Objective Network pharmacology and molecular docking techniques were used to predict the potential mechanisms by which the active components of Piper nigrum(PN)regulate depressive-like behaviors in chronic restraint stress(CRS)mice.Methods The major chemical components and targets of PN were screened using the Traditional Chinese Medicine Systems Pharmacology database.Targets related to ferroptosis and depression were obtained from the Online Mendelian Inheritance in Man,GeneCards,and FerrDB databases.The intersecting targets were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Gnomes(KEGG)pathway enrichment analyses,and molecular docking was performed to validate the binding capacities between the core targets and their corresponding active components.Finally,we established a CRS mouse model.Mice were treated with PN 75,150,and 300 mg/kg for 4 weeks,followed by behavioral assessments and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)to verify the expression of core genes.Results Nine active components were screened from PN,corresponding to 27 targets,and 8377 targets related to depression and 547 targets associated with ferroptosis were screened from the databases.The intersection of these three sets resulted in 25 target genes.KEGG enrichment analysis revealed that these core targets were predominantly enriched in signaling pathways,including cholinergic synapses,serotonergic synapses,and neuroactive ligand-receptor interactions.Molecular docking result showed that the main active components of PN had strong binding affinities for the targets CHRM2,SLC6A4,PTGS2,and SLC6A2.Behavioral assessments demonstrated that PN significantly increased the sucrose preference index(P＜0.01,P＜0.001),reduced immobility time in the tail suspension and forced swimming tests(P＜0.01,P＜0.001),and enhanced exploratory behavior in the open field test(P＜0.05.P＜0.01,P＜0.001).PN significantly reduced the serum levels of inflammation markers(P＜0.05.P＜0.01,P＜0.001),as shown by enzyme-linked immunosorbent assay,and neurotransmitter analysis revealed that PN significantly increased the levels of serotonin and acetylcholine in the mouse hippocampus(P＜0.05).RT-qPCR showed that PN demonstrated the mRNA expression of SLC6A4(P＜0.05.P＜0.01,P＜0.001).Conclusions PN may improve depressive-like behavior in mice by modulating serotonin and acetylcholine levels,inhibiting inflammatory responses,participating in immune regulation,and exerting neuroprotective effects.

Objective:To explore the effects of diversified teaching combined with the affective-cognitive theory in neurology clerkship instruction.Methods:We enrolled 406 medical students on clerkship at the affiliated hospitals of Sun Yat-sen University from November 2023 to April 2024. They were randomly assigned by cluster to either observation group ( n=164) or control group ( n=242). The observation group received a diversified teaching model that selected context-appropriate teaching methods based on clinical scenarios, while using the affective-cognitive theory to optimize instructional pathways. The control group received traditional teaching. The effectiveness of teaching was evaluated through an objective structured clinical examination (OSCE; maximum score, 10 points) and a questionnaire survey. SPSS 22.0 was used to perform Mann-Whitney U test, chi-square test, and multiple linear regression analysis. NVivo 12.0 was employed to process open-ended questions. Results:In the OSCE, the observation group had a significantly higher mean score than the control group [9 (8, 10) points vs. 8 (7, 9) points, Z=-6.10, P<0.001]. The distribution difference across different score ranges between the two groups was also statistically significant ( Z=-5.94, P<0.001). Stratified analyses by sex and neurological theory test score demonstrated significantly higher mean scores in the observation group than in the control group ( P<0.001). The multiple linear regression analysis indicated an independent positive correlation between the novel teaching model and OSCE score ( P<0.001). The results of the questionnaires revealed that in the observation group, 98.57% reported that they were satisfied with the teaching model, and 90.72% reported that they accomplished the core teaching objectives; core competencies including knowledge and skills, communication and collaboration, and professionalism were improved; additionally, the participants of the observational group highly endorsed the practical content, the logical structure and richness of instruction, and the active classroom learning environment. Conclusions:The diversified teaching model integrated with the affective-cognitive theory significantly improves proficiency in core clinical skills across different groups of neurology clerks.

Objective:To investigate the status quo and influencing factors of humanistic concern among nursing undergraduates, and to explore the educational path of improving humanistic concern.Methods:A total of 345 nursing undergraduates from Xiangya School of Nursing of Central South University were investigated using a questionnaire of general demographic data, the Caring Ability Inventory, and the Self-directed Learning Instrument. The SPSS 26.0 statistical software was used for data analysis. The humanistic caring ability scores of nursing undergraduates with different characteristics were compared by the independent sample t-test and analysis of variance, and the pairwise comparison was conducted by the least significant difference t-test. All dimensions and total scores of humanistic caring ability and self-directed learning ability failed to meet normal distribution, and the correlation between them was determined by Spearman correlation analysis. Results:The humanistic caring ability score of nursing undergraduates was (169.52±10.62). The correlation analysis showed that the humanistic caring ability of nursing undergraduates was positively correlated with their self-directed learning ability ( r=0.426, P<0.001). The stepwise regression analysis showed that interpersonal communication ability, learning motivation, grades, genders, and class leader experience were influencing factors of humanistic caring ability of nursing undergraduates. Conclusions:Nursing undergraduates should improve their humanistic caring ability, whose score is lower than that in the existing research (175.70±18.74). In humanistic education, nursing educators should pay attention to individualized development needs of nursing undergraduates with different grades and genders, set students with class leader experience as a good example, and effectively improve the humanistic caring ability of nursing undergraduates by stimulating learning motivation and strengthening interpersonal communication.

Objective:To explore the effects of diversified teaching combined with the affective-cognitive theory in neurology clerkship instruction.Methods:We enrolled 406 medical students on clerkship at the affiliated hospitals of Sun Yat-sen University from November 2023 to April 2024. They were randomly assigned by cluster to either observation group ( n=164) or control group ( n=242). The observation group received a diversified teaching model that selected context-appropriate teaching methods based on clinical scenarios, while using the affective-cognitive theory to optimize instructional pathways. The control group received traditional teaching. The effectiveness of teaching was evaluated through an objective structured clinical examination (OSCE; maximum score, 10 points) and a questionnaire survey. SPSS 22.0 was used to perform Mann-Whitney U test, chi-square test, and multiple linear regression analysis. NVivo 12.0 was employed to process open-ended questions. Results:In the OSCE, the observation group had a significantly higher mean score than the control group [9 (8, 10) points vs. 8 (7, 9) points, Z=-6.10, P<0.001]. The distribution difference across different score ranges between the two groups was also statistically significant ( Z=-5.94, P<0.001). Stratified analyses by sex and neurological theory test score demonstrated significantly higher mean scores in the observation group than in the control group ( P<0.001). The multiple linear regression analysis indicated an independent positive correlation between the novel teaching model and OSCE score ( P<0.001). The results of the questionnaires revealed that in the observation group, 98.57% reported that they were satisfied with the teaching model, and 90.72% reported that they accomplished the core teaching objectives; core competencies including knowledge and skills, communication and collaboration, and professionalism were improved; additionally, the participants of the observational group highly endorsed the practical content, the logical structure and richness of instruction, and the active classroom learning environment. Conclusions:The diversified teaching model integrated with the affective-cognitive theory significantly improves proficiency in core clinical skills across different groups of neurology clerks.

[Objective] To study the relationship between the expression intensity of HLA-Ⅰ platelet antibodies in patients with platelet transfusion refractoriness (PTR) and platelet cross-matching, and to further evaluate other factors in order to provide relevant data support for improving platelet transfusion efficiency and optimizing platelet transfusion regimens. [Methods] Luminex single antigen flow cytometry was used to detect platelet specific antibodies in 35 patients with hematological disease. Subsequently, the Capture-P method was employed to perform 102 crossmatchings between plasma with HLA-Ⅰ antibodies and platelets with known HLA-Ⅰ genotypes. The cross-matching results were assessed and the clinical transfusion outcomes were tracked. [Results] The positive detection rate of HLA-Ⅰ and HPA antibodies in this study was 48.6% (17/35). The negative rate of cross-matching in 102 cases was 37.3% (38/102). Multiple factors affect platelet cross-matching, such as HLA-Ⅰ antibody expression level and antibody type, antigen expression level, cross-reactivity group and eplets. Among them, the expression level and antibody type of HLA-Ⅰ antibody are the main influencing factors. However, the effectiveness of clinical platelet transfusion is not completely determined by the compatibility of platelet cross-matching. [Conclusion] In addition to avoiding strong positive HLA-Ⅰ antibodies, clinical matching should also be vigilant against the serological cross-incompatibility caused by weak positive HLA-Ⅰ antibodies. It may be necessary to establish HLA-Ⅰ low expression antigen database as a better alternative platelet donor selection strategy, and gradually explore the effectiveness of ‘low expression mismatch’ strategy for clinical platelet transfusion.

Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.

Bone morphogenetic proteins (BMPs) are multifunctional growth factors of the transforming growth factor β (TGF-β) superfamily. They regulate steroid secretion from mammalian granulosa cells, promote granulosa cell survival and proliferation, and inhibit follicular atresia, luteinization, and granulosa cell apoptosis, thereby promoting the development and maturation of mammalian follicles. At the same time, BMPs play an important role in embryonic morphogenesis, induction of uterine receptivity, and blastocyst attachment. This paper describes the effects of BMPs on mammalian follicular and embryonic development and the roles of BMPs in female reproduction, focusing on the process in which BMPs promote follicular maturation by regulating steroid secretion from granulosa cells during mammalian oocyte maturation. This review aims to provide a reference for further research on mammalian oocyte culture and improvement of reproductive efficiency in female animals.
Animals ; Embryonic Development/drug effects* ; Female ; Bone Morphogenetic Proteins/pharmacology* ; Reproduction/physiology* ; Humans ; Granulosa Cells/cytology* ; Oocytes

ObjectiveTo investigate the current status and related factors of maternal influenza vaccination willingness among pregnant and postpartum women in Shanghai and Liaoning Province, China, and to explore the facilitators and barriers affecting vaccination uptake, so as to provide references for future practices in promoting maternal influenza immunization in China. MethodsA convergent mixed-methods research was conducted. From January to March 2024, a questionnaire survey was conducted among women attending prenatal and postnatal care at 7 medical institutions in Shanghai and Dalian, Liaoning Province, which aimed to assess pregnant women’s knowledge about influenza vaccine and their willingness to vaccination during pregnancy, as well as to identify the related factors. In addition, purposive sampling method was used to conduct in-depth interviews with pregnant women and perinatal healthcare service providers to explore their perspectives on influenza vaccination during pregnancy, including the reasons for their willingness or unwillingness to receive ( or recommend) the vaccine, and the relevant facilitators and barriers to vaccination. ResultsA total of 366 pregnant and postpartum women participated in the questionnaire survey, and 9.56% (35/366) of them were willing to receive the influenza vaccine during pregnancy. The results of multivariate logistic stepwise regression analyses showed that primipara (aOR=0.158, 95%CI: 0.037‒0.671, P=0.012), family members’ support for influenza vaccination during pregnancy (aOR=0.015, 95%CI: 0.003‒0.082, P<0.001) were associated with higher willingness to receive influenza vaccine during pregnancy. Absence of influenza infection during pregnancy (aOR=5.383, 95%CI: 1.801‒16.092, P<0.001), and lack of knowledge regarding influenza vaccination during pregnancy (aOR=11.294, 95%CI: 3.593‒35.496, P<0.01) were associated with lower willingness to receive influenza vaccine during pregnancy. Qualitative findings indicated that the facilitators to vaccination willingness among pregnant and postpartum women included the recommendation of healthcare service providers, adequate knowledge of influenza vaccine information and family members’ support for vaccination. Conversely, the barriers to vaccination willingness included low recommendation from the healthcare service providers, lack of knowledge about the safety of influenza vaccine during pregnancy and inadequate attention to influenza and influenza vaccine. ConclusionThe willingness to receive influenza vaccination among pregnant and postpartum women in Shanghai and Liaoning Province is relatively low. It is recommended that China should promptly improve the evidence-based system for the safety and efficacy of influenza vaccines for pregnant and postpartum women, along with an establishment of the mechanism for addressing adverse reactions. Furthermore, it is essential to enhance educational outreach to pregnant and postpartum women, their families, and healthcare service providers, thereby increasing the accessibility of information regarding influenza vaccination, which are expected to enhance the willingness of pregnant and postpartum women to receive the vaccine.

The glymphatic system is an important pathway for fluid drainage and metabolic waste clearance in the central nervous system. Its core mechanism involves the active cerebrospinal fluid-interstitial fluid circulation process mediated by perivascular spaces and aquaporin-4 channels located on astrocytic endfeet. This process is crucial for eliminating neurotoxic substances such as β-amyloid and tau proteins, as well as maintaining homeostasis in the central nervous system. Recent studies have shown that dynamic changes in the glymphatic system are associated with recovery after ischemic stroke. This article elaborates on the role of the glymphatic system in ischemic stroke and evaluates its potential value as a novel therapeutic target, providing new insights for post-stroke treatment strategies.

Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.