Post-traumatic stress disorder (PTSD) is a relatively common but complex mental illness with a range of diverse risk factors. Typical symptoms include the re-experience or avoidance of traumatic events, cognitive impairment, and hypervigilance. While the exact pathogenesis of PTSD is unclear, many studies indicate that epigenetic regulation plays a key role in its development. Specifically, numerous studies have indicated that the levels of histone acetylation and methylation, DNA methylation, and noncoding RNA are altered in PTSD patients. Further to this, natural products have been found to achieve epigenetic regulation of PTSD by regulating the expression of epigenetic enzymes, long noncoding RNA (lncRNA), and miRNA, thereby playing a role in improving PTSD symptoms. To date, however, no epigenetic regulation related drugs have been used in the treatment of PTSD. Furthermore, while natural products that can epigenetically regulate PTSD have received increasing levels of attention, there have not yet been any systematic reports on the topic. Here, we summarized the roles and mechanisms of natural products in the epigenetic regulation of PTSD, providing a novel and unique perspective that will help to guide the development and application of new PTSD treatments.

Objective To explore the clinical significance of detecting mitochondrial DNA(mtDNA)content and 10398 site mutation in serum.Methods A tatol of 314 healthy women who underwent physical examinations at the Yichang Second People's Hospital were collected from January to December 2020 as health examination group,and collect 82 cervical cancer patients who received medical treatment at the Second People's Hospital of Yichang City from January 2020 to December 2023 as cervical cancer group.Detect the mtDNA content and 10398 locus genotype of serum samples from two groups of participants,and compare the differences in indicators between two groups of participants.Results The mtDNA content of cervical cancer patients was significantly higher than that of healthy examination group(P＜0.05);There was no statistically significant difference in genotype at locus 10398 between two groups of participants(P＞0.05).The mtDNA content of women aged≥45 in health examination group was higher,and the difference was statistically significant(P＜0.05);There was no statistically significant difference in the distribution of mtDNA at different 10398 loci(P＞0.05).Patients aged ≥45 in cervical cancer group have higher mtDNA content,and the difference is statistically significant(P＜0.05);There was no statistically significant difference in mtDNA content among patients with different clinical stages and pathological types(P＞0.05),and there was no statistically significant difference in mtDNA content at different 10398 loci(P＞0.05).Conclusion The detection of mtDNA content has certain significance for both healthy physical examination population and cervical cancer population.The mtDNA content in both groups is related to age and increases with age.The mtDNA content in cervical cancer population is significantly higher than that in normal physical examination population.The detection of mtDNA at 10398 site in serum has little significance for both groups.The mtDNA content and 10398 site distribution in cervical cancer population are not related to pathology and stage.The detection of mtDNA content can be considered as a serum biomarker for the diagnosis of cervical cancer.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective:To determine a simpler and more practical scoring standard for predicting mucosal histological healing in ulcerative colitis (UC).Methods:From April 11, 2017 to February 8, 2021, 68 UC patients diagnosed with mucosal healing under endoscopy and hospitalized at Department of Gastroenterology, the Tenth People′s Hospital of Tongji University and during the same period 60 healthy individuals who underwent endoscopy for health checkup were retrospectively analyzed. Modified Mayo score and ulcerative colitis endoscopic index of severity (UCEIS), the modified Nancy index and Robarts histopathology index were determined based on the collected clinical data, endoscopic reports and histopathological evaluation. The proportions of neutrophils, eosinophils, and plasma cells in the colonic mucosal lamina propria were calculated. The proportions of activated neutrophils and T cells in the colonic mucosal lamina were calculated according to CD177 and CD40L, respectively. The new clinical and laboratory diagnostic formulas were determined by multivariate logistic regression analysis, the effectiveness of the equations was evaluated by receiver operating characteristic curve (ROC).Results:Among the 68 patients with UC, the modified Mayo score was 0.7 (0.4, 1.1), the UCEIS was 0.5 (0.3, 0.8), the Nancy index was 5.9±3.2, and the Robarts histopathology index was 2.6±1.7. According to multivariate logistic regression analysis, the formula for clinical diagnosis of histological healing was Y1=-21.09+ 355.9 X1+ 305.8 X2+ 44.91 X3 ( X1, X2 and X3 were the proportions of neutrophils, eosinophils, and plasma cells, respectively). The results of ROC analysis indicated that Y1<-0.747 was the cut-off value of diagnosis of histological healing, and the area under the curve (AUC) was 0.986 and 95% confidence interval ( CI) was 0.922 to 1.000 ( P<0.001), the sensitivity was 97.10% and the specificity was 91.20%. The formula of laboratory diagnosis of histological healing was Y2=-10.57+ 469.1 X1 + 132.7 X2 + 101.2 X3 + 18.56 X4 ( X1, X2, X3, and X4 were the proportions of CD177 + neutrophils, eosinophils, CD40L + T cells and plasma cells, respectively). The results of ROC analysis indicated that Y2<1.960 was the cut-off value of diagnosis of histological healing, and the AUC was 0.980, 95% CI was 0.913 to 0.999 ( P<0.001), the sensitivity was 84.78%, and the specificity was 100.00%. The new clinical and laboratory diagnostic criteria were positively correlated with the Nancy histological index ( r=0.411 and 0.308, P=0.001 and 0.011), and Robarts histopathology index ( r=0.311, 0.273, P=0.010 and 0.024). Conclusions:Compared with the Nancy index, the new clinical and laboratory diagnostic criteria are simpler and more practical. The new clinical diagnostic formula Y1<-0.747 and the new laboratory diagnosis formula Y2<1.960 are the independent factors for predicting histological healing in UC patients.

【Objective】 To explore the effect of mobile transfusion closed-loop information system in the whole process management of clinical blood transfusion. 【Methods】 The hospital information system (HIS) of Soochow Hospital affiliated to Nanjing Medical University was integrated with the blood information system (BIS) and personal digital assistant (PDA) to build a closed-loop transfusion management process to ensure the safety of clinical blood use. From May 2021 to April 2022, 1 395 patients who were admitted to our hospital for blood transfusion therapy were studied. Among them, 632 patients from May to October 2021 (before the implementation of closed-loop management) were the control group, and 763 patients from November 2021 to April 2022 (after the implementation of closed-loop management) were the observation group. Before and after the implementation of closed-loop management, we compared the implementation rate of double-checking before blood sample collection, rate of transfusion within 30 min after blood issuing, implementation rate of double-checking of bedside transfusion, situation of patrol every 15 minutes, rate of transfusion completed within 4 h, rate of nursing documentation standardization, so as to evaluate the improvement effect of the whole process of transfusion management. 【Results】 The implementation rate of double-checking before blood sample collection was 99.48%(759/763) in the observation group and 93.99%(594/632) in the control group; the transfusion rate within 30 min after blood issuing was 95.02%(725/763) in the observation group and 91.46%(578/632) in the control group; the implementation rate of double-checking of bedside transfusion was 100%(763/763) in the observation group and 95.73%(605/632) in the control group; the complete rate of patrol every 15-min was 94.36%(720/763) in the observation group and 90.35%(571/632) in the control group; the completion rate of transfusion within 4 h was 95.81%(731/763) in the observation group and 92.25%(583/632) in the control group; the rate of nursing paperwork standardization was 98.03%(748/763) in the observation group and 81.80%(517/632) in the control group, and the difference between the two groups was statistically significant (P<0.05). 【Conclusion】 The mobile transfusion closed-loop information system can realize the whole process management of clinical blood transfusion, effectively improve the standardization of blood transfusion and transfusion documents, and guarantee the safety of clinical blood transfusion.

Objective To explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population. Methods We conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort. Results In the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95％CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95％CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95％CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95％CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95％CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95％CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95％CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Cox model with forward stepwise selection, triglycerides were the only lipid markers entered into the final model. Conclusion Lipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.

Objective: The aim of this study was to evaluate the influence of concomitant carcinoma in situ (CCIS) on tumor survival for the upper tract urinary carcinoma (UTUC) through systematic review and meta-analysis. Methods: In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE China National Knowledge Infrastructure (CNKI) and Wanfang database by key words "upper urinary tract urothelial carcinoma" "renal sputum cancer" "concomitant carcinoma in situ" , and "radical ureterectomy" were performed for all reports that included detailed results on the predictors of CCIS. The search deadline is June 2019, and the search terms are English and Chinese. Methodological quality evaluation was performed using the QUIPS tool, and statistical analysis of the relevant data was performed using Stata 12.0 and RevMan 5.3 software. Results: Sixteen articles were included in this study and all published between 2012 and 2019. A total of 11 131 patients with UTUC, including 1 774 (15.9%) patients with CCIS. According to our final results, there was a significant correlation of CCIS with worse cancer-specific survival (CSS) (HR=1.10, 95%CI 1.05-1.16, P<0.001), recurrence-free survival (RFS) (HR=1.15, 95%CI 1.09-1.21, P<0.001) and overall survival (OS) (HR=1.10, 95%CI 1.03-1.17, P=0.003). Begg′s bias analysis showed no significant publication bias in CSS (P=0.822), RFS (P=0.348), and OS (P=0.452). Conclusions This study demonstrated that CCIS was associated with poor oncological outcome and could serve as a independent prognostic factor for patient with UTUC after radical nephroureterectomy.

Objective To systematically evaluate the expression of microvascular invasion (MVI) in predicting the clinical prognosis of patients with non-metastatic renal cell cancer (nmRCC) after surgical operation.Methods The relevant search strategy,including and excluding criteria for the relevant literature were developed by two independent researchers.Pubmed,EMBASE,China National Knowledge Infrastructure (CNKI),and Wanfang databases were searched from the inception to May 2018 for the study of tumor prognosis in the patients of nmRCC with MVI following surgical resection.The search language was English and Chinese.The methodological quality of the included studies was assessed by the NOS.Stata 12.0 software and Review Manager 5.3 were used to perform a clinical meta-analysis of relevant literature data.Results A total of 25 related clinical studies were included,published from 2004 to 2018.There were 6 741 patients with nmRCC,of which 1 768 cases of MVI,with a proportion rate of 26.2％.The results showed that the patients with MVI in pathological sections had a lower cancer-specific survival rate (CSS) [HR =1.51,95％ CI(1.41-1.62),P ＜0.001],recurrence-free survival rate(RFS) [HR =1.47,95％ CI (1.26-1.71),P＜0.001] and overall survival rate(OS) [HR=1.37,95％C1(1.19-1.57),P＜ 0.001].Egger's publication bias analysis showed no significant publication bias in terms of CSS (t =1.43,P=0.176),RFS (t =1.21,P=0.253) and OS(t =0.37,P=0.725).Conclusions MVI had a significant poor outcome in patients with surgical resection of nmRCC.It can be used as an independent risk factor to evaluate the postoperative prognosis of those patients.

OBJECTIVE:To systematically review the efficacy and safety of Moxifloxacin(MFX)in the treatment of acute ex-acerbation of chronic bronchitis (AECB),and provide evidence-based reference for Tational use of MFX. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,Medline,CBM,CJFD,VIP and Wanfang Database,the relevant conference proceed-ings and grey literature were also hand-searched,randomized controlled trials(RCT)about MFX(test group)versus other antibiot-ics (control group) in the treatment of AECB were collected. Meta-analysis was performed by using Rev Man 5.2 software with ITT analysis and PP analysis after literature selection,data extraction and quality evaluation. RESULTS:Totally 14 RCTs were in-cluded,involving 6 058 patients. Results of PP analysis showed,the clinical effective rate in test group was similar to that of con-trol group [RR=1.02,95%CI(1.00,1.04),P=0.06],while bacteria clearance rate was significantly higher than control group [RR=1.07,95%CI(1.04,1.11),P<0.001]. Results of ITT analysis showed,the clinical effective rate in test group was significantly high-er than control group [RR=1.03,95%CI(1.00,1.06),P=0.03],while there was no significant difference in the bacteria clearance rate [RR=1.02,95%CI(0.92,1.12),P=0.73] and the incidence of adverse reactions [RR=0.97,95%CI(0.87,1.08),P=0.52] be-tween 2 groups. CONCLUSIONS:The efficacy of MFX is not inferior to other antibiotics in the treatment of AECB,safety is simi-lar to other antibiotics.

Objective To investigate the MRI features and Ki-67 expression and correlation with prognosis in undifferentiated pleomorphic sarcoma (UPS).Methods MRI and clinicopathological data of 34 cases with UPS proved by operation and pathology were analyzed retrospectively(with an average follow-up of 3 years).According to the presence of local recurrence,the data were divided into two groups:no recurrence group (15 cases)and recurrence group(19 cases).Two groups were analyzed according to age,tumor size,location,MRI features (lesions margin,hemorrhage,necrosis,pseudocapsule and perilesional characteristics)and expression of Ki-67.Results The results showed that two groups tumor’s size(P =0.002),location(P =0.025),pseudocapsule(P =0.025 ),peritumoral tissue inva-sion(P =0.008)and expression of Ki-67 (P =0.000)were of statistical correlation with tumor local recurrence.Conclusion Preoper-ative MRI can observe the characteristics of undifferentiated pleomorphic sarcoma,the relationship with the adjacent tissue and local invasive scope,which will be helpful for clinical diagnosis and decision of surgical plan.