Objective:To understand the latent categories of apathy in young and middle-aged patients with hemorrhagic stroke and analyze the relationship between these categories and disability acceptance, providing a theoretical basis for targeted interventions.Methods:A convenience sampling method was used to select young and middle-aged patients with hemorrhagic stroke hospitalized at Huai′an First Hospital Affiliated to Nanjing Medical University between September 2020 and September 2023. A general information questionnaire, the Apathy Evaluation Scale-Clinician Administered, and the Acceptance of Disability Scale Revised were used for a cross-sectional survey. Latent profile analysis was conducted using Mplus 8.7 software to categorize apathy in these patients, and differences in disability acceptance among the categories were compared.Results:A total of 210 questionnaires were distributed and 203 valid questionnaires were collected. Among 203 patients were included, with 112 males and 91 females, aged 30-59 (47.60 ± 8.51) years old. The apathy score was (46.66 ± 8.78) points, and three latent categories were identified: "high active ability-low apathy" (26.1%, 53/203), "high social ability-moderate apathy" (28.6%, 58/203), and "generally high apathy" (45.3%, 92/203). The total disability acceptance scores for the three categories were (78.19 ± 13.30), (69.50 ± 11.01), and (60.86 ± 14.00) points, respectively, with statistically significant differences ( F=30.39, P<0.01). Conclusions:Apathy in young and middle-aged patients with hemorrhagic stroke can be categorized into three latent profiles, with differences in disability acceptance among the categories. Targeted management and interventions should be developed based on these homogeneous groups to improve disability acceptance.

Objective To investigate the mechanism by which ginkgetin attenuates H9c2 cells injury.Methods H9c2 cells were divided into five groups:control,lipopolysaccharide(LPS),LPS+3-methyladenine(3-MA,an autophagy inhibitor),LPS+ginkgetin,and LPS+3-MA+ginkgetin.Cell viability and cytotoxicity were assessed using the cell CCK-8 and lactate dehydrogenase assays,respectively.Immunofluorescence staining for LC3,monodansylcadaverine staining for autophagosomes,and flow cytometry were used to measure apop-tosis rates.Quantitative real-time PCR was performed to measure the expression of NR4A2/p53/Bax pathway.Western blotting was used to detect the expression of NR4A2,p53,Bax,LC3,Beclin-1,p62,cleaved caspase-3,and Bcl-2 proteins.Results Compared to the LPS group,ginkgetin significantly increased LC3 fluorescence levels and monodansylcadaverine fluorescence intensity,decreased apoptosis,upregulated NR4A2,downregulated p53 and Bax,increased LC3,Beclin-1,and Bcl-2 proteins,and decreased p62 and cleaved caspase-3(P＜0.05).The autophagic inhibitor,3-MA,confirmed that ginkgetin protected H9c2 cells from LPS-induced apoptosis via autophagy regulation.Conclusion Ginkgetin mitigated cardiomyocyte injury by enhancing autophagic flux and alleviating LPS-induced H9c2 cells apoptosis by modulating the NR4A2/p53/Bax pathway.

OBJECTIVE To evaluate the status of microbial contamination in the environment of respiratory tract specimens sampling rooms and observe the association of the factors such as design and layouts of the sampling rooms with the potential risk of infections in the environment so as to provide scientific bases for optimizing the construction standards of fever clinics of the medical institutions.METHODS The sampling rooms of fever clinic were chosen from 10 tertiary or above medical institutions of Hangzhou,and the samples were collected from the key sites such as air,object surfaces and hands of health care workers.The respiratory tract pathogens in the sam-ples were detected by FilmArray full-automatic medical PCR analysis system,and the pathogens in the samples were detected by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF MS).The data including the areas,windows,mechanical ventilation facilities,physical partitions,frequencies and modes of disinfection and daily amounts of diagnosis and treatment of the 10 sampling rooms were investigated,and the univariate analysis was performed for their association with the microbial contamination of environment.RESULTS The isolation rate of respiratory tract pathogens was 10.00％(4/40),respiratory syn-cytial virus,human rhinovirus and adenovirus were dominant among the respiratory tract pathogens.The isolation rate of bacteria was 71.88％(23/32),Staphylococcus ho minis and Staphylococcus epidermidis were the major species of opportunistic pathogens isolated.The result of univariate analysis indicated that both the presence of windows(P=0.012)and mechanical ventilation facilities(P=0.047)were associated with the potential risk of infections in the environment(P＜0.05);while the factors such as the areas of sampling rooms,physical parti-tions,disinfection modes and daily amounts of diagnosis and treatment were not remarkably associated with the potential risk of infections in the environment.CONCLUSION It is an effective way to physically separate the air-flow from other areas or fix the mechanical ventilation facilities to create proper airflow during the construction of fever clinic sampling rooms so as to reduce the potential risk of infections in the environment of sampling rooms.

OBJECTIVE To evaluate the status of microbial contamination in the environment of respiratory tract specimens sampling rooms and observe the association of the factors such as design and layouts of the sampling rooms with the potential risk of infections in the environment so as to provide scientific bases for optimizing the construction standards of fever clinics of the medical institutions.METHODS The sampling rooms of fever clinic were chosen from 10 tertiary or above medical institutions of Hangzhou,and the samples were collected from the key sites such as air,object surfaces and hands of health care workers.The respiratory tract pathogens in the sam-ples were detected by FilmArray full-automatic medical PCR analysis system,and the pathogens in the samples were detected by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF MS).The data including the areas,windows,mechanical ventilation facilities,physical partitions,frequencies and modes of disinfection and daily amounts of diagnosis and treatment of the 10 sampling rooms were investigated,and the univariate analysis was performed for their association with the microbial contamination of environment.RESULTS The isolation rate of respiratory tract pathogens was 10.00％(4/40),respiratory syn-cytial virus,human rhinovirus and adenovirus were dominant among the respiratory tract pathogens.The isolation rate of bacteria was 71.88％(23/32),Staphylococcus ho minis and Staphylococcus epidermidis were the major species of opportunistic pathogens isolated.The result of univariate analysis indicated that both the presence of windows(P=0.012)and mechanical ventilation facilities(P=0.047)were associated with the potential risk of infections in the environment(P＜0.05);while the factors such as the areas of sampling rooms,physical parti-tions,disinfection modes and daily amounts of diagnosis and treatment were not remarkably associated with the potential risk of infections in the environment.CONCLUSION It is an effective way to physically separate the air-flow from other areas or fix the mechanical ventilation facilities to create proper airflow during the construction of fever clinic sampling rooms so as to reduce the potential risk of infections in the environment of sampling rooms.

Houpo Sanwutang， included in the Catalogue of Ancient Classical Prescriptions （Second Batch）， was first recorded in the Synopsis of Golden Chamber written by ZHANG Zhongjing from the Eastern Han dynasty and was modified by successive generations of medical experts. A total of 37 pieces of effective data involving 37 ancient Chinese medical books were retrieved from different databases. Through literature mining， statistical analysis， and data processing， combined with modern articles， this study employed bibliometrics to investigate the historical origin， composition， decoction methods， clinical application， and other key information. The results showed that the medicinal origin of Houpo Sanwutang was clearly documented in classic books. Based on the conversion of the measurements from the Han Dynasty， it is recommended that 110.4 g Magnolia Officinalis Cortex， 55.2 g Rhei Radix et Rhizoma， and 72 g Aurantii Fructus Immaturus should be taken. Magnolia Officinalis Cortex and Aurantii Fructus Immaturus should be decocted with 2 400 mL water first， and 1 000 mL should be taken from the decocted liquid. Following this， Rhei Radix et Rhizoma should be added for further decoction， and then 600 mL should be taken from the decocted liquid. A single dose of administration is 200 mL， and the medication can be stopped when patients restore smooth bowel movement. Houpo Sanwutang has the effect of moving Qi， relieving stuffiness and fullness， removing food stagnation， and regulating bowels. It can be used in treating abdominal distending pain， guarding， constipation， and other diseases with the pathogenesis of stagnated heat and stagnated Qi in the stomach. The above results provide reference for the future development and research of Houpo Sanwutang.

Objective:To understand the latent categories of apathy in young and middle-aged patients with hemorrhagic stroke and analyze the relationship between these categories and disability acceptance, providing a theoretical basis for targeted interventions.Methods:A convenience sampling method was used to select young and middle-aged patients with hemorrhagic stroke hospitalized at Huai′an First Hospital Affiliated to Nanjing Medical University between September 2020 and September 2023. A general information questionnaire, the Apathy Evaluation Scale-Clinician Administered, and the Acceptance of Disability Scale Revised were used for a cross-sectional survey. Latent profile analysis was conducted using Mplus 8.7 software to categorize apathy in these patients, and differences in disability acceptance among the categories were compared.Results:A total of 210 questionnaires were distributed and 203 valid questionnaires were collected. Among 203 patients were included, with 112 males and 91 females, aged 30-59 (47.60 ± 8.51) years old. The apathy score was (46.66 ± 8.78) points, and three latent categories were identified: "high active ability-low apathy" (26.1%, 53/203), "high social ability-moderate apathy" (28.6%, 58/203), and "generally high apathy" (45.3%, 92/203). The total disability acceptance scores for the three categories were (78.19 ± 13.30), (69.50 ± 11.01), and (60.86 ± 14.00) points, respectively, with statistically significant differences ( F=30.39, P<0.01). Conclusions:Apathy in young and middle-aged patients with hemorrhagic stroke can be categorized into three latent profiles, with differences in disability acceptance among the categories. Targeted management and interventions should be developed based on these homogeneous groups to improve disability acceptance.

Objective To investigate the mechanism by which ginkgetin attenuates H9c2 cells injury.Methods H9c2 cells were divided into five groups:control,lipopolysaccharide(LPS),LPS+3-methyladenine(3-MA,an autophagy inhibitor),LPS+ginkgetin,and LPS+3-MA+ginkgetin.Cell viability and cytotoxicity were assessed using the cell CCK-8 and lactate dehydrogenase assays,respectively.Immunofluorescence staining for LC3,monodansylcadaverine staining for autophagosomes,and flow cytometry were used to measure apop-tosis rates.Quantitative real-time PCR was performed to measure the expression of NR4A2/p53/Bax pathway.Western blotting was used to detect the expression of NR4A2,p53,Bax,LC3,Beclin-1,p62,cleaved caspase-3,and Bcl-2 proteins.Results Compared to the LPS group,ginkgetin significantly increased LC3 fluorescence levels and monodansylcadaverine fluorescence intensity,decreased apoptosis,upregulated NR4A2,downregulated p53 and Bax,increased LC3,Beclin-1,and Bcl-2 proteins,and decreased p62 and cleaved caspase-3(P＜0.05).The autophagic inhibitor,3-MA,confirmed that ginkgetin protected H9c2 cells from LPS-induced apoptosis via autophagy regulation.Conclusion Ginkgetin mitigated cardiomyocyte injury by enhancing autophagic flux and alleviating LPS-induced H9c2 cells apoptosis by modulating the NR4A2/p53/Bax pathway.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Aim Investigating the effects of exercise during pregnancy on blood pressure and brain ischemia-reperfusion injury in 1-month-old(1M)and 3-month-old(3M)offspring of spontaneously hypertensive rat(SHR).Methods SHR and Wistar Kyoto rats(WKY)were selected,they were paired in a 1∶1 male-to-female ratio within the same strain,and the first day of pregnancy was confirmed by the presence of copulatory plugs and sperm on a vaginal smear.Pregnant rats were randomly divided into pregnancy sedentary group(p-WKY-SED,p-SHR-SED)and pregnancy exercise group(p-WKY-EX,p-SHR-EX).The rats in the exercise group were performed non-weight-bearing swimming for 60 minutes per day,6 days per week,in water 40 cm deep at a temperature of 34～35 ℃,until the 20th day of preg-nancy.The body weight of the pregnant rats,as well as physiological indicators such as fetal weight,body length,and placental efficiency were monitored to reflect the growth and development of the fetus.1M and 3M offspring were selected as research subjects,non-invasive blood pressure was measured in the tail artery,a rat middle cerebral artery occlusion(MCAO)model was prepared by using the thread embolism method,and the area of cerebral infarction was observed 24 hours after reperfusion.Results(1)Compared with p-WKY-SED group,the body weight of p-SHR-SED pregnant rats was significantly decreased(P＜0.01);there was no significant difference in the litter size among all groups of preg-nant rats(P＞0.05).(2)Compared with p-SHR-SED group,exercise during pregnancy can significantly increase the body weight and placental efficiency of both female and male fetal rats in the p-SHR-EX group(P＜0.05),and decrease the weight of the placenta(P＜0.05).(3)Compared with p-WKY-SED group,the body weight of both female and male offspring rats at 1M and 3M was significantly decreased in the p-SHR-SED group,and their blood pressure was significantly increased(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy had no significant effect on the body weight and blood pressure of 1M offspring in the p-SHR-EX group(P＞0.05),but it could significantly reduce the blood pressure of 3M male offspring in the p-SHR-EX group(P＜0.01);The body weight and blood pressure of 3M male off-spring were significantly higher in p-WKY-SED group and p-SHR-SED group than those of female in the same group(P＜0.01).(4)Compared with p-WKY-SED group,the infarct area of MCAO injury in both female and male offspring rats at 1M and 3M was significantly increased in the p-SHR-SED group(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy can significantly reduce the infarct area of MCAO injury in both female and male offspring at 1M and 3M in the p-SHR-EX group(P＜0.05).Conclusion Aerobic exercise during pregnancy can significantly improve blood pressure in the offspring of hypertensive rats,and reduce their susceptibility to ischemic reperfusion injury in the brain as adults.

The key pathogenesis of coronary heart disease （CHD） is spleen deficiency and phlegm stasis， and dysfunctional high-density lipoprotein （dys-HDL） may be the biological basis for the occurrence of CHD due to spleen deficiency and phlegm stasis. Considering the biological properties and effects of high-density lipoprotein （HDL）， it is believed that the structure and components of HDL are abnormal in the state of spleen deficiency which led to dys-HDL； and dys-HDL contributes to the formation of atherosclerotic plaques through two major pathways， namely， mediating the dysfunction of endothelial cells and mediating the foaminess of macrophages and smooth muscle cells， thus triggering the development of CHD. It is also believed that dys-HDL is a microcosmic manifestation and a pathological product of spleen deficiency， and spleen deficiency makes foundation for the production of dys-HDL； dys-HDL is also an important biological basis for the phlegm-stasis interactions in CHD. The method of fortifying spleen， resolving phlegm， and dispelling stasis， is proposed as an important principle in the treatment of CHD by traditional Chinese medicine， which can achieve the therapeutic purpose by affecting the changes in the structure and components of dys-HDL， thus revealing the scientific connotation of this method， and providing ideas for the diagnosis and treatment of CHD by traditional Chinese medicine.