Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.

Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.

Women with infertility, as a group with special needs, are affected by intimate partner violence (IPV) , which influences both the progression of their disease and their mental health. This article reviews the concept of IPV, the prevalence of IPV in women with infertility, assessment tools, and influencing factors, aiming to provide a reference for developing appropriate intervention programs.

Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.

Objective:To explore the value of N-terminal brain natriuretic peptide precursor (NT-proBNP), CHA2DS2-VASc score combined with echocardiography in predicting the prognosis of patients with atrial fibrillation (AF).Methods:A retrospective analysis was performed on 320 AF patients admitted to the First People′s Hospital of Chuzhou from January 2022 to June 2024. All patients completed echocardiography, NT-proBNP blood sample testing, and CHA2DS2-VASc assessment. They were followed up for 6 months or until the occurrence of endpoint events (stroke or all-cause death). According to the prognosis, patients were divided into the endpoint event group and the good prognosis group. The clinical data of the two groups were compared. Multivariate logistic regression analysis was used to screen the influencing factors of endpoint events in AF patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of NT-proBNP, CHA2DS2-VASc score and echocardiography for the prognosis of AF patients.Results:By the end of follow-up, among 320 AF patients, 64 cases (20.00%) had endpoint events, including 33 cases (10.31%) of stroke and 31 cases (9.69%) of all-cause death; 256 cases (80.00%) had no endpoint events. The age, CHA2DS2-VASc score, proportion of New York Heart Association (NYHA) cardiac function grade Ⅳ, proportion of complicated type 2 diabetes, proportion of complicated peripheral vascular disease, left atrial diameter (LAD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), logarithm of NT-proBNP, and C-reactive protein (CRP) level in the endpoint event group were all higher than those in the good prognosis group (all P<0.05). The hemoglobin (Hb) level, left ventricular ejection fraction (LVEF), and proportions of lipid-lowering and anticoagulant drug treatments were lower than those in the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that CHA2DS2-VASc score and NT-proBNP were independent risk factors for poor prognosis in AF patients (all P<0.05), and anticoagulant and lipid-lowering drug treatments were independent protective factors (all P<0.05). The sensitivity, specificity, and area under the ROC curve (AUC) of NT-proBNP, CHA2DS2-VASc score combined with echocardiography in predicting the prognosis of AF patients were 90.63%, 95.31%, and 0.927, respectively. The specificity and AUC of the combined prediction were higher than those of single assessment (all P<0.05), and there was no significant difference in sensitivity compared with single prediction (all P>0.05). Conclusions:NT-proBNP, CHA2DS2-VASc score, and echocardiography all have certain predictive value for the prognosis of AF patients, but the combined prediction value of the three is higher.

Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.

Objective To investigate the relationship between pan-immune inflammation value(PIV)and the disease severity and outcome of acute respiratory distress syndrome(ARDS).Methods A total of 162 ARDS patients admitted to the hospital from February 2023 to February 2024 were selected as the study group,which were divided into mild group(n=52),moderate group(n=65)and severe group(n=45)ac-cording to the severity of the disease,and death group(n=37)and survival group(n=125)according to the 28 d disease outcome.Another 116 healthy people in the same hospital during the same period were selected as the control group.Neutrophil count(NEUT),platelet count(PLT),monocyte count(MONO)and lympho-cyte count(LYMPH)in peripheral blood of each group were detected,and PIV was calculated.Pearson corre-lation analysis was used to analyze the correlation between PIV and disease severity in ARDS patients.Receiv-er operating characteristic(ROC)curve was used to evaluate the diagnostic value of PIV for the disease out-come of ARDS patients.Binary Logistic stepwise regression analysis was used to analyze the related factors af-fecting the outcome of ARDS patients.Results Peripheral blood PIV in the study group was significantly higher than that in the control group(P<0.05).The severe group had a significantly higher peripheral blood PIV than the moderate disease and mild group(P<0.05),and the moderate group had a significantly higher peripheral blood PIV than the mild group(P<0.05).Pearson correlation analysis showed that PIV was nega-tively correlated with arterial partial pressure of oxygen/fraction of inspired oxygen(PaO2/FiO2)in ARDS patients(r=-0.452,P<0.001).Sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation(APACHE)Ⅱ score,white blood cell count,C-reactive protein and PIV in the death group were significantly higher than those in the survival group(P<0.05),PaO2/FiO2 was significantly low-er than that in the survival group(P<0.05).ROC curve analysis showed that the area under the curve of PIV to diagnose the disease outcome of ARDS patients was 0.906(95%CI:0.865-0.956).Binary Logistic step-wise regression analysis showed that SOFA score>11.84 points(OR=2.591,95%CI:1.639-3.964),A-PACHEⅡ score>20.65 points(OR=3.367,95%CI:1.863-6.086),PaO2/FiO2>115.62 mmHg(OR=2.106,95%CI:1.521-2.916),PIV>465.52(OR=3.931,95%CI:2.075-7.448)were risk factors for the outcome of ARDS patients(P<0.05).Conclusion PIV is abnormally elevated in ARDS patients,and is closely related to the severity and outcome of the disease.It can be used as an effective indicator for early diag-nosis of the disease outcome in patients with ARDS.

Objective:To evaluate the application of the reaming-irrigation-aspirator (RIA) technique in autologous bone grafting for non-union of lower limb fracture.Methods:A retrospective analysis was conducted of the data of 16 patients with non-union of lower limb fracture who had undergone autologous bone grafting using the RIA technique at Department of Lower Limb Orthopaedics Ⅰ, Zhengzhou Orthopaedic Hospital from July 2023 to March 2024. There were 12 males and 4 females with an age of (47.2±14.3) years. Sites of non-union: the femur in 14 cases and the tibia in 2 cases. Initial surgical fixation: intramedullary nail fixation in 5 cases, plate fixation in 10 cases, and intramedullary nail plus plate fixation in 1 case. The time for fracture non-union was (21.0±12.0) months. Intraoperatively, autologous bone reaming was conducted using a drill bit of RIA system, and simultaneous flushing using irrigation fluid. The bone debris carried out by the irrigation fluid was collected into a filtration device through negative pressure aspiration. After the filter was opened to squeeze out congestion, bone paste was taken out for standby. Internal fixation methods were adjusted according to the non-union condition of the fractures. Finally, the bone paste was implanted into bone defects. The time for autologous bone harvest, amount of bone harvested, intraoperative blood loss, postoperative pain at a donor site, fracture healing, functional recovery of a lower limb and occurrence of complications were recorded.Results:In 2 of the 16 patients, fracture of the RIA drill bit occurred when bone marrow was harvested from the tibia, and their operation was completed only after the drill bits were replaced. In the 16 patients, time for bone harvest was (31.4±6.1) min, bone harvest volume (42.6±9.5) mL, and intraoperative blood loss (815.6±238.6) mL. The incisions in this cohort healed primarily after operation, and 4-week follow-up revealed that no patients had pain symptoms at a donor site. The 16 patients were followed up for (8.0±2.0) months after operation. All patients achieved bone union after (4.4±0.5) months. Follow-ups showed that no patients had complications like delayed infection, donor site fracture, or loosening or fracture of an internal fixator. According to the rating scale for lower limb function at the last follow-up, the function of affected limb was evaluated as excellent in 7 cases, as good in 8 cases, and as fair in 1 case.Conclusion:Application of RIA technique for autologous bone grafting to treat non-union of lower limb fracture can lead to fine fracture healing and good lower limb function, but no long-term pain symptoms in the donor area for the patients.

Objective:To compare the anterior long-segment fixation, posterior long-segment fixation, and combined anterior-posterior fixation in the treatment of ankylosing spondylitis with cervical fracture (ASCF).Methods:A retrospective study was conducted to analyze the 153 patients with ASCF who had been treated at Department of Orthopaedics, Peking University Third Hospital and Department of Orthopedics, Luoche Central Hospital between January 2014 and December 2023. The cohort included 86 males and 67 females, with an age of (41.6±11.5) years, a disease duration of (10.0±3.9) years, and an interval from injury to surgery of (3.3±1.4) d. By Frankel's classification for preoperative nerve injury, 57 cases were grade B, 51 grade C, and 45 grade D. Based on the surgical approaches, the patients were divided into 3 groups: an anterior group ( n=63) undergoing the anterior cervical long-segment fixation, a posterior group ( n=51) undergoing the posterior cervical long-segment fixation, and a combination group ( n=39) undergoing combined anterior-posterior cervical fixation. Surgical time, intraoperative blood loss, fracture healing, complications, and changes in Frankel grading for spinal cord injury were compared among the 3 groups. Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P > 0.05). All patients were followed up for (33.5±12.0) months after surgery. In the anterior group, the surgical time [(103.0±16.8) min] was significantly shorter than that in the posterior group [(148.4±17.7) min] and that in the combination group [(228.5±23.9) min], the intraoperative blood loss [(92.8±27.8) mL] was significantly less than that in the posterior group [(477.5±109.5) mL] and that in the combination group [(769.5±136.9) mL], and the incidence of complications [9.5% (6/63)] was significantly lower than that in the posterior group [41.2% (21/51)] and that in the combination group [53.8% (21/39)] (all P<0.05). There was no statistically significant difference in the fracture healing time among the 3 groups ( P=0.111). At the last follow-up, X-ray and CT scans showed no loosening or breakage of internal fixation in all the 3 groups. The Frankel grading at the last follow-up: 12 cases of grade C, 15 cases of grade D, and 36 cases of grade E in the anterior group; 3 cases of grade B, 12 cases of grade C, 12 cases of grade D, and 24 cases of grade E in the posterior group; 6 cases of grade C, 12 cases of grade D, and 21 cases of grade E in the combination group. At the last follow-up, all patients showed a significant improvement compared to their Frankel grades before surgery ( P<0.001), but there was no statistically significant difference between the 3 groups ( H=2.238, P=0.327). Conclusions:In the treatment of ASCF, anterior long-segment fixation is advantageous over posterior long-segment fixation and combined anteri-or-posterior fixation due to its shorter surgical time, reduced intraoperative blood loss, and a lower complication incidence. All the 3 surgical approaches demonstrate comparable outcomes in terms of fracture healing time, radiographic stability, and final neurological recovery.

Objective To analyze the development trends,research status,and hotspots in the field of gut microbiota and cognitive dysfunction from 2015 to 2025,providing a more comprehensive reference for researchers in this field and exploring cutting-edge research directions.Methods Liter-ature in relevant research fields was retrieved from the WoSCC database.Bibliometric and visualiza-tion analyses were conducted using VOSviewer,CiteSpace,ScimangoGraphica,and the R package"bibliometrix".Results A total of 665 eligible English articles were retrieved from the WoSCC data-base.The analysis revealed that the number of publications has shown an increasing trend annually since 2018.China and the United States had the leading roles globally in terms of the number of pub-lications and collaborative relationships.Huazhong University of Science and Technology are the most influential research institution in this field,with NUTRIENTS(IF=4.8)being the journal with the highest number of publications,and KIM D H ranking first in outstanding contributions and influ-ence.Keyword co-occurrence analysis indicated that"neuronal apoptosis","SCFAs","synaptic dysfunction",and"dementia prevention"were the research hotspots in this field.Furthermore,trend analysis revealed that short-chain fatty acids(SCFAs),important metabolites of gut microbiota,insulin resistance,and neuroinflammation were the research frontiers in this field,highlighting insulin resistance as a mediating hub in microbiota-cognition research.Additionally,traditional Chinese medicine interventions(such as electroacupuncture)were identified as an emerging characteristic direction in this field.Conclusion Through bibliometric research,the current status and develop-ment trends of gut microbiota and cognitive dysfunction research are analyzed from multiple perspec-tives in the paper.Comprehensive insights into the cutting-edge dynamics of this research field are provided,offering valuable references for further in-depth research by more scholars in this area.