BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.

BACKGROUND:The imbalance between bone resorption and bone formation in microgravity environments leads to significant bone loss in astronauts.Current research indicates that bone loss under microgravity conditions is the result of the combined effects of various cells,tissues,and systems. OBJECTIVE:To review different biological effects of microgravity on various cells,tissues,or systems,and summarize the mechanisms by which microgravity leads to the development of osteoporosis. METHODS:Databases such as PubMed,Web of Science,and the Cochrane Database were searched for relevant literature from 2000 to 2023.The inclusion criteria were all articles related to tissue engineering studies and basic research on osteoporosis caused by microgravity.Ultimately,85 articles were included for review. RESULTS AND CONCLUSION:(1)In microgravity environment,bone marrow mesenchymal stem cells tend to differentiate more into adipocytes rather than osteoblasts,and hematopoietic stem cells in this environment are more inclined to differentiate into osteoclasts,reducing differentiation into the erythroid lineage.At the same time,microgravity inhibits the proliferation and differentiation of osteoblasts,promotes apoptosis of osteoblasts,alters cell morphology,and reduces the mineralization capacity of osteoblasts.Microgravity significantly increases the number and activity of osteoclasts.Microgravity also hinders the differentiation of osteoblasts into osteocytes and promotes the apoptosis of osteocytes.(2)In a microgravity environment,the body experiences changes such as skeletal muscle atrophy,microvascular remodeling,bone microcirculation disorders,and endocrine disruption.These changes lead to mechanical unloading in the bone microenvironment,insufficient blood perfusion,and calcium cycle disorders,which significantly impact the development of osteoporosis.(3)At present,the mechanism by which microgravity causes osteoporosis is relatively complex.A deeper study of these physiological mechanisms is crucial to ensuring the health of astronauts during long-term space missions,and provides a theoretical basis for the prevention and treatment of osteoporosis.

Objective To systematically evaluate the efficacy and safety of single and bilateral lung transplantation in the treatment of end-stage chronic obstructive pulmonary disease (COPD). Methods Chinese and English databases were searched by computer, including PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang database, VIP database and CBM. Case-control studies on single lung transplantation or bilateral lung transplantation for COPD were collected from the inception to July 31, 2022. We evaluated the quality of the literature via Newcastle-Ottawa Scale (NOS). All results were analyzed using Review Manager V5.3 and STATA 17.0. Results A total of 8 studies were included covering 14076 patients, including 8326 patients in the single lung transplantation group and 5750 patients in the bilateral lung transplantation group. NOS scores were≥6 points. The results of meta-analysis showed that there was no statistical difference in the postoperative 1-year survival between the two groups (P=0.070). The 2-year survival rate (P=0.002), 3-year survival rate (P<0.001), 5-year survival rate (P<0.001), overall survival rate (P＜0.001), postoperative forced expiratory volume in one second/predicted value (P<0.001), postoperative forced vital capacity (P<0.001), and postoperative 6-minute walking distance (P=0.002) were lower or shorter than those in the bilateral lung transplantation group, the postoperative intubation time (P=0.030) was longer than that in the bilateral lung transplantation group. Bilateral lung transplantation group showed better surgical results. There was no statistical difference in the mortality, obliterative bronchiolitis, length of hospitalization, primary graft dysfunction, or postoperative adverse events (P>0.05). Conclusion Bilateral lung transplantation is associated with better long-term survival and postoperative lung function compared with single lung transplantation. In-hospital mortality and postoperative complications are similar between them.

Chronic prostatitis is a common and frequently occurring disease in male clinics. Due to the diverse symptoms， complex etiology， unclear mechanisms， and recurrent episodes of chronic prostatitis， Western medicine often faces the challenge of limited treatment options and unsatisfactory outcomes. In order to fully leverage the unique advantages of traditional Chinese medicine （TCM） in the treatment of chronic prostatitis， the China Association of Chinese Medicine organized a discussion among experts from the fields of TCM urology， Western urology， and related pharmacy. The experts focused on the advancements in the understanding of chronic prostatitis in modern medicine， various theories on the etiology， pathogenesis， and treatment of chronic prostatitis in TCM， entry points from interdisciplinary fields， the role and advantages of TCM in the comprehensive management of chronic prostatitis， and research into mechanisms related to chronic prostatitis. After discussions， the experts concluded that chronic prostatitis is one of the diseases where TCM has a distinct advantage. TCM can effectively improve the clinical syndromes of chronic prostatitis， including urinary issues， social psychology， organ specificity， infection， nervous system problems， pain and discomfort， sexual dysfunction， etc.， and can enhance the quality of life. For patients with chronic prostatitis who cannot tolerate or may not accept the adverse effects of Western medicine， as well as for those with non-inflammatory chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）， those with pain as the primary symptom， those with urinary tract symptoms， those with coexisting anxiety and depression， and those with abnormal semen liquefaction， TCM-based treatment can be the main approach. Currently， the optimal diagnosis and treatment strategy for chronic prostatitis has not yet been established， and further research from perspectives such as clinical epidemiology， evidence-based medicine， and molecular biology is needed. Both TCM and Western medicine should integrate their respective strengths， clarify the role and advantages of TCM interventions based on mutual reference， and improve the diagnosis and treatment standards for chronic prostatitis in China.

【Objective】 To identify the best surgical treatment for patients with calculous pyonephrosis by evaluating the clinical effectiveness of percutaneous nephrolithotripsy (PCNL) in stageⅠ, percutaneous nephrostomy (PCN) in stageⅠ, and percutaneous nephrolithotripsy in stageⅡ. 【Methods】 For publications published between Jan.2012 and Oct.2022, we thoroughly examined the databases of PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, Wanfang, and VIP.We then chosed the literature based on the inclusion and exclusion criteria.After data were retrieved and literature quality was assessed, Review Manager software (RevMan 5.4.3, Cochrane Collaboration, Oxford, UK) was utilized to Meta-analysis. 【Results】 Out of 688 participants across 105 researches, we chosed 11 trials.Among them, 341 patients received both stageⅠPCN and stage ⅡPCNL (hereinafter referred to as phase ⅡPCNL), while 347 patients received stageⅠPCNL.According to the results of the Meta-analysis, there was no discernible difference between stage Ⅰ PCNL and stage Ⅱ PCNL in terms of stone clearance rate (P=0.95), operation duration (P=0.48), postoperative septic shock (P=0.36), or perirenal effusion infection (P=0.27).There were significant differences between stage Ⅰ PCNL and stage Ⅱ PCNL in fever (P=0.03), indwelling nephrostomy tube time (P=0.01), hospitalization costs (P=0.01), hospitalization time (P=0.01), and postoperative hospitalization time (P=0.02).The following two regimens were comparable in terms of stone clearance rate, operating time, postoperative perirenal effusion infection, and septic shock for patients with calculous pyonephrosis.Despite the fact that there were more patients who developed fever after stage ⅠPCNL, hospitalization costs were lower, indwelling nephrostomy tube time, overall hospitalization time, and postoperative hospitalization time were all reduced. 【Conclusion】 ⅠPCNL was affordable, safe, and successful for treating renal and upper ureteral calculi with pyonephrosis, and it had some promotional value in clinical practice.

BACKGROUND:Total knee arthroplasty is an effective treatment for late-stage osteoarthritis,but postoperative pain and joint function recovery are the main challenges.Nerve block and mixed drug injection are two common pain relief methods,but the effect of their combined use is still unclear. OBJECTIVE:To investigate the effects of ultrasound-guided continuous adductor canal block+single sciatic nerve block+"cocktail"mixed drug analgesia on postoperative pain relief and joint function recovery in total knee arthroplasty. METHODS:120 patients with osteoarthritis admitted to Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from January to May 2022 were randomly divided into two groups(n=60).The observation group received ultrasound-guided continuous adductor canal block+single sciatic nerve block+"cocktail"mixed drug analgesia.The control group received ultrasound-guided continuous adductor canal block+single sciatic nerve block.The differences in visual analog scale score,hospital for special surgery score,pain mediators,expression levels of inflammatory factors,the occurrence of adverse reactions,and postoperative barehanded muscle strength test were compared between the two groups. RESULTS AND CONCLUSION:(1)The visual analog scale scores at rest and exercise were lower in the observation group than those in the control group at 6,8,12,24,48,and 72 hours postoperatively(P<0.05).(2)Hospital for special surgery scores at 1 and 3 months postoperatively were significantly higher in the observation group than those in the control group(P<0.05).(3)In terms of pain mediators and inflammatory factors,the expression levels were significantly lower in the observation group than those in the control group(P<0.05).(4)There was no statistically significant difference in terms of adverse effects and postoperative barehanded muscle strength examination between the two groups(P>0.05).(5)In total knee arthroplasty,ultrasound-guided continuous adductor canal block and single sciatic nerve block,together with a"cocktail"mixed drug analgesia injected into the joint cavity,can provide excellent analgesia,facilitate the recovery of joint function,and relieve postoperative pain and inflammation with a high degree of safety.

BACKGROUND:Fluid shear stress plays an important role in osteoblast proliferation and apoptosis.However,whether Caveolin-1 is involved in the process of fluid shear stress-induced proliferation and apoptosis in osteoblasts is unknown. OBJECTIVE:To explore the role of Caveolin-1 in fluid shear stress-regulated osteoblast proliferation and apoptosis. METHODS:The MC3T3-E1 osteoblasts in good growth status were selected and loaded with fluid shear stress at an intensity of 1.2 Pa for different times(0,30,60,90 minutes).The expression of Caveolin-1 protein was observed and conditions with a time of 60 minutes were screened for the experiment.MC3T3-E1 cells were divided into control group,fluid shear stress group,fluid shear stress+pcDNA 3.1 group(control),fluid shear stress+pcDNA Cav-1 group(plasmid overexpression),and intervened with fluid shear stress and overexpression of Cav-1,respectively.The expression of molecules related to proliferation and apoptosis in MC3T3-E1 cells was detected by qRT-PCR and western blot.In addition,the proliferative activity of MC3T3-E1 cells was detected by cell counting kit-8 and EdU assay;and cell apoptosis was detected by Hoechst 33258 and flow cytometry. RESULTS AND CONCLUSION:The expression of Caveolin-1 in MC3T3-E1 cells was significantly down-regulated after loading fluid shear stress,and the expression level was lowest after 60 minutes.Overexpression of Caveolin-1 attenuated the proliferation-promoting and apoptosis-suppressing effects of fluid shear stress in MC3T3-E1 cells.In conclusion,Caveolin-1 has a vital role in fluid shear stress-regulated osteoblast proliferation and apoptosis,which may offer a potential therapeutic strategy for osteoporosis.

The high-quality development requirements for public hospitals,national examination orientations,and DIP medical insurance payment reforms present significant challenges to the refined management of public hospitals.Therefore,it is essential to enhance the operational management of these institutions.This paper aims to develop an operation evaluation index system for clinical departments using the Delphi method for assessing the efficiency of resource input and output across various clinical departments.It provides a scientific basis for decision-making regarding resource allocation,transformation towards re-fined management,and the enhancement of operational guidance for departments.

A major impedance to neuronal regeneration after peripheral nerve injury(PNI)is the activation of various programmed cell death mechanisms in the dorsal root ganglion.Ferroptosis is a form of pro-grammed cell death distinguished by imbalance in iron and thiol metabolism,leading to lethal lipid peroxidation.However,the molecular mechanisms of ferroptosis in the context of PNI and nerve regeneration remain unclear.Ferroportin(Fpn),the only known mammalian nonheme iron export protein,plays a pivotal part in inhibiting ferroptosis by maintaining intracellular iron homeostasis.Here,we explored in vitro and in vivo the involvement of Fpn in neuronal ferroptosis.We first delineated that reactive oxygen species at the injury site induces neuronal ferroptosis by increasing intracellular iron via accelerated UBA52-driven ubiquitination and degradation of Fpn,and stimulation of lipid peroxidation.Early administration of the potent arterial vasodilator,hydralazine(HYD),decreases the ubiquitination of Fpn after PNI by binding to UBA52,leading to suppression of neuronal cell death and significant ac-celeration of axon regeneration and motor function recovery.HYD targeting of ferroptosis is a promising strategy for clinical management of PNI.

A spatial-temporal convolutional neural network-based method is proposed for schizophrenia classification.Unlike the mainstream methods that only analyze the temporal frequency features in EEG and ignore the spatial features between brain regions,the model mainly obtains the spatial-frequency features by convolving the adjacency matrix composed of wavelet coherence coefficients between different channels and EEG sequences,and then extracts the temporal-frequency features through one-dimensional temporal convolution.The processed matrix is flattened after multiple convolutions and input to the classification model.Experimental results show that the method has a classification accuracy of 96.32%on the publicly available dataset Zenodo,demonstrating its effectiveness and exhibiting the advantages of fusing temporal-frequency and spatial-frequency features for schizophrenia diagnosis.