ObjectiveTo investigate the effect and mechanism of transplantation of human umbilical cord mesenchymal stem cell （hUC-MSC） with overexpression of the Numb gene in the treatment of cholestatic liver fibrosis （CLF）. MethodsThe technique of lentiviral transfection was used to induce the overexpression of the Numb gene in hUC-MSC （hUC-MSC^Numb-OE）， and hUC-MSC transfected with empty vector （hUC-MSC^OE-EV） was used as negative control. Bile duct ligation （BDL） was performed to establish a rat model of CLF， and then the rats were randomly divided into BDL group， hUC-MSC group， hUC-MSC^OE-EV group， and hUC-MSC^Numb-OE group， while a sham-operation group was also established. The rats in the intervention groups were given a single splenic injection of the corresponding cells after BDL， and samples were collected at the end of week 4. Related indicators were measured， including serum biochemistry， liver histopathology， the content of hydroxyproline （Hyp） in the liver， hepatic stellate cell activation， ductular reaction， liver regeneration， and the expression levels of key molecules in the Numb-p53 signaling axis. 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 BDL group， the hUC-MSC group and the hUC-MSC^OE-EV group had significant reductions in the levels of serum biochemical parameters （aspartate aminotransferase， gamma-glutamyl transpeptidase， total bile acid， total bilirubin， and direct bilirubin）， liver fibrosis markers （the content of Hyp and the expression levels of alpha-smooth muscle actin， tumor necrosis factor-α， and transforming growth factor-beta 1）， and ductular reaction markers （the expression levels of CK7 and CK19） （all P <0.05）， and compared with the hUC-MSC^OE-EV group， the hUC-MSC^Numb-OE group had significantly greater improvements in the above indicators （all P <0.05）. In addition， compared with the hUC-MSC^OE-EV group， the hUC-MSC^Numb-OE group had significant improvements in the expression levels of liver regeneration-related markers （albumin and hepatocyte nuclear factor 4α） and the molecules associated with the Numb-p53 signaling axis （Numb， pNumb， Mdm2， and p53） （all P <0.05）. ConclusionOverexpression of the Numb gene can enhance the therapeutic effect of hUC-MSC on CLF， possibly by activating the Numb-PTB^L-p53-HNF4α axis， promoting the hepatic differentiation of hUC-MSCs and subsequently enhancing liver regeneration.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Under the new educational development trends,numerous universities are actively exploring the deep integration of digital information technology and artificial intelligence(AI)technology with teaching.Through a three-phase process involving stu-dents'pre-class AI-assisted online self-learning via knowledge graphs,interactive classroom teaching between teachers and students,and post-class collaborative enhancement,we explored intelligent visualization-assisted teaching,personalized learning,and multi-di-mensional,fine-grained formative assessment to help teachers offer differentiated attention and personalized guidance,encourage stu-dents'autonomous and personalized learning,enhance students'self-study capabilities.This teaching practice has achieved remark-able results in stimulating students'learning enthusiasm,broadening their knowledge base,and enhancing their self-directed learning capabilities.

Under the background of increasingly severe drug-resistant bacteria infections,protracted course of chronic wounds has become clinical difficulties disturbing both patients and doctors.With the unique advantages of broad antibacterial spectrum,low drug resistance rate and high safety,polyhexanide antibacterial agent has gradu-ally become a major approach for treatment and nursing of chronic wounds.The application of polyhexamethylene biguanide(PHMB)antimicrobial agents in treatment and nursing of chronic wounds was reviewed in the article,including the antibacterial properties,comparisons with other antimicrobial agents,actual clinical practice and potential side effects,aiming to guide the further application of PHMB antimicrobial agents in treatment of chronic wounds.

Objective: To observe the effect of Xipayimaizibizi oral liquid (XP) in an overactive bladder (OAB) experimental rat model and to explore its pharmacological mechanisms. Methods: Network pharmacology was used to explore the potential mechanisms of action of XP. The rats underwent bladder outlet obstruction surgery and were administered the corresponding drug concentrations by gavage for 4 weeks. The study observed the body weight, water intake, bladder and kidney indices (to evaluate their general status), urination behavior pattern (to observe frequency and urgency), and urodynamics (to measure bladder parameters). Hematoxylin and eosin and Masson's trichome staining were used to observe changes in the bladder structure. Enzyme-linked immunosorbent assay was used to measure the levels of nerve growth factor, brain-derived neurotrophic factor, and acetylcholine in the urine. The key targets involved in these mechanisms were validated using reverse transcription-quantitative polymerase chain reaction, immunohistochemistry, and western blot in vivo/vitro experiments. Result: Network pharmacological analysis predicted that XP may alleviate OAB by affecting the cholinergic synapse and calcium signaling pathways. XP treatment significantly reduced the bladder index, improved urine behavior and urodynamic parameters, decreased the neurotransmitters in urine, and reduced the thickness of the bladder wall and collagen ratio. These results indicate that XP can alleviate OAB symptoms and improve the bladder structure. In vivo/vitro experiments further demonstrated that XP can inhibit targets, such as muscarinic acetylcholine receptor 2, and participate in cholinergic synapses to further regulate the parasympathetic nervous system. It can also reduce the overexpression of Ca2+ caused by agonists, inhibit targets such as transient receptor potential vanilloid type 1, and participate in calcium signaling pathways to maintain Ca2+ homeostasis. Conclusion These results suggest that XP inhibited bladder overactivity by maintaining Ca2+ homeostasis and regulating the parasympathetic nervous system.

Objective To investigate the value of geometric parameters of vertebrobasilar artery(VBA)for judging whether vertebral artery(VA)provide cross blood supply of posterior cerebral artery(PCA)blood supply area.Methods MR T2-fluid attenuated inversion recovery(FLAIR),3D time of flight(TOF)MR angiography(MRA)and territorial arterial spin labeling(t-ASL)images of 244 healthy adults were prospectively acquired.The angles between left VA(LVA)or right VA(RVA)and basilar artery(BA)were measured,and the sum and difference between the two angles were calculated(referred to as the sum of VA angles and the difference of VA angles),and the differences of diameters of LVA and RVA were measured and calculated(referred to as the difference of VA diameters).VA perfusion distribution type in PCA blood supply area were observed,and those with type Ⅲ or Ⅵ were enrolled in cross group,while those with type Ⅱ or Ⅴ were enrolled in non-cross group,respectively.The geometric parameters of VBA were compared between groups.Receiver operating characteristic(ROC)curve of parameters being significant different between groups were drawn,and the efficacy of these parameters for judging whether VA provide cross blood supply of PCA area were evaluated.Results There were 34 subjects in cross group and 75 in non-cross group.The sum of VA angles and the difference of VA angles in cross group were both larger than those in non-cross group(both P＜0.05),while the difference of VA diameters were not significantly different between groups(P＞0.05).The AUC of the difference of VA angles for judging whether VA provide cross blood supply of PCA area was 0.676(P＜0.05),while of the sum of VA angles was 0.598(P=0.103).Conclusion The angle differences of LVA and RVA with BA had certain application value for judging whether VA provide cross blood supply of PCA area.

Under the new educational development trends,numerous universities are actively exploring the deep integration of digital information technology and artificial intelligence(AI)technology with teaching.Through a three-phase process involving stu-dents'pre-class AI-assisted online self-learning via knowledge graphs,interactive classroom teaching between teachers and students,and post-class collaborative enhancement,we explored intelligent visualization-assisted teaching,personalized learning,and multi-di-mensional,fine-grained formative assessment to help teachers offer differentiated attention and personalized guidance,encourage stu-dents'autonomous and personalized learning,enhance students'self-study capabilities.This teaching practice has achieved remark-able results in stimulating students'learning enthusiasm,broadening their knowledge base,and enhancing their self-directed learning capabilities.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Objective To investigate the value of geometric parameters of vertebrobasilar artery(VBA)for judging whether vertebral artery(VA)provide cross blood supply of posterior cerebral artery(PCA)blood supply area.Methods MR T2-fluid attenuated inversion recovery(FLAIR),3D time of flight(TOF)MR angiography(MRA)and territorial arterial spin labeling(t-ASL)images of 244 healthy adults were prospectively acquired.The angles between left VA(LVA)or right VA(RVA)and basilar artery(BA)were measured,and the sum and difference between the two angles were calculated(referred to as the sum of VA angles and the difference of VA angles),and the differences of diameters of LVA and RVA were measured and calculated(referred to as the difference of VA diameters).VA perfusion distribution type in PCA blood supply area were observed,and those with type Ⅲ or Ⅵ were enrolled in cross group,while those with type Ⅱ or Ⅴ were enrolled in non-cross group,respectively.The geometric parameters of VBA were compared between groups.Receiver operating characteristic(ROC)curve of parameters being significant different between groups were drawn,and the efficacy of these parameters for judging whether VA provide cross blood supply of PCA area were evaluated.Results There were 34 subjects in cross group and 75 in non-cross group.The sum of VA angles and the difference of VA angles in cross group were both larger than those in non-cross group(both P＜0.05),while the difference of VA diameters were not significantly different between groups(P＞0.05).The AUC of the difference of VA angles for judging whether VA provide cross blood supply of PCA area was 0.676(P＜0.05),while of the sum of VA angles was 0.598(P=0.103).Conclusion The angle differences of LVA and RVA with BA had certain application value for judging whether VA provide cross blood supply of PCA area.

Under the background of increasingly severe drug-resistant bacteria infections,protracted course of chronic wounds has become clinical difficulties disturbing both patients and doctors.With the unique advantages of broad antibacterial spectrum,low drug resistance rate and high safety,polyhexanide antibacterial agent has gradu-ally become a major approach for treatment and nursing of chronic wounds.The application of polyhexamethylene biguanide(PHMB)antimicrobial agents in treatment and nursing of chronic wounds was reviewed in the article,including the antibacterial properties,comparisons with other antimicrobial agents,actual clinical practice and potential side effects,aiming to guide the further application of PHMB antimicrobial agents in treatment of chronic wounds.