Objective:To explore the possible pharmacodynamic material basis and mechanism of Shaogan Fuzi Decoction in the treatment of rheumatoid arthritis through ultra-high performance liquid chromatography-high-resolution tandem mass spectrometry (UPLC-HRMS/MS) combined with network pharmacology and molecular docking method.Methods:The blood components of Shaogan Fuzi Decoction were analyzed by UPLC-HRMS/MS; the targets of blood components in Shaogan Fuzi Decoction were predicted by PubChem database and Swiss Target Prediction database; DrugBank database, Therapeutic Target Database (TTD) and GeneCards database were used to screen rheumatoid arthritis-related targets, and Venn map of common targets was obtained; the protein interaction network was constructed by STRING database, and the key targets and key components were screened; GO function enrichment analysis and KEGG pathway enrichment analysis were performed by DAVID 6.8 database; the "blood component-target-pathway" network was constructed by Cytoscape 3.2.1 software; Autodock software was used to verify the molecular docking between the predicted key components and key targets in the network.Results:Totally 26 blood components of Shaogan Fuzi Decoction, 526 related targets, 478 related targets of rheumatoid arthritis, and 111 common targets were obtained; the key components such as tangeretin, kaempferol, glycyrrhetinic acid, liquiritigenin, quillaic acid and glabrolide were screened, which acted on key targets such as TNF, IL6, VEGFA, PTGS2, JUN and PPARG. They were mainly involved inflammatory response, steroid metabolic process, response to lipopolysaccharide, extracellular region, cytoplasm, RNA polymerase Ⅱ transcription factor activity, steroid bindingand other biological processes. It mainly regulated steroid hormone biosynthesis, PI3K-Akt signaling pathway, apoptosis, IL-17 signaling pathway, rheumatoid arthritisand other signaling pathways. Molecular docking results showed that the key components had good binding activity with key targets.Conclusion:Shaogan Fuzi Decoction may act on TNF, IL6, VEGFA, PTGS2, JUN, PPARG and other targets through tangeretin, kaempferol, glycyrrhetinic acid and other blood components to regulate PI3K-Akt and other signaling pathways, inhibiting cell proliferation and promoting apoptosis, reducing inflammation, to treat rheumatoid arthritis.

Objective:To explore the effect of the "trinity" training mode with curriculum training as the core, lecture training as supplement and community training as reinforcement, and to improve the health education ability of higher vocational nursing students.Methods:A total of 209 nursing students were selected as the research objects by random cluster sampling, and they were randomly divided into experimental group and control group. The experimental group adopted the "trinity" system to improve the health education ability of higher vocational nursing students, while the control group carried out the routine teaching. The health education ability of nursing students was evaluated by using the health education ability scale of nursing staff, and the nursing students of the experimental group were investigated by questionnaire. Statistics analysis was made by SPSS 15.0 software, the t test was conducted for analysis of measurement data, and Z test was used for counting data. Results:The health education ability of the nursing students in the experimental group was significantly higher than that of the control group ( P < 0.001). Nursing students in the experimental group generally had high recognition of the training mode of "trinity" system. The pass rate was 98.13%. Among them, 68.87% of the nursing students thought it would be a big gain to attend the special lectures; 69.81% of the nursing students thought it would be a big gain to participate in the community activities. Conclusion:The "trinity" health education ability training model can significantly improve the health education ability of higher vocational nursing students.

The surgical outcomes of robot-assisted radical prostatectomy have shown remarkable improvement over the last two decades since its advent, due to advances in surgical concepts, techniques, and equipment. Today, ongoing research aims to compare the benefits and drawbacks of various surgical approaches, such as anterior, posterior, lateral, transvesical, and transperineal approaches, in terms of tumor control, functional recovery, and complication reduction in order to achieve the goal of pentafecta (no postoperative complications and negative surgical margins in addition to trifecta) to the maximum extent. It is imperative to explore and integrate novel technologies such as 5G remote surgery and artificial intelligence into the clinical practice of robot-assisted radical prostatectomy while ensuring patient safety, which has immense potential for substantial benefits to patients with prostate cancer.

The surgical outcomes of robot-assisted radical prostatectomy have shown remarkable improvement over the last two decades since its advent, due to advances in surgical concepts, techniques, and equipment. Today, ongoing research aims to compare the benefits and drawbacks of various surgical approaches, such as anterior, posterior, lateral, transvesical, and transperineal approaches, in terms of tumor control, functional recovery, and complication reduction in order to achieve the goal of pentafecta (no postoperative complications and negative surgical margins in addition to trifecta) to the maximum extent. It is imperative to explore and integrate novel technologies such as 5G remote surgery and artificial intelligence into the clinical practice of robot-assisted radical prostatectomy while ensuring patient safety, which has immense potential for substantial benefits to patients with prostate cancer.

Background::Genetic variants of dopaminergic transcription factor-encoding genes are suggested to be Parkinson’s disease (PD) risk factors; however, no comprehensive analyses of these genes in patients with PD have been undertaken. Therefore, we aimed to genetically analyze 16 dopaminergic transcription factor genes in Chinese patients with PD.Methods::Whole-exome sequencing (WES) was performed using a Chinese cohort comprising 1917 unrelated patients with familial or sporadic early-onset PD and 1652 controls. Additionally, whole-genome sequencing (WGS) was performed using another Chinese cohort comprising 1962 unrelated patients with sporadic late-onset PD and 1279 controls.Results::We detected 308 rare and 208 rare protein-altering variants in the WES and WGS cohorts, respectively. Gene-based association analyses of rare variants suggested that MSX1 is enriched in sporadic late-onset PD. However, the significance did not pass the Bonferroni correction. Meanwhile, 72 and 1730 common variants were found in the WES and WGS cohorts, respectively. Unfortunately, single-variant logistic association analyses did not identify significant associations between common variants and PD. Conclusions::Variants of 16 typical dopaminergic transcription factors might not be major genetic risk factors for PD in Chinese patients. However, we highlight the complexity of PD and the need for extensive research elucidating its etiology.

Objective: To analyze the prevalence and related factors of pediatric flexible flatfoot (PFF) among 7-8 year old children in Changzhou, so as to provide a feasible basis for the prevention and treatment of PFF. Methods: From December 2023 to February 2024, a total of 1 685 children aged 7-8 from 10 primary schools in Changzhou were selected by stratified cluster random sampling method, and screened for PFF by using a foot optical assessment recording device. Information including sex, body mass index (BMI), diet, exercise and shoe wearing habits were collected. The valgus angle of the hindfoot was measured on the body surface by using an orthopedic measuring ruler in the standing position. Pain levels were evaluated by using visual analogue score (VAS) for children with flatfoot syndrome. Multivariate Logistic analysis was used to analyze related factors of PFF. Results: The overall detection rate of PFF was 27.4%, and there was a significant difference in the detection rate of PFF between boys and girls, with 30.3% and 24.1% respectively ( χ 2=7.96, P < 0.01 ). Most cases of PFF were mild flatfoot (60.8%) and bilateral ( 60.4% ). Approximately 13.2% of children with PFF had flatfoot syndrome, with a mean VAS of (2.86±0.73). About 56.1% of children with PFF had a normal valgus angle of the hindfoot. Sex, high BMI and preference for shoe last with front upturned shoe shape were positively correlated with the detection of PFF ( OR= 1.74, 1.54, 1.13, P <0.05). After stratified by sex, regular exercise in boys and age in girls were negatively correlated with the detection of PFF ( OR=0.40, 0.64, P <0.05). Conclusions The detection rate of PFF in 7-8 year old children is high. Additionally, PFF combined with flatfoot syndrome or valgus hindfoot is relatively rare and is likely to be underestimated, which emphasizes the importance of early detection and intervention for PFF.

CD47 is widely expressed on the cell surface, and combines with signal regulatory protein α (SIRPα) to transmit the "don't eat me" signal, which plays a key role in self-recognition and tumor immune escape. Studies have shown that the high expression of CD47 in different hematologic neoplasms is associated with the occurrence, progression and poor prognosis of tumors. As a new immune checkpoint, CD47 is gradually becoming an effective target for tumor immunotherapy. and various related preclinical and clinical studies for hematologic neoplasms are underway. This article summarizes the application of CD47 in hematologic neoplasms, in order to provide references for the treatment.

Objective:Efficacy and safety analysis of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) in promoting hematopoietic recovery after autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with lymphoma.Methods:A total of 149 patients after auto-HSCT in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled in this study from April 2016 to December 2021. There were 75 cases in the PEG-rhG-CSF group who were given a single subcutaneous dose of 100 μg/kg on the first day and +8 d, while 74 cases in the rhG-CSF group were given a dose of 5-10 μg·kg -1·d -1 by subcutaneous injection from +1d continuing to an absolute value of neutrophil (ANC) of more than 1.5×10 9/L. Results:①The time of grade 3/4 agranulocytosis and neutrophil implantation in the PEG-rhG-CSF group were significantly different from that in rhG-CSF group ( P=0.010, 0.030, 0.007) . There were no significant differences in the platelet implantation time, anemia incidence and duration, and platelet and red blood cell infusion within 1 month after transplantation between groups. ②The agranulocytosis with fever incidence in PEG-rhG-CSF group was similar to that in rhG-CSF group (84.0% vs 82.4% , P=0.798) , but the duration was shorter in the PEG-rhG-CSF group (4.0 d vs 5.5 d, P=0.005) . ③The incidence of infection in the PEG-rhG-CSF and the rhG-CSF groups were 22.7% (17/75) and 31.1% (23/74) , respectively ( P=0.247) , and the bloodstream infection incidence were 5.3% (4/75) and 9.5% (7/74) , respectively ( P=0.336) . ④The PEG-rhG-CSF group and rhG-CSF group’s mean length of hospital stay were 31.5 (23-43) days and 37 (25-75) days, respectively ( P<0.001) . ⑤The PEG-rhG-CSF group and rhG-CSF group’s disease-free survival rates were (96.4±2.5) % and (94.7±2.6) % ( P=0.638) , respectively, and the OS rates were 100.0% and (98.6±1.3) % ( P=0.312) , respectively. Conclusion:PEG-rhG-CSF application after auto-HSCT in patients with lymphoma can promote hematopoietic granulocyte reconstruction and shorten hospital stay, but has no significant effect on the incidence of infection, disease-free survival, and overall survival after transplantation.

Objective:To retrospectively analyze the clinical and pathologic characteristics, response to treatment, survival, and prognosis of patients with primary large B-cell lymphoma of the central nervous system (PCNSLBCL) .Methods:Clinical and pathologic data of 70 patients with PCNSLBCL admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2010 to November 2022 were collected for retrospective analysis. Survival analysis was performed using the Kaplan-Meier method and log-rank test, and prognosis analysis was conducted using the Cox proportional hazards model.Results:Among 70 patients with PCNSLBCL, complete remission (CRs) were achieved in 49 (70.0% ) and partial remission in 4 (5.7% ) after the first-line induction therapy; the overall remission rate was 75.7%. The 2-year progression-free survival (PFS) rate was 55.8% and the median progression-free survival (mPFS) time was 35.9 months, whereas the 2-year overall survival (OS) rate was 79.1% with a median OS time not reached. After CR induced by first-line therapy, cumulative incidence of relapse (CIR) was lower in patients who had received auto-HSCT than in those who had not received consolidation therapy ( P=0.032), whose 2-year PFS rate was 54.4% and mPFS time was 35.9 months; comparatively, the 2-year PFS rate in patients having received oral maintenance of small molecule drugs reached 84.4% with a mPFS time of 79.5 months ( P=0.038). Multivariant analysis demonstrated that Class 3 in the Memorial Sloan-Kettering Cancer Center (MSKCC) prognostic model is an independent adverse prognostic factor of OS in patients with PCNSLBCL ( HR=3.127, 95% CI 1.057-9.253, P=0.039) . Conclusions:In patients with PCNSLBCL achieving CR after the first-line induction therapy, auto-HSCT as consolidation therapy would lead to a decreased CIR, and PFS time could be prolonged by oral maintenance of small molecule drugs. Class 3 MSKCC prognostic model is independently associated with poorer OS.

As an interface between external electronic devices and internal neural nuclei, microelectrodes play an important role in many fields, such as animal robots, deep brain stimulation and neural prostheses. Aiming at the problem of high price and complicated fabrication process of microelectrode, a microelectrode twisting machine based on open source electronic prototyping platform (Arduino) and three-dimensional printing technology was proposed, and its microelectrode fabrication performance and neural stimulation performance were verified. The results show that during the fabrication of microelectrodes, the number of positive twisting turns of the electrode wire should generally be set to about 1.8 times of its length, and the number of reverse twisting rings is independent of the length, generally about 5. Moreover, compared with the traditional instrument, the device is not only inexpensive and simple to manufacture, but also has good expandability. It has a positive significance for both the personalization and popularization of microelectrode fabrication and the reduction of experimental cost.
Equipment Design ; Microelectrodes ; Printing, Three-Dimensional