ObjectiveTo observe the intervention effect of Fufang Kangjiaolv capsules on anxiety-like behaviors in the rat model of chronic restraint stress （CRS） and explore the mechanism underlying the anti-anxiety effect via the microbiota-gut-brain axis. MethodsRats were assigned into blank， model， positive drug （diazepam， 1 mg·kg^-1）， and low-， medium-， and high-dose （0.75， 1.5， 3 g·kg^-1， respectively） Fufang Kangjiaolv capsules groups. After 14 days of administration， the elevated plus maze test， open field test， light and dark box test， and marble burying test were performed. Hematoxylin-eosin staining was employed to observe the pathological changes in the hippocampus and colon of rats， and Nissl staining was conducted to observe the damage of hippocampal neurons. The gut microbiota was analyzed by 16S rRNA gene sequencing. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was employed to determine the mRNA levels of zonula occludens-1 （ZO-1） and occludin in the colon of rats. The levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in the colon， serum， and hippocampus were determined by enzyme-linked immunosorbent assay. Western blot was employed to determine the protein levels of ZO-1， occludin， nuclear factor-κB p65 （NF-κB p65） in the colon tissue and NF-κB p65 and brain-derived neurotrophic factor （BDNF） in the hippocampal tissue. ResultsCompared with the blank group， the model group showed reductions in the time and frequency ratio of rats entering the elevated plus maze， the time and frequency of rats entering the central area of the open field， the time of entering the open box， the times of passing through the light and dark box， and the number of unburied beads （P<0.05， P<0.01）. Compared with the model group， Fufang Kangjiaolv capsules ameliorated the anxiety of the model rats to varying degrees， and the high-dose group had the best effect， with increases in the proportions of time and frequency of rats entering the open arm in the elevated plus maze （P<0.05）， the number of rats entering the central area in the open field （P<0.05）， the time of entering the open box， the times of passing through the light and dark boxes， and the number of unburied beads （P<0.01）. Moreover， the high-dose group showed alleviated pathological damage of hippocampal neurons and colon. The results of 16S rRNA gene sequencing showed that the model group had increased relative abundance of Firmicutes， Deferribacterota， Romboutsia， and Phascolarctobacterium， while it had decreased relative abundance of Bavcteroidota and Lactobacillus. The drug administration groups showed increased relative abundance of Bavcteroidota， Bacteroides， norank f norank o Clostridia UCG-014， and Blautia and decreased relative abundance of Firmicutes and Deferribacterota. Compared with the blank group， the model group showed down-regulated protein and mRNA levels of ZO-1 and occludin in the colon （P<0.01）， elevated levels of TNF-α， IL-6， and IL-β in the colon， serum， and hippocampus （P<0.01）， up-regulated protein level of NF-κB p65 in the colon and hippocampus （P<0.01）， and down-regulated protein level of BDNF in the hippocampus （P<0.05）. Compared with the model group， high-dose Fufang Kangjiaolv capsules up-regulated the mRNA levels of ZO-1 and occludin in the colon （P<0.01）， lowered the levels of TNF-α， IL-6， and IL-β in the colon， serum， and hippocampus （P<0.01）， up-regulated the protein levels of ZO-1 （P<0.01） and occludin （P<0.05） in the colon， down-regulated the protein level of NF-κB p65 in the colon and hippocampus （P<0.05）， and up-regulated the protein level of BDNF in the hippocampus. ConclusionFufang Kangjiaolv capsules can reduce the anxiety-like behaviors in the rat model of CRS by regulating the gut microbiota disturbance， up-regulating the expression of tight junction proteins in the colon， repairing intestinal mucosal mechanical barrier， and down-regulating NF-κB/BDNF signaling pathway， thereby reducing peripheral and central inflammation. This study proves the hypothesis that Fufang Kangjiaolv capsules play an anti-anxiety role via the microbiota-gut-brain axis， providing a new idea for further research.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

A U-Net incorporating improved Transformer and convolutional channel attention module is designed for biventricular segmentation in MRI image.By replacing the high-level convolution of U-Net with the improved Transformer,the global feature information can be effectively extracted to cope with the challenge of poor segmentation performance due to the complex morphological variation of the right ventricle.The improved Transformer incorporates a fixed window attention for position localization in the self-attention module,and aggregates the output feature map for reducing the feature map size;and the network learning capability is improved by increasing network depth through the adjustment of multilayer perceptron.To solve the problem of unsatisfactory segmentation performance caused by blurred tissue edges,a feature aggregation module is used for the fusion of multi-level underlying features,and a convolutional channel attention module is adopted to rescale the underlying features to achieve adaptive learning of feature weights.In addition,a plug-and-play feature enhancement module is integrated to improve the segmentation performance which is affected by feature loss due to channel decay in the codec structure,which guarantees the spatial information while increasing the proportion of useful channel information.The test on the ACDC dataset shows that the proposed method has higher biventricular segmentation accuracy,especially for the right ventricle segmentation.Compared with other methods,the proposed method improves the DSC coefficient by at least 2.83%,proving its effectiveness in biventricular segmentation.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Organoid is a newly developed cellular there-dimensional culture system in recent years. Organoids have a three-dimensional structure, which is similar to that of the real organs. Together with the characteristics of self-renewal and reproduction of tissue origin, organoids can better simulate the function of real organs. Organoids provide a new platform for the study of organogenesis, regeneration, disease pathogenesis, and drug screening. The digestive system is an essential part of the human body and performs important functions. To date, organoid models of various digestive organs have been successfully established. This review summarizes the latest research progress of organoids of taste buds, esophagi, stomachs, livers and intestines, and prospects future application of organoids.
Humans ; Organoids ; Intestines ; Liver

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Objective:To investigate the clinical characteristics of patients who develop chronic critical illness (CCI) after sepsis.Methods:The survival patients with sepsis admitted to the department of critical medicine of Baoan Central Hospital of Shenzhen for the first time from April 2019 to October 2020 were enrolled. According to clinical outcomes, patients were divided into CCI group [intensive care unit (ICU) stay ≥14 days, with persistent organ dysfunction] and rapid recovery (RAP) group. The baseline characteristic on admission and clinical outcomes of patients in the two groups were collected and compared. Blood samples were collected to measure serum interleukins (IL-6, IL-10) levels and peripheral blood lymphocyte count (LYM) count were obtained from all patients after admission. The differences of above indexes on the 1st, 7th and 14th day in ICU between the two groups were compared, the 180 day cumulative survival rate of the two groups was observed.Results:① Twenty-two septic patients developed CCI and 28 patients with RAP were included. There were no significant differences in gender and infection site between the two groups. The age, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), proportion of septic shock, mechanical ventilation time, length of ICU stay, total length of hospital stay and proportion of secondary infection of CCI patients were higher than those in RAP group [age (years old): 61.0±13.8 vs. 50.3±13.9, proportion of patients aged ≥ 65 years old: 54.5% (12/22) vs. 25.0% (7/28), APACHEⅡscore: 20.5±4.4 vs. 14.4±4.3, SOFA score: 10 (7, 12) vs. 5 (3, 8), septic shock ratio: 40.9% (9/22) vs. 17.9% (5/28), time of mechanical ventilation (days): 18.5 (12.0, 28.0) vs. 5.0 (3.0, 7.0), length of ICU stay (days): 26 (18, 46) vs. 8 (6, 12), total length of hospital stay (days): 31 (26, 51) vs. 14 (12, 17), secondary infection ratio: 72.7% (16/22) vs. 7.1% (2/28), all P < 0.05]. ② The IL-6 levels of CCI group were higher than that of RAP group at all time points (ng/L: 176.86±103.54 vs. 113.32±71.34 on the 1st day, 84.72±46.06 vs. 54.98±26.61 on the 7th day, 44.28±20.20 vs. 17.76±4.70 on the 14th day, all P < 0.05). On the 1st and 7th day of admission, there were no significant differences in IL-10 and LYM levels between the two groups. On the 14th day of admission, IL-10 levels in CCI group were higher than that in RAP group (ng/L: 15.09±3.61 vs. 8.92±1.98, P < 0.05), while LYM was relatively lower [×10 9/L: 0.62 (0.43, 1.02) vs. 1.17 (0.93, 1.71), P < 0.05]. ③ The Log-Rank test results of Kaplan-Meier survival curve showed that the 180-day cumulative survival rate of CCI group was significantly lower than that of RAP group (63.6% vs. 96.4%, Log-Rank:χ 2 = 9.024, P = 0.007). Conclusions:Septic patients with advanced age, high APAHCEⅡscore and high SOFA score are prone to secondary CCI, resulting in long hospital stay, high secondary infection rate and poor prognosis. The occurrence of CCI may be related to the continuous expression of proinflammatory mediators and subsequent immunosuppression.

Objective To explore effect of early rehabilitation nursing in prevention of persistent stroke syndrome patients.Methods A total of 60 patients with stroke from January to August 2016 were treated as control group,given routine nursing.Another 60 patients with stroke from September 2016 to May 2017 were treated as observation group,given early rehabilitation nursing intervention on the basis of the control group.The occurrence of shoulder hand syndrome and the function of upper limb were compared between the two groups.Results Shoulder hand syndrome incidence rate in the observation group after 3 months of the intervention was lower,the severity was lighter,the activity degree of shoulder joint was greater,pain score was lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The Ashworth score of muscle tone in the observation group after 3 months of the intervention was lower than that in the control group,and the simplified FMA score of the upper limb was higher than that in the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Early rehabilitation nursing intervention can prevent the occurrence of stroke hand shoulder syndrome and improve the function of upper limb,so it is worth popularizing.

Objective To explore effect of early rehabilitation nursing in prevention of persistent stroke syndrome patients.Methods A total of 60 patients with stroke from January to August 2016 were treated as control group,given routine nursing.Another 60 patients with stroke from September 2016 to May 2017 were treated as observation group,given early rehabilitation nursing intervention on the basis of the control group.The occurrence of shoulder hand syndrome and the function of upper limb were compared between the two groups.Results Shoulder hand syndrome incidence rate in the observation group after 3 months of the intervention was lower,the severity was lighter,the activity degree of shoulder joint was greater,pain score was lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The Ashworth score of muscle tone in the observation group after 3 months of the intervention was lower than that in the control group,and the simplified FMA score of the upper limb was higher than that in the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Early rehabilitation nursing intervention can prevent the occurrence of stroke hand shoulder syndrome and improve the function of upper limb,so it is worth popularizing.

Objective To explore the relationship between semen leukocyte and liquefaction and sperm motility through the anal‐ysis of routine semen examination results .Methods Retrospectively analyze on 8 666 cases of routine semen examination .Accord‐ing to the leukocyte count the semen samples which had sperms were divided into three groups ,Group A :white blood cells≤1 × 106/mL ,Group B:(1-4)× 106/mL ,Group C :>4 × 106/mL .Then compare the liquefaction time and sperm motility of these three groups .Results Among the 8 666 cases of semen analysis ,there were 164 cases of azoospermia(accounting for 1 .9% ) and 8 502 fine cases(accounting for 98 .1% ) .There were 7 419 ,1 014 and 69 cases in Group A ,B ,C respectively .In the three groups ,there were 5 323 ,740 and 50 cases of normal sperm motility respectively ;there were 2 096 ,274 and 19 cases of the abnormal motility ca‐ses respectively .In the three groups ,the normal cases of semen liquefaction time were 4 593 ,608 and 43 respectively ;the abnormal were 2 826 ,406 and 26 cases respectively .Statistical analysis showed no significant correlation between semen leukocyte and lique‐faction(P=0 .712) ,and between semen leukocyte and sperm motility(P=0 .486) .There were 1 217 cases of normal sperm motility and 4 027 cases of abnormal sperm motility in normal liquefaction group;there were 1 172 cases of normal sperm motility and 2 086 cases of sperm motility in abnormal liquefied group .There was statistically significant difference between the two groups(P=0 .000<0 .05) .Conclusion There were no correlation between semen leukocyte count and liquefaction or sperm motility ,but sperm mo‐tility and liquefaction are correlated .