the rabies prevention and treatment guideline, is a safe and effective treatment. It prevents rabies, and facial deformities and severe scar deformity in patients.

Objective:To evaluate the safety and clinical efficacy of primary suturing of dog bite injuries on the head and face.Methods:A total of 42 cases with the dog bite injuries of Grade Ⅲ rabies exposure on the head and face(20 females and 22 males, aged from 1 to 81) were enrolled from October 2015 to October 2018 at the Department of Plastic Surgery, The Second People’s Hospital of Gansu Province. The primary suturing was performed after meticulous wound debridement and sufficient irrigation, the patients who were under 11 years old only received rabies vaccine for the rabies post-exposure prophylaxis, whereas the others were reinforced with tetanus antitoxin (1 500 IU) and human rabies immunoglobulin (20 IU/kg) around the wound, followed by Dermatix anti-scarring treatment for at least one year. Post-operative observation included wound healing and potential complications. All patients were followed up for facial deformities and bilateral symmetry, and the scars were assessed using the Vancouver Scar Scale (VSS).Results:Among the 42 cases, 38 cases (90.4%) were Class-A healed, 2 cases (4.8%) were Class-B healed (one of the two cases had a mandibular wound deep in the muscular layer. A deep abscess appeared in the neck 10 days after surgery, and was cured after puncture and drainage), and 2 cases (4.8%) were Class-C healed. Thirty-two patients had fever to different extent 2 to 5 days after surgery, and their body temperatures were below 38.5 ℃. The body temperature returned to normal after 1 to 2 days. During 6-24 months of follow-up, no tetanus and rabies occurred in all cases. During 1 to 2 years of follow-up, 1 of 42 cases had asymmetrical cheek 1 year post-operation. 1 case had scars on the upper eyelid 1 year after operation, and both eyes were asymmetric when eyes were open. Other 40 cases were recovered with bilateral symmetry without dysfunction of opening and closing the mouth and eyes. Facial contour recovery was cosmetically satisfactory with VSS score 1-3.Conclusions:Primary suturing of dog bite injuries on the head and face, according to the rabies prevention and treatment guideline, is a safe and effective treatment. It prevents rabies, and facial deformities and severe scar deformity in patients.

Objective:To investigate the role and mechanism of vitamin D(VD)in renal ischemia-reperfusion(I/R group)injury.Methods:Forty-eight male C57BL/6J mice were divided into four groups:Sham operation group(Sham group),active VD analog alfacalcidol treatment group(VD group),renal ischemia-reperfusion injury group(I/R group)and alfacalcidol treated I/R group(I/R+VD group).After 24 h renal I/R injury,mice in each group were sacrificed,and peripheral blood was collected to detect the levels of blood urea nitrogen(BUN),serum creatinine(SCr)and inflammatory factors IL-1β,IL-18 and tumor necrosis factor-α(TNF-α).The renal tissues of mice in each group were collected,the apoptosis level of renal tissues was detected by TUNEL staining,and the positive expression rate of NLRP3 was detected by IHC.Western blot was used to detect the NLRP3 inflammasome associated factors NLRP3,GSDMD-N,cleaved Caspase-1,IL-1β and NF-κB p65,IκBα in renal tissues of mice in each group.Results:Com-pared with Sham group,there was no significant difference in serum BUN,SCr,IL-1β,IL-18 and TNF-α levels in VD group(P>0.05),significantly increased in I/R group and I/R+VD group(P<0.05).Compared with I/R group,BUN,SCr,IL-1β,IL-18 and TNF-α were significantly decreased in I/R+VD group(P<0.05).Compared with Sham group,the positive rate of TUNEL and NLRP3 expression in renal tissues of mice in VD group had no significant difference(P>0.05),the positive rate of TUNEL and NLRP3 expres-sion in renal tissues of mice in I/R group and I/R+VD group were significantly increased(P<0.01),while the positive rate of TUNEL and NLRP3 expression in I/R+VD group were significantly decreased(P<0.05).Western blot results showed that compared with Sham group,there was no significant difference in protein expression levels of NLRP3,GSDMD-N,cleaved Caspase-1,IL-1β,NF-κB P65,IκBα in VD group(P>0.05).The protein expression of IκBα in I/R group and I/R+VD group was significantly decreased(P<0.05),while the other protein expression levels were significantly increased(P<0.05).Compared with the I/R group,the expression levels of NLRP3,GSDMD-N,cleaved Caspase-1,IL-1β and NF-κB p65 were significantly decreased in the I/R+VD group(P<0.05),while the expression level of IκBα was significantly decreased(P<0.05).Conclusion:VD plays a protective role in I/R injury by inhibiting NF-κB mediated activation of NLRP3 inflammasome.

Objective To explore the practice and effect of peer education in improving the empathic ability of in-service nurses. Methods A total of 122 in-service nurses at a tertiary hospital scoring below 60％ in empathy ability, were randomly divided into a control group and a research group by data table method. The nurses in the control group received theoretical training in empathy, and the nurses in the research group participated in peer-educated periodic empathy training activities. The Chinese version of interpersonal response index scale ( IRI-C) , nurses'humanistic care quality table, general self-efficacy scale were used before and after intervention. Results Before the intervention, the scores of the two groups of Chinese version of interpersonal response index scale ( IRI-C) , perspective-taking ( PT) , Fantasies ( FS) , empathic concern (EC) and Personal Distress (PD) were not statistically significant (P >0. 05). After intervention, the scores of the two groups of Chinese version of interpersonal response index scale ( IRI-C) , Fantasies ( FS) and Personal Distress ( PD) scores in the research group were all higher than those in the control group (P<0. 05). There was no significant difference in the scoring before and after intervention in the control group (P>0. 05). The total score and personal pain (PD) dimensions of the Chinese version of interpersonal response index scale ( IRI-C) were significantly higher than those before the intervention ( P<0. 01). The total score of nurses' humanistic care quality, the score of humanistic care ability and humanistic care perception were all higher than those before intervention in the study group (P<0. 05), and differences are statistically significant. Conclusions The practice of peer-education empathy training can effectively improve the empathy and humanistic care quality of the in-service nurses, and improve the nursing service level.

Objective:To explore the clinical features and genetic etiology for a child with developmental delay, impaired growth, facial dysmorphism, and axonal neuropathy (DIGFAN).Methods:A child who was admitted to the Second Affiliated Hospital of Guangxi Medical University on March 22, 2021 was selected the study subject. Clinical data of the child was collected. Following extraction of genomic DNA, the child and his parents were subjected to whole exome sequencing (WES), and candidate variant was verified by Sanger sequencing and bioinformatic analysis.Results:The child, a 10-year-and-9-month-old boy, had manifested with short stature, intellectual disability, delayed speech, motor and language development, and facial dysmorphism. WES and Sanger sequencing revealed that he has harbored a novel de novo c. 800T>C (p.Leu267Pro) variant of the MORC2 gene. The Leucine at position 267, which is highly conserved among various species, is located in the S5 domain of ribosome protein in the ATPase binding region of MORC2. And the Leu267Pro may affect the function of MORC2 by altering the spatial conformation and activity of ATPase. Based on the guidelines from the American College of Medical Genetics and Genomics, the c. 800T>C variant was classified as likely pathogenic (PS2+ PM2_Supporting+ PP2+ PP3). Conclusion:The MORC2: c. 800T>C (p.Leu267Pro) variant probably underlay the pathogenesis of DIGFAN syndrome in this child.

Objective:To evaluate the drug-drug interactions and the tolerability of combined medication between yimitasvir phosphate capsules with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets in healthy volunteers.Methods:A randomized, open, and continuous administration design was used in trial 1 (yimitasvir phosphate capsules with sofosbuvir tablets). 28 subjects were randomly divided into two groups. A non-randomized, open design was used in trial 2 (yimitasvir phosphate capsules with omeprazole magnesium enteric-coated tablets), and included 42 subjects divided into three groups. The open design method was used in trial 3 (yimitasvir phosphate capsules with rosuvastatin calcium tablets), and included 14 subjects. The plasma concentrations of yimitasvir phosphate, sofosbuvir and their main metabolites GS-331007, omeprazole and rosuvastatin were validated by a liquid chromatography/tandem mass spectrometry (LC-MS/MS). The pharmacokinetic parameters were calculated by Phoenix winNonlin software.Results:(1) in trial 1, after single and co-administration, the 90% CI of sofosbuvir C max and AUC 0-tau geometric mean ratio (GMR) were 152.0% (118.0% ~ 197.0%) and 230.0% (184.0% ~ 287.0%), with an increase of 52.0% and 130.0% compared to single dose of sofosbuvir, respectively. The 90% CI of GS-331007 C max GMR was 74.0% (67.5% ~ 81.2%) and reduced by 26% compared to single dose of sofosbuvir. (2) in trial 2, the 90% CI of C max GMR after yimitasvir single or co-administration at the same time, with a 4-hours interval, or with a 12- hours interval were 68.9% (44.5% ~ 106.7%) , 64.0% (43.8% ~ 93.6%) and 56.4%(38.9% ~ 81.9%), and the 90% CI of AUC 0-t GMR were 68.6% (46.5% ~ 101.2%), 68.3% (47.6% ~ 98.0%) and 60.5% (41.8% ~ 87.5%), respectively. Compared with single dose of yimitasvir, the C max and AUC 0-t were decreased by 31.1% and 31.4%, 36.0% and 31.7%, 43.6% and 39.5%, respectively. (3) In trial 3, after single and co-administration, the 90% CI of rosuvastatin C max and AUC 0-72 GMR were 172.4% (153.6% ~ 193.5%) and 158.0% (144.3% ~ 172.9%), respectively, with an increase of 74.9% and 60.5% compared to single dose of rosuvastatin. There were no serious adverse events and adverse events leading to withdrawal from the trial. Conclusion:Yimitasvir phosphate capsules have drug-drug interactions with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets.

Hepatic ischemia/reperfusion injury (HIRI) is a serious complication that occurs following shock and/or liver surgery. Gut microbiota and their metabolites are key upstream modulators of development of liver injury. Herein, we investigated the potential contribution of gut microbes to HIRI. Ischemia/reperfusion surgery was performed to establish a murine model of HIRI. 16S rRNA gene sequencing and metabolomics were used for microbial analysis. Transcriptomics and proteomics analysis were employed to study the host cell responses. Our results establish HIRI was significantly increased when surgery occurred in the evening (ZT12, 20:00) when compared with the morning (ZT0, 08:00); however, antibiotic pretreatment reduced this diurnal variation. The abundance of a microbial metabolite 3,4-dihydroxyphenylpropionic acid was significantly higher in ZT0 when compared with ZT12 in the gut and this compound significantly protected mice against HIRI. Furthermore, 3,4-dihydroxyphenylpropionic acid suppressed the macrophage pro-inflammatory response in vivo and in vitro. This metabolite inhibits histone deacetylase activity by reducing its phosphorylation. Histone deacetylase inhibition suppressed macrophage pro-inflammatory activation and diminished the diurnal variation of HIRI. Our findings revealed a novel protective microbial metabolite against HIRI in mice. The potential underlying mechanism was at least in part, via 3,4-dihydroxyphenylpropionic acid-dependent immune regulation and histone deacetylase (HDAC) inhibition in macrophages.