Radiation-induced thrombocytopenia (RIT) faces a perplexing challenge in the clinical treatment of cancer patients, and current therapeutic approaches are inadequate in the clinical settings. In this research, oxymatrine, a new molecule capable of healing RIT was screened out, and the underlying regulatory mechanism associated with magakaryocyte (MK) differentiation and thrombopoiesis was demonstrated. The capacity of oxymatrine to induce MK differentiation was verified in K-562 and Meg-01 cells in vitro. The ability to induce thrombopoiesis was subsequently demonstrated in Tg (cd41:enhanced green fluorescent protein (eGFP)) zebrafish and RIT model mice. In addition, we carried out network pharmacological prediction, drug affinity responsive target stability assay (DARTS) and cellular thermal shift assay (CETSA) analyses to explore the potential targets of oxymatrine. Moreover, the pathway underlying the effects of oxymatrine was determined by Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, Western blot (WB), and immunofluorescence. Oxymatrine markedly promoted MK differentiation and maturation in vitro. Moreover, oxymatrine induced thrombopoiesis in Tg (cd41:eGFP) zebrafish and accelerated thrombopoiesis and platelet function recovery in RIT model mice. Mechanistically, oxymatrine directly binds to toll-like receptor 2 (TLR2) and further regulates the downstream pathway stimulator of interferon genes (STING)/nuclear factor-kappaB (NF-κB), which can be blocked by C29 and C-176, which are specific inhibitors of TLR2 and STING, respectively. Taken together, we demonstrated that oxymatrine, a novel TLR2 agonist, plays a critical role in accelerating MK differentiation and thrombopoiesis via the STING/NF-κB axis, suggesting that oxymatrine is a promising candidate for RIT therapy.

Carbamate pesticides, a new type of broad-spectrum pesticides for controlling pests, mites, and weeds, are developed to address the shortcomings of organochlorine and organophosphorus pesticides. Their widespread use and slow degradation have led to environmental pollution, causing damage to ecosystems and human health. Managing pesticide residues is a pressing issue in the current environmental protection. This study aims to investigate the expression of SyEst870, a member of the SGNH/GDSL hydrolase family in Sphingobium yanoikuyae, in a prokaryotic system and evaluate the ability of the recombinant protein to degrade carbamate pesticides. The prokaryotic expression vector pET-32a-SyEst870 was constructed and transformed into the Escherichia coli BL21 for heterologous expression. The purified protein was studied in terms of enzyme activity and effects of temperature, pH, and metal ions on the enzyme activity, with p-nitrophenol acetate as the substrate and based on the standard curve of p-nitrophenol. LC-MS (liquid chromatography-mass spectrometry) was employed to examine the degradation effects of SyEst870 on carbaryl, metolcarb, and isoprocarb. GC-MS (gas chromatography-mass spectrometry) was employed to detect the degradation products of SyEst870 for the three pesticides. The soluble protein SyEst870 was successfully obtained through the heterologous expression in Escherichia coli, which yielded an enzyme with the activity of 677.5 U after affinity chromatography. SyEst870 exhibited degradation rates of 82.34%, 84.43%, and 92.87% for carbaryl, metolcarb, and isoprocarb, respectively, at an initial concentration of 100 mg/L within 24 h at 30 ℃ and pH 7.0. The primary degradation products of carbaryl were identified as α-naphthol and methyl isocyanate. Metolcarb was mainly degraded into m-cresol and methyl isocyanate, and isoprocarb was mainly degraded into 2-isopropylphenol and methyl isocyanate. Compared with the half-life of carbamate pesticides in the natural environment, which ranges from a few days to several weeks, the recombinant protein SyEst870 can rapidly eliminate the residues of carbamate pesticides. This study lays a foundation for addressing pesticide residues in the environment and in fruits and vegetables.
Escherichia coli/metabolism* ; Sphingomonadaceae/genetics* ; Recombinant Proteins/metabolism* ; Biodegradation, Environmental ; Esterases/metabolism* ; Pesticides/isolation & purification* ; Carbamates/isolation & purification*

In response to the major national strategic needs of "Healthy China" and "Chengdu-Chongqing Economic Circle", and in strict accordance with the requirements of "New Medicine" construction, Chongqing University builds the medical discipline with a high starting point, develops high-quality medical education, and promotes the exploration and practice of elite education of clinical medical talents in the cross-disciplinary context of medicine and engineering. From the perspective of SWOT, this study analyzed the situations and trends of clinical medical education in "Double First Class" universities which newly established the medical discipline. Combined with the training model of clinical talent class in Chongqing University and the practices of "Four Capacity-Buildings", "Four Integration-Measures", and "Three Optimization-Mechanisms", we discuss the thoughts and strategies of cultivating clinical medical talents in the background of "New Medicine" construction and in the cross-disciplinary context of medicine and engineering.

This paper reviewed the concept of organizational silence, elaborated on the content, evaluation methods, reliability, validity, characteristics, and other aspects of nurse organizational silence assessment tools, and compares the basic characteristics, content, and application of each tool. The aim was to provide reference for selection of appropriate assessment tools to identify nurse organizational silence, as well as for the development of comprehensive assessment tools and the early formulation of management strategies.

Objective:To explore the effect of ultraviolet-C (UV-C) combined with Kangfuxin liquid wet compress and oxygen blowing method on the post chemotherapy oral mucositis (OM) in patients with hematological malignancies.Methods:From January 2022 to February 2023, convenience sampling was used to select 120 patients with post chemotherapy OM in the Department of Hematology of the Affiliated Huai'an First People's Hospital of Nanjing Medical University. The patients were randomly divided into a control group and an observation group, with 60 cases in each group. The control group received Kangfuxin liquid wet compress, while the observation group carried out a combination of UV-C irradiation and oxygen oral blowing method on the basis of the control group. This study compared the Visual Analogue Scale (VAS) score before and two days after treatment, the healing status of OM after treatment on the 5th day, and the healing time of OM between the two groups of patients.Results:A total of 108 patients completed the study, with 52 in the control group and 56 in the observation group. After two days of treatment, the VAS scores of both groups of patients were lower than those before treatment, and those of the observation group were lower than those of the control group, with statistically significant differences ( P<0.05). On the 5th day of treatment, the healing rate of OM in the observation group was higher than that in the control group, and the difference was statistically significant (χ 2=5.425, P<0.05). The healing time of OM in the observation group was shorter than that in the control group, and the difference was statistically significant ( t=2.458, P<0.05) . Conclusions:The combination of UV-C, Kangfuxin liquid and oxygen blowing method can alleviate pain, improve the healing rate of OM, and shorten the healing time of post chemotherapy OM in patients with hematological malignancies, which is worthy of clinical promotion.

Carbohydrates,with complex and diverse structures,exist widely in animals,plants,and microorganisms.Carbohydrates have a wide range of pharmacological activities,especially in anticoagulation,antithrombotic,blood lipid regula-tion,and immune function regulation.With the deepening of the research of carbohydrate drugs and the application of modern an-alytical technology,the detection of chemical structure,molecular weight and molecular weight distribution,and related sub-stances(impurities)of carbohydrate drugs has been developed rapidly.In this paper,the progress of carbohydrate drugs in ex-traction technology,separation and purification technology,composition analysis,content determination,and structural analysis in recent years was briefly reviewed,which provided some guidance for developing and quality control of carbohydrate drugs.

ObjectiveTo explore the distribution characteristics of traditional Chinese medicine （TCM） syndrome elements of macroangiopathy in patients with type 2 diabetes mellitus （T2DM） and the key elements of occurrence， development and progression of disease. MethodsA multicenter cross-sectional study was conducted to enroll 445 T2DM patients from five hospitals， and according to the presence or absence of macroangiopathy， the patients were divided into a T2DM group （120 cases） and a diabetic macroangiopathy （DM） group （325 cases）. Patients in DM group were divided into grade Ⅰ， Ⅱ， Ⅲ and Ⅳ according to the peripheral vascular color Doppler ultrasound results and the vascular anomalies classification standard. The general data including gender， age， duration of T2DM and body mass index （BMI） were collected， and the data of four examinations were obtained for syndrome differentiation. According to the diagnostic criteria of TCM syndrome elements， the patients can be divided into 9 patterns including qi deficiency， blood deficiency， yin deficiency， yang deficiency， qi stagnation， blood stasis， excess heat， and excess cold. The general data and distribution of TCM syndrome elements were compared between the two groups. The distribution of TCM syndrome elements in different vascular anomalies grades in the DM group was analyzed. Logistic regression analysis was used to explore the influence of various TCM syndrome elements on the occurrence of macroangiopathy in T2DM. ResultsThere was no significant difference in gender and BMI between groups （P＞0.05）. The age and duration of diabetes in the DM group were older and longer than those in the T2DM group （P＜0.01）. With the increase of age and prolonged course of disease， the severity of diabetic macroangiopathy increases gradually （P＜0.05 or P＜0.01）. There was no significant difference in BMI and course of disease among the different TCM syndrome elements （P＞0.05）. The average age of patients with blood stasis syndrome was the oldest （P＜0.05）. There was significant difference in gender distribution between the excess heat syndrome and yin deficiency syndrome （P＜0.05）. A total of 240 TCM syndrome elements were extracted from the T2DM group， while 731 TCM syndrome elements extracted from the DM group. The top two high-frequency syndrome elements in the two groups were qi deficiency and yin deficiency， with a frequency of larger than 50%. The distribution of phlegm-damp syndrome and blood-stasis syndrome were significantly higher in the DM group than in the T2DM group （P＜0.01）. There were significant differences in the distribution of qi deficiency syndrome， yin deficiency syndrome， phlegm-damp syndrome， blood stasis syndrome， and excess heat syndrome among different grades of vascular anomalies （P＜0.01）； qi deficiency and yin deficiency were both high-frequency TCM syndrome elements in patients at grades 0 to Ⅲ； phlegm-damp syndrome increased in frequency with the progression of the disease from grades 0 to Ⅳ， and the frequency of blood stasis syndrome showed an overall upward trend. The frequency of phlegm-dampness syndrome increased from grades 0 to Ⅳ with the progression of the disease， and the frequency of blood stasis syndrome showed an overall upward trend. Logistic regression analysis showed that phlegm-damp syndrome and blood stasis syndrome were important TCM syndrome elements related to the vascular anomalies degree of macrovascular disease in T2DM （P＜0.05 or P＜0.01）. ConclusionQi deficiency and yin deficiency are the basic TCM syndrome elements throughout the whole process of T2DM and diabetic macrovascular disease. Phlegm-damp and blood stasis are related to the degree of vascular anomalies in diabetic macrovascular disease and are the key TCM syndrome elements in the progression of macroangiopathy in T2DM.

Objective:To compare the efficacy of Solution-focused brief therapy (SFBT) and the conventional care in the improvement of the prognosis and mental state of patients with chronic bone infection.Methods:A retrospective cohort study was conducted to analyze the clinical data of 219 patients with chronic bone infection who were admitted to the First Affiliated Hospital of the Army Medical University from January 2018 to February 2019, including 172 males and 47 females, aged 15-65 years [(42.1±3.8)years]. Infection sites were the tibia in 144 patients and the femur in 75 patients. According to the classification of Cierny-Mader bone infection, there were 44 patients with type I (intramedullary bone infection), 57 with type II (superficial bone infection), 79 with type III (local bone infection), and 39 with type IV (diffuse bone infection). The patients were divided into conventional care group (admitted from January to July 2018, n=106) and SFBT group (admitted from August 2018 to February 2019, n=113) according to their admission time. The conventional care group received the conventional care, while the SFBT group underwent SFBT on the basis of the conventional care, with an intervention period of 6 months. The Hospital for Special Surgery (HSS) knee score, 36-item Short Form Health Survey (SF-36) for somatic, emotional, role and social function, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups before surgery, at discharge and at 6 months after surgery. The rates of satisfaction with the nursing care and bone healing were collected at the last follow-up. Results:All the patients were followed up for 12-36 months [(24.5±6.3)months]. The differences in HSS knee score, SF-36 for somatic, emotional, role, and social function scores, SAS score, and SDS score between the two groups were not statistically significant before surgery ( P>0.05). At discharge, the HSS knee score and SF-36 for somatic, emotional, role, and social function scores of the SFBT group were (68.6±6.9)points, (23.0±1.8)points, (23.2±1.6)points, (23.4±1.5)points, and (23.1±1.8)points respectively, which were all significantly higher than those of the conventional care group [(66.3±7.2)points, (19.7±3.3)points, (20.0±2.7)points, (19.8±3.2)points, and (20.5±2.7)points respectively] ( P<0.05); The SAS and SDS scores in the SFBT group were (40.9±6.2)points and (41.1±6.2)points respectively, which were both significantly lower than those in the conventional care group [(46.4±6.3)points and (47.3±6.4)points] ( P<0.05). At 6 months after surgery, the HSS knee score and SF-36 for somatic, emotional, role, and social function scores in the SFBT group were (81.6±6.7)points, (26.3±1.6)points, (27.9±1.4)points, (26.6±1.4)points, and (27.9±1.6)points respectively, which were all significantly higher than those in the conventional care group [(78.5±7.2)points, (17.4±2.9)points, (18.7±2.5)points, (18.3±3.0)points, and (20.0±2.5)points respectively] ( P<0.05 or 0.01); the SAS and SDS scores in the SFBT group were (32.8±4.8)points and (30.8±5.5)points respectively, which were significantly lower than those in the conventional care group [(44.2±5.5)points and (42.5±6.2)points] ( P<0.05). At the last follow-up in the conventional care group and the SFBT group, the rates of satisfaction with the nursing care were 66.0% (70/106) and 88.5% (100/113) respectively ( P<0.01), and the bone healing rates were 96.2% (102/106) and 94.7% (107/113) respectively ( P>0.05). Conclusion:Compared with the conventional care, SFBT for intervention to patients with chronic bone infection is a safe and effective mental nursing model which can improve the recovery of the function and the quality of the patients′ life, reduce their anxiety and depression, and enhance their satisfaction rate.

Objective To analyze the trajectory categories of fatigue development in middle-aged and elderly stroke patients and explore its influencing factors. Methods A convenient sampling method was used to select 230 middle-aged and elderly stroke patients in the Luzhou People's Hospital from January 2021 to January 2023 as the research subjects. A self-compiled general information-questionnaire, the Fatigue Severity Scale (FSS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI) were used to investigate the sociodemographic and clinical data, fatigue, sleep quality, and depression status of patients at 2 days after admission and 3 and 6 months after discharge. The latent growth curve model was used to fit the categories and trajectories of fatigue development, and the unordered multinomial Logistic regression model was used to analyze the influencing factors of trajectory categories of fatigue development. Results The fatigue development trajectory of middle-aged and elderly stroke patients showed three potential categories, namely the low-level fatigue stability group (33.04%), the medium-level fatigue rapid aggravation group (42.17%), and the high-level fatigue slow aggravation group (24.79%). The results of unordered multinomial Logistic regression analysis showed that age, marital status, education level, disease severity, the Activity of Daily Living (ADL) score, PSQI score, and BDI score were the influencing factors of fatigue development trajectory in middle-aged and elderly stroke patients (all P < 0.05). Conclusion The fatigue development trajectory of middle-aged and elderly stroke patients is heterogeneous. Nurses should understand the evolution characteristics of fatigue in different patients and implement targeted management measures according to patients'symptoms to improve their health outcomes.