Objective:To investigate the protective effect of Akebia saponin D(ASD)on non-alcoholic fatty liver disease(NAFLD)in rats by regulating IL-6/STAT3 axis.Methods:Fifty SD rats were separated into control group,model group,low dose ASD group(ASD 20 mg/kg),high dose ASD group(ASD 40 mg/kg)and inhibitor group(ASD 40 mg/kg+IL-6/STAT3 signal pathway inhibitor LMT-28 3 mg/kg),with 10 rats in each group.Rats in control group were fed with standard diet,while the other four groups were fed with high fat and high sugar diet.All rats were fed for 6 consecutive weeks,and the corresponding dose of drugs was injected intraperitoneally from the 7th week,which were given drugs for 8 consecutive weeks.All rats were weighed to calculate liver index;levels of serum total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and triglyceride(TG)were mea-sured by automatic biochemical analyzer;HE staining was used to observe pathological changes of rats liver;oil red staining was used to observe lipid accumulation in rats liver;expressions of IL-6,JAK1,STAT3 in rats liver were detected by qRT-PCR;Western blot was used to detect expressions of IL-6,JAK1,p-JAK1,STAT3 and p-STAT3 proteins.Results:Compared with control group,hepatocytes in liver tissue of model group were swollen,accompanied by many ballooning changes,severe cytoplasmic vacuolization,the structure of hepatic lobule was unclear,and accompanied by inflammatory cell infiltration,and obvious red granular lipid droplets occupied most of the cytoplasm,body mass,liver index,levels of serum TC,ALT,AST,TG,expressions of IL-6,JAK1,STAT3 mRNAs,and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue of rats were obviously increased(P<0.05);compared with model group,damage of hepatic lobule structure in low and high doses ASD groups were reduced,swelling and vacuolization of liver cells were reduced,and accumulation of lipid droplets in liver tissue was obviously reduced.Body mass,liver index,levels of serum TC,ALT,AST and TG in rats were obviously decreased(P<0.05),while expressions of IL-6,JAK1,STAT3 mRNAs and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue were further increased(P<0.05);LMT-28,an inhibitor of IL-6/STAT3 signaling pathway,attenuated the liver protective effect of ASD on NAFLD rats.Conclusion:ASD can protect liver of NAFLD rats by activating IL-6/STAT3 signaling pathway.

Inguinal hernia is one of the most prevalent general surgical conditions affecting the elderly population.Currently, open or laparoscopic surgical repair represents the only curative approach.Among various surgical techniques, tension-free hernia repair via the preperitoneal space effectively addresses the complications associated with traditional surgical methods, such as excessive tension in the surgical area, postoperative pain and discomfort, and a subsequent decline in patients' quality of life.Nevertheless, a certain recurrence rate persists.This paper aims to highlight the insufficient research on preperitoneal hernia repair procedures within the field of hernia surgery and to conduct a comprehensive analysis of the primary factors contributing to postoperative recurrence.This analysis will be approached from three key perspectives: medical origins, individual patient variability, and the characteristics of the patch used.The goal is to provide a foundation for the theoretical framework and practical strategies aimed at reducing postoperative recurrence rates.

Objective:To investigate the protective effect of Akebia saponin D(ASD)on non-alcoholic fatty liver disease(NAFLD)in rats by regulating IL-6/STAT3 axis.Methods:Fifty SD rats were separated into control group,model group,low dose ASD group(ASD 20 mg/kg),high dose ASD group(ASD 40 mg/kg)and inhibitor group(ASD 40 mg/kg+IL-6/STAT3 signal pathway inhibitor LMT-28 3 mg/kg),with 10 rats in each group.Rats in control group were fed with standard diet,while the other four groups were fed with high fat and high sugar diet.All rats were fed for 6 consecutive weeks,and the corresponding dose of drugs was injected intraperitoneally from the 7th week,which were given drugs for 8 consecutive weeks.All rats were weighed to calculate liver index;levels of serum total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and triglyceride(TG)were mea-sured by automatic biochemical analyzer;HE staining was used to observe pathological changes of rats liver;oil red staining was used to observe lipid accumulation in rats liver;expressions of IL-6,JAK1,STAT3 in rats liver were detected by qRT-PCR;Western blot was used to detect expressions of IL-6,JAK1,p-JAK1,STAT3 and p-STAT3 proteins.Results:Compared with control group,hepatocytes in liver tissue of model group were swollen,accompanied by many ballooning changes,severe cytoplasmic vacuolization,the structure of hepatic lobule was unclear,and accompanied by inflammatory cell infiltration,and obvious red granular lipid droplets occupied most of the cytoplasm,body mass,liver index,levels of serum TC,ALT,AST,TG,expressions of IL-6,JAK1,STAT3 mRNAs,and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue of rats were obviously increased(P<0.05);compared with model group,damage of hepatic lobule structure in low and high doses ASD groups were reduced,swelling and vacuolization of liver cells were reduced,and accumulation of lipid droplets in liver tissue was obviously reduced.Body mass,liver index,levels of serum TC,ALT,AST and TG in rats were obviously decreased(P<0.05),while expressions of IL-6,JAK1,STAT3 mRNAs and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue were further increased(P<0.05);LMT-28,an inhibitor of IL-6/STAT3 signaling pathway,attenuated the liver protective effect of ASD on NAFLD rats.Conclusion:ASD can protect liver of NAFLD rats by activating IL-6/STAT3 signaling pathway.

Inguinal hernia is one of the most prevalent general surgical conditions affecting the elderly population.Currently, open or laparoscopic surgical repair represents the only curative approach.Among various surgical techniques, tension-free hernia repair via the preperitoneal space effectively addresses the complications associated with traditional surgical methods, such as excessive tension in the surgical area, postoperative pain and discomfort, and a subsequent decline in patients' quality of life.Nevertheless, a certain recurrence rate persists.This paper aims to highlight the insufficient research on preperitoneal hernia repair procedures within the field of hernia surgery and to conduct a comprehensive analysis of the primary factors contributing to postoperative recurrence.This analysis will be approached from three key perspectives: medical origins, individual patient variability, and the characteristics of the patch used.The goal is to provide a foundation for the theoretical framework and practical strategies aimed at reducing postoperative recurrence rates.

Objective To investigate the current status,evolving hotspots,and emerging trends in the field of human re-source allocation research in public hospitals,both domestically and internationally,to provide a reference for future research di-rections in China.Methods CiteSpace was used to conduct a visual analysis of the research literature on human resource alloca-tion in public hospitals based on China National Knowledge Infrastructure(CNKI)and the Web of Science(WOS).The analysis encompassed co-authorship,institutional collaboration,keyword co-occurrence and clustering,and burst detection.Results A total of 1 417 Chinese articles and 981 international articles were included.Domestic research in this field focused more on healthcare reform and management,resource allocation,hierarchical diagnosis,and treatment,and informatization and efficiency improvement.On the contrary,international research primarily centered on the employee satisfaction,healthcare system quality,work environment and medical staff.Future trends in domestic research included cost reduction,efficiency enhancement,and a greater emphasis on public welfare in public hospitals,while international research was beginning to explore the influence of polit-ical concepts in this field.Conclusion Compared to international research,domestic research needs to further improve its theo-retical and localized understanding,broaden its research scope,explore the interdisciplinary collaboration opportunities,and delve into research directions such as the application of artificial intelligence and automation technology in healthcare services,management of a diverse workforce,and innovative management techniques and applications.

Objective:To investigate the correlation between serum miR-122-5p and FOXO3 levels and osteoporosis (OP) in postmenopausal women with non-alcoholic fatty liver disease (NAFLD) .Methods:The clinical data and serum of 30 postmenopausal women with NAFLD and 48 postmenopausal women with no-NAFLD were collected. The levels of miR-122-5p and FOXO3 in serum were detected by qRT-PCR. Triglycerides, high-density lipoproteins, and low-density lipoproteins were detected by biochemical autoanalyzer. The bone mineral density of lumbar vertebrae 1-4, Wards triangular bone, femoral neck, greater trochanter and total hip was detected by bone mineral density analyzer. The correlation between the above clinical indicators and OP was analyzed.Results:The expression of miR-122-5p in postmenopausal female NAFLD patients (0.76±0.28) was lower than that in non-NAFLD patients (1±0.31) ( t=3.43, P=0.001) . The downstream target gene FOXO3 of miR-122-5p was identified by bioinformatics website analysis. The expression of FOXO3 in postmenopausal female NAFLD patients (1.31±0.30) was higher than that in non-NAFLD patients (1±0.27) ( t=4.73, P<0.001) . Student’ s t test and Logistic regression analysis showed that triglyceride, miR-122-5p and FOXO3 levels were risk factors for NAFLD (all P<0.05) . Pearson correlation coefficient showed that miR-122-5p level was significantly positively correlated with BMD of femoral neck ( r=0.488, P=0.006) , greater trochanter ( r=0.367, P=0.046) and whole hip ( r=0.404, P=0.027) . FOXO3 level was negatively correlated with bone mineral density of femoral neck ( r=-0.445, P=0.014) and whole hip ( r=-0.507, P=0.004) , while other indexes were not significantly correlated (all P>0.05) . Conclusion:Decreased serum miR-122-5p level and increased FOXO3 level in postmenopausal women with NAFLD may increase the risk of OP.

Objective:To investigate the risk factors of non-alcoholic fatty liver disease (NAFLD) in patients with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) breast cancer (HR+/HER2-BC) and the impact of NAFLD on the survival of patients.Methods:54 HR+BC patients were enrolled in this study. The liver fat accumulation was examined by magnetic resonance imaging (MRI). The patients were divided into two groups: non-NAFLD and NAFLD. Student's t test or Fisher's test was used to analyze the clinical indicators of the two groups. Logistic univariate and multivariate tests were used to analyze the clinical risk factors related to NAFLD. Receiver operating characteristic curve (ROC curve) was used to further analyze the sensitivity of clinical risk factors to predict the diagnosis of NAFLD. The Disease-free survival (DFS) and Overall survival (OS) of the two groups were analyzed by Log-rank (Mantel-Cox) test. Results:There were 22 NAFLD patients and 32 non-NAFLD patients diagnosed by MRI. Student's t test or Fisher's test showed that BMI, waist circumference, AST, ALT, GGT, TG, LDL and HDL were statistically different between the two groups (all P<0.05). Logistic univariate and multivariate analysis showed that AST ( OR=1.05, 95% CI: 1.02-1.10, P=0.007), GGT ( OR=1.04, 95% CI: 1.01-1.09, P=0.038), TG ( OR=1.03, 95% CI: 1.01-1.06, P=0.011) and HDL ( OR=1.06, 95% CI: 1.01-1.12, P=0.037) were the risk factors associated with NAFLD. ROC curve analysis showed that the combination of AST, GGT, TG and HDL had high sensitivity in predicting NAFLD (AUC=0.869, P<0.05). There was no difference in DFS ( HR=1.830, 95% CI: 0.983-3.409, P=0.057) or OS ( HR=2.482, 95% CI: 0.761-8.093, P=0.132) between the two groups. Conclusion:AST, GGT, TG and HDL are the independent risk factors for NAFLD in HR+BC patients during treatment, but concurrent NAFLD has no significant effect on DFS or OS.

Objective:To determine the epidemiological characteristics of acute aortic dissectionand the negative rate of D-dimer of type A and B acute aortic dissection, and to explore the factors related to the negative rate of D-dimer with onset time≤ 24 h.Methods:The study retrospectively analyzed the age, sex, clinical manifestations, medical history, and laboratory test data of patients with acute aortic dissection in the Emergency Department of Xiangya Hospital of Central South University from September 1, 2017 to August 31, 2020. Exclusion criteria included 1) aortic aneurysm, 2) intermural aortic hematoma, 3) penetrating aortic ulcer, and 4) patients with prior aortic dissection, but no new hairclip was shown on this CTA. Stanford typing was used for aortic dissection. The patients were divided into two groups for analysis: onset time ≤ 24 h and onset time in 1-14 days. All statistical analyses were performed using GraphPad Prism 9. Student t-test was used for normal distribution and Mann-Whitney U test for non-normally distributed continuous variables. Comparisons of ratios between groups were performed using the χ2 test or Fisher's exact test. Binary logistic regression analysis was performed to identify independent factors related to the negative rate of D-dimer. A P<0.05 was considered statistically significant. Results:A total of 352 patients with acute aortic dissection were included in this study. Male patients accounted for 79.26%, patients with a history of hypertension accounted for 70.45%, and the ratio of patients with type A:B acute aortic dissection was 2:3. The overall negative rate of D-dimer was 13.64%. The negative rate of D-dimer of type A acute aortic dissection (7.09%) was significantly lower than that of type B acute aortic dissection (7.09% vs. 18.01%, P=0.004). A total of 17 patients died in the emergency department, with an overall mortality rate of 4.83%. The mortality rate of type A acute aortic dissection patients was significantly higher than that of type B acute aortic dissection ( P<0.05). A total of 235 patients (66.76%) with acute aortic dissection had an onset time of ≤24 h. In the hyperacute phase of ≤24 h, there were no statistically significant differences in sex, age, underlying diseases, and vital signs between the normal and elevated D-dimer groups ( P>0.05). In the laboratory test results, the levels of platelet, blood urea nitrogen, creatinine, lactate dehydrogenase, myoglobin, fibrin degradation product, prothrombin time and international normalized ratio of patients in the normal D-dimer group were significantly lower than those in the elevated D-dimer group ( P<0.05). Binary logistic regression analysis showed that the level of FDP was closely related to D-dimer ( P<0.001). Conclusions:The negative rate of D-dimer of type A acute aortic dissection was significantly lower than that of type B acute aortic dissection, but the mortality rate of patients with type A acute aortic dissection was significantly higher than that of type B acute aortic dissection, and the level of FDP was closely related to D-dimer.

Objective:To explore the nurses' knowledge hiding behavior and its correlation with organizational climate and innovative behavior.Methods:From August to November 2021, 208 registered nurses from Henan Provincial People's Hospital were selected as the research object by convenient sampling. The nurses were investigated with the General Information Questionnaire, Knowledge Hiding Behavior Questionnaire, Organizational Climate Scale for Nursing, and Nurse Innovative Behavior Scale.Results:The score of nurses' knowledge hiding behavior was 18 (13, 26) , the total score of nursing organizational atmosphere was (93.76±15.95) , and the score of nurses' innovative behavior was (34.45±8.39) . The total score of knowledge hiding behavior was negatively correlated with the score of the Organizational Climate Scale for Nursing ( P<0.05) , and was negatively correlated with the innovative behavior of nurses ( P<0.05) , and the differences were statistically significant. Multiple linear regression analysis showed that gender, intimacy and enterprising atmosphere behavior were the influencing factors of knowledge hiding behavior ( P<0.05) . Conclusions:Nurses have knowledge hiding behavior, which is influenced by gender, intimacy and enterprising atmosphere. The knowledge hiding behavior can be reduced by creating a harmonious organizational atmosphere, so as to enhance the innovative ability of nurses, and improve the team fee performance and group competitiveness.

Cholangiocarcinoma (CCA) has emerged as an intractable cancer with scanty therapeutic regimens. The aberrant activation of Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) are reported to be common in CCA patients. However, the underpinning mechanism remains poorly understood. Deubiquitinase (DUB) is regarded as a main orchestrator in maintaining protein homeostasis. Here, we identified Josephin domain-containing protein 2 (JOSD2) as an essential DUB of YAP/TAZ that sustained the protein level through cleavage of polyubiquitin chains in a deubiquitinase activity-dependent manner. The depletion of JOSD2 promoted YAP/TAZ proteasomal degradation and significantly impeded CCA proliferation