Objective To explore the improving effect and mechanism of saikosaponin A on insomnia rats based on cAMP/PKA/CREB pathway.Methods Seventy-five SD rats were randomly divided into blank group,model group,low-dose saikosaponin A group(0.625 mg·kg-1),high-dose saikosaponin A group(2.500 mg·kg-1)and Estazolam group(0.1 mg·kg-1),with 15 rats in each group.Insomnia rat model was established by intraperitoneal injection of Phenylalanine(PCPA,0.1 mg·kg-1).The general condition and circadian rhythm of rats were observed;the sleep latency and sleep duration of rats were measured by pentobarbital sodium righting experiment.The sleep phase of rats was observed,and the duration of slow wave sleep phase 1(SWS1),slow wave sleep phase 2(SWS2),rapid eye movement sleep phase(REMS)and total sleep time(TST)were recorded.The mRNA expression levels of hypothalamic circadian genes Clock,Bmal1 and clock-controlled genes Rev-erbα and Rorα were determined by qRT-PCR.The expression level of NeuN in hippocampus was determined by immunofluorescence.The level of cAMP in brain tissue was determined by ELISA.The expression levels of Clock,Bmal1,Rev-erbα,Rorα and cAMP/PKA/CREB pathway-related proteins in brain tissue were determined by Western Blot.Results Compared with the blank group,the rats in the model group had disordered circadian rhythms,extreme excitement,irritability,and reduced sleep;the sleep latency was significantly prolonged(P＜0.05),and the sleep duration and SWS1,SWS2,REMS and TST were significantly shortened(P＜0.05).The arrangement of neurons was disordered,and the IOD value of NeuN positive neurons was significantly decreased(P＜0.05).The mRNA and protein expression levels of Clock,Bmal1,Rev-erbα and Rorα in brain tissue were significantly decreased(P＜0.05).The expression levels of cAMP,p-PKA/PKA and p-CREB/CREB in brain tissue were significantly decreased(P＜0.05).Compared with the model group,the aggressiveness of the rats in the administration group was significantly weakened,the circadian rhythm was rhythmic,the activity was reduced,and the sleep was increased.The sleep latency was significantly shortened(P＜0.05),and the sleep duration and SWS1,SWS2,REMS and TST were significantly prolonged(P＜0.05).The disorder of neuronal arrangement was restored,and the IOD value of NeuN positive neurons was significantly increased(P＜0.05).The mRNA and protein expression levels of Clock,Bmal1,Rev-erbα and Rorα in brain tissue were significantly increased(P＜0.05).The protein expression levels of cAMP,p-PKA/PKA and p-CREB/CREB in brain tissue were significantly increased(P＜0.05).Conclusion Saikosaponin A may improve the circadian rhythm of insomnia rats by activating cAMP/PKA/CREB pathway.

Objective:To measure the overall and lobulated volume of the liver with different degrees of liver fibrosis and to further observe pathological changes such as liver microvasculature, hepatocyte apoptosis, and regeneration in order to understand the macroscopic volume changes of the liver during liver fibrosis and its relationship with liver tissue microscopic pathology in patients with chronic liver disease.Methods:53 patients with chronic hepatitis B, alcoholic fatty liver disease, autoimmune liver disease, nonalcoholic fatty liver disease, and drug-induced chronic liver disease who underwent both liver biopsy tissue and abdominal magnetic resonance imaging were collected. Patients were divided into early (F1-2), middle (F3-4), and late (F5-6) in accordance with the Ishak fibrosis stage and Masson stain. The liver and spleen volumes were measured using ITK-SNAP software. CD31 immunohistochemical staining was used to reflect intrahepatic angiogenesis. Ki67 and HNF-4α multiplex immunohistochemical staining were used to reflect hepatocyte regeneration. GS staining was used to determine parenchymal extinction lesions. TUNEL staining was used to observe hepatocyte apoptosis. Spearman correlation analysis was used to analyze the relationship between liver volume changes and liver histopathological changes.Results:As liver fibrosis progressed, the total liver volume and right lobe liver volume gradually decreased ( P<0.05), while the spleen volume gradually increased ( P<0.05). The expression of CD31 and GS gradually increased ( P<0.05), and the expression of Ki67 first increased and then decreased ( P<0.05). The positivity rate of CD31 was negatively correlated with the right lobe liver volume ( r=-0.609, P<0.001) and the total liver volume ( r=-0.363, P=0.017). The positivity rate of Ki67 was positively correlated with the right lobe liver volume ( r=0.423, P=0.018), while the positivity rate of apoptotic cells was significantly negatively correlated with the total liver volume ( r=-0.860, P<0.001). The positivity rate of GS was negatively correlated with the right lobe liver volume ( r=-0.440, P=0.002), and the number of PELs was negatively correlated with RV ( r=-0.476, P=0.013). The CD31 positive staining area was negatively correlated with the Ki67 positive staining area( r=-0.511, P=0.009). Conclusion:As liver fibrosis progresses, patients with chronic liver disease have a depletion in total liver volume and right lobe liver volume, and this is mainly in correlation with fewer liver cells and liver tissue microvasculature disorders.

Objective:To investigate the interventional effect of bone marrow mesenchymal stem cell (BMMSC) transplantation with different doses of X-ray irradiation induced hepatic injury in mice.Methods:Eighteen female C57BL/6J mice were randomly divided into 0, 2, and 3 Gy irradiation groups and 0, 2, and 3 Gy transplantation groups. The irradiation group was used as the control and injected with an equal volume of culture medium. The mice in the transplantation group were irradiated with different doses of X-ray irradiation, and BMMSCs were intravenously infused into the bone marrow. The mice were sacrificed for sampling at the end of the 21st day. Mice body weight changes were recorded daily. The changes in the content of peripheral blood lymphocytes, red blood cells, platelets, and hemoglobin were detected by an automatic blood tester. The morphological changes in mice liver tissues were observed by hematoxylin-eosin staining. The serum activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected by a biochemical analyzer. The reduced glutathione contents in liver tissue were detected by the microplate method. The malondialdehyde content in liver tissue was detected by thiobarbituric acid. The content of total superoxide dismutase (T-SOD) in liver tissue was detected by the hydroxylamine method. The expression of the F4/80 protein in liver tissue was detected by the immunohistochemistry method. The protein expression of nuclear transcription factor erythroid 2 related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) in liver tissue was determined by the western blotting method. The mRNA expression of NLRP3, IL-6, and Nrf2 in liver tissue was detected by a real-time quantitative polymerase chain reaction. The multiple-group comparisons were analyzed by factorial analysis of variance. The inter-group comparisons were analyzed by the LSD method for statistical analysis.Results:The contents of peripheral blood lymphocytes, erythrocytes, platelets, and hemoglobin were significantly decreased in the 3 Gy irradiation group than the 0 Gy irradiation group ( P<0.05), while the activities of serum ALT and AST were significantly increased ( P<0.05). The malondialdehyde content, F4/80 protein expression level, nucleotide-binding domain and leucine-rich repeats, nucleotide oligomerization domain-like receptor family, pyrin domain containing 3 (NLRP3), and interleukin 6 mRNA expression levels were significantly increased in liver tissue, while the contents of T-SOD and glutathione, Nrf2 and HO-1 protein expression levels, and Nrf2 mRNA expression level in liver tissue were significantly decreased ( P<0.05). The contents of peripheral blood lymphocytes, red blood cells, platelets, and hemoglobin were significantly increased in the 3 Gy transplantation group than the 3 Gy irradiation group ( P<0.05), while the activities of serum ALT and AST were significantly decreased ( P<0.05). The malondialdehyde content, F4/80 protein expression level, NLRP3 and interleukin-6 mRNA expression levels in liver tissue were significantly decreased ( P<0.05), while the content of T-SOD and glutathione, Nrf2 and HO-1 protein expression levels, and Nrf2 mRNA expression level in liver tissue were significantly increased ( P<0.05). Conclusion:X-ray irradiation at a dose of 3 Gy can induce liver oxidative damage in mice. BMMSC transplantation can improve X-ray irradiation-induced liver oxidative damage in mice, and its mechanism of action may be related to the regulation of the Nrf2/HO-1 pathway.

Objective:To explore the application effect of preoperative autologous blood localization method in laparoscopic resection of gastric stromal tumors in unfavorable areas of the stomach.Methods:A retrospective analysis was conducted on the case data of 40 patients with gastric stromal tumors in unfavorable locations admitted to Jinjiang Hospital from January 2019 to December 2022. The patients were divided into a control group (intraoperative endoscopic localization method) and an autologous blood localization group according to different intraoperative lesion localization methods, with 20 cases in each group. The surgical time, intraoperative blood loss, hospitalization time, postoperative exhaust time, and adverse reactions were compared between the two groups.Results:The surgery time of the autologous blood localization group was shorter than that of the control group [(92.30±8.80)min vs (108.20±14.87)min, P<0.05]. There was no statistically significant difference in intraoperative bleeding, hospitalization time, and postoperative exhaust time between the two groups (all P>0.05). Two groups of patients did not show an increase in inflammatory indicators such as white blood cells and C-reactive protein on the day after surgery. Both groups of patients did not experience adverse reactions such as fever, abdominal pain, or postoperative complications. Conclusions:The autologous blood injection localization method provides a safe, simple, and effective method for preoperative localization of gastric stromal tumors in unfavorable areas of the stomach under laparoscopy, and is worthy of clinical promotion and use.

Objective:To discuss the protective effect of velvet antler peptide(VAP)in the osteoporosis(OP)model rats,and to clarify the possible mechanism.Methods:Sixty 12-week-old SD rats were randomly divided into control group,model group,positive drug group(treated with 1 mg·kg-1·d-1 of alendronate sodium by gavage),low dose of VAP group(treated with 100 mg·kg-1·d-1 VAP),medium dose of VAP group(treated with 200 mg·kg-1·d-1 VAP),and high dose of VAP group(treated with 300 mg·kg-1·d-1 VAP),and there were ten rats in each group.Except for control group,the rats in the other groups were injected with dexamethasone(2 mg·kg-1)to replicate the OP rat model,while the rats in control group were injected with the equivalent volume of saline twice a week for 11 consecutive weeks.Dual-energy X-ray absorptiometry was used to detect the bone mineral density(BMD)of femur tissue of the rats in various groups;enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of serum calcium(Ca2+),phosphate(P),osteoprotegerin(OPG),alkaline phosphatase(ALP),and osteocalcin(OCN)in serum of the rats in various groups;biochemical method was used to detect the malondialdehyde(MDA)level and superoxide dismutase(SOD)activity in serum of the rats in various groups;HE staining was used to observe the pathomorphology of bone tissue of the rats in various groups;Western blotting method was used to detect the expression levels of silent information regulator 1(SIRT1),catalase(CAT),Runt-related transcription factor 2(RUNX2),and forkhead box protein O1(FOXO1)proteins in bone tissue of the rats in various groups.Results:Compared with control group,the BMD of femoral tissue of the rats in model group was decreased(P<0.05);compared with model group,the BMD of femur tissue of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were increased(P<0.05 or P<0.01).Compared with control group,the levels of Ca2+,P,OPG,and SOD activities in serum of the rats in model group were decreased(P<0.05),and the levels of ALP,OCN,and MDA were increased(P<0.05);compared with model group,the level of OPG in serum of the rats in low dose of VAP group was significantly increased(P<0.05),the levels of Ca2+,P,OPG,and activities of SOD in serum of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were significantly increased(P<0.05 or P<0.01),and the levels of ALP,OCN,and MDA in serum of the rats in positive drug group and different doses of VAP groups were decreased(P<0.05 or P<0.01).The HE staining results showed that compared with control group,the rats in model group had fewer bone cells and disordered arrangements in the bone tissue,thinner bone trabeculae with large fractures,and an expanded marrow cavity;compared with model group,the rats in positive drug group,medium dose of VAP group,and high dose of VAP group had thicker bone trabeculae arranged more tightly.The Western blotting results showed that compared with control group,the expression levels of SIRT1,CAT,RUNX2,and FOXO1 proteins in bone tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of SIRT1,CAT,RUNX2,and FOXO1 proteins in bone tissue of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were significantly increased(P<0.05 or P<0.01).Conclusion:VAP has the protective effect against OP in the rats,and its mechanism may be related to mediating the antioxidant stress action through the SIRT1/FOXO1 signaling pathway.

ObjectiveTo investigate the effect of transplantation of bone marrow mesenchymal stem cells （BMSCs） co-cultured with bone marrow-derived M2 macrophages （M2-BMDMs）， named as BMSC^M2， on a rat model of liver cirrhosis induced by carbon tetrachloride （CCl₄）/2-acetaminofluorene （2-AAF）. MethodsRat BMDMs were isolated and polarized into M2 phenotype， and rat BMSCs were isolated and co-cultured with M2-BMDMs at the third generation to obtain BMSC^M2. The rats were given subcutaneous injection of CCl₄ for 6 weeks to establish a model of liver cirrhosis， and then they were randomly divided into model group （M group）， BMSC group， and BMSC^M2 group， with 6 rats in each group. A normal group （N group） with 6 rats was also established. Since week 7， the model rats were given 2-AAF by gavage in addition to the subcutaneous injection of CCl₄. Samples were collected at the end of week 10 to observe liver function， liver histopathology， and hydroxyproline （Hyp） content in liver tissue， as well as changes in the markers for hepatic stellate cells， hepatic progenitor cells， cholangiocytes， and hepatocytes. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the N group， the M group had significant increases in the activities of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in ALT and AST （P<0.01）， and the BMSC^M2 group had significantly better activities than the BMSC group （P<0.05）. Compared with the N group， the M group had significant increases in Hyp content and the mRNA and protein expression levels of alpha-smooth muscle actin （α-SMA） in the liver （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in Hyp content and the expression of α-SMA （P<0.05）， and the BMSC^M2 group had a significantly lower level of α-SMA than the BMSC group （P<0.01）. Compared with the N group， the M group had significant increases in the mRNA expression levels of the hepatic progenitor cell markers EpCam and Sox9 and the cholangiocyte markers CK7 and CK19 （P<0.01） and significant reductions in the expression levels of the hepatocyte markers HNF-4α and Alb （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in the mRNA expression levels of EpCam， Sox9， CK7， and CK19 （P<0.05） and significant increases in the mRNA expression levels of HNF-4α and Alb （P<0.05）， and compared with the BMSC group， the BMSC^M2 group had significant reductions in the mRNA expression levels of EpCam and CK19 （P<0.05） and significant increase in the expression level of HNF-4α （P<0.05）. ConclusionM2-BMDMs can enhance the therapeutic effect of BMSCs on CCl₄/2-AAF-induced liver cirrhosis in rats， which provides new ideas for further improving the therapeutic effect of BMSCs on liver cirrhosis.

Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during ¹⁷⁷Lu-DOTATATE therapy. Methods A ward for ¹⁷⁷Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of ¹⁷⁷Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of ¹⁷⁷Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during ¹⁷⁷Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.

Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during ¹⁷⁷Lu-DOTATATE therapy. Methods A ward for ¹⁷⁷Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of ¹⁷⁷Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of ¹⁷⁷Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during ¹⁷⁷Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.

Objective To investigate the current situation of emergency rescue patient retention in Jianyang People's Hospital and explore its causes.Methods A retrospective analysis was conducted on the data of 4 834 patients rescued in the emergency room of Jianyang People's Hospital in 2022.They were divided into retention group and non retention group based on whether the emergency detention time exceeded 6 hours.With detention as the dependent variable and factors that may lead to emergency detention as the independent variable,binary logistic regression method was applied to screen for factors related to emergency detention.Results The median retention time for emergency rescue patients was 4.84 hours,with 3 721 cases(76.98%)having a retention time≤6 hours and 1 113 cases(23.02%)having a retention time＞6 hours;the main influencing factors for emergency detention included age,visit time,visit season,admission method,involving two or more departments,diversion direction,and treatment compliance(P＜0.05).Conclusion Emergency patients aged≥41 years old,treated from 17:00 to＜08:00 the next day,visited in winter,admitted on their own,involving two or more departments,diverted to hospitalization,and with average or poor treatment compliance are prone to emergency detention.Therefore,the emergency department of the hospital should develop appropriate management measures based on the above factors to reduce emergency detention time.