ObjectiveTo evaluate the therapeutic effect of stewed Polygoni Multiflori Radix on androgenic alopecia （AGA） and study the treatment mechanism. MethodNinety-nine SPF-grade male C57BL/6J mice were randomized into control， model， positive drug （finasteride， 0.65 mg·kg^-1）， low （0.78 g·kg^-1）， medium （1.56 g·kg^-1）， and high （3.12 g·kg^-1）-dose stewed Polygoni Multiflori Radix， and Polygoni Multiflori Radix Praeparata groups by the random number table method. The mouse model of AGA was constructed by subcutaneous multi-point injection of testosterone propionate diluent for 60 days， and the mice were administrated with corresponding drugs by gavage from day 11. The therapeutic effects of stewed Polygoni Multiflori Radix and Polygoni Multiflori Radix Praeparata on AGA were evaluated by newly hair area， hair length， hair weight in the hair removal area， and hematoxylin-eosin staining. Enzyme-linked immunosorbent assay was employed to determine the levels of testosterone （T）， dihydrotestosterone （DHT）， and 5α-reductase （5-AR） in the skin tissue of mice. Western blot was employed to determine the expression levels of key proteins in the Wnt/β-catenin signaling pathway. ResultCompared with the control group， the model group （after 60 days of modeling） showed reductions in the newly hair area， hair length and weight in the back hair removal area， and ratio of hair follicles containing melanin to total hair follicles （P<0.05， P<0.01）， elevated levels of T， DHT， and 5-AR， up-regulated expression level of glycogen synthase kinase-3β （GSK-3β） （P<0.05， P<0.01）， and down-regulated expression levels of β-catenin， phospho-glycogen synthase kinase-3β （p-GSK-3β）， and p-GSK-3β/GSK-3β （P<0.05， P<0.01） in the skin tissue. Compared with the model group， the positive drug， low-， medium-， and high-dose stewed Polygoni Multiflori Radix， and low-， medium-， and high-dose Polygoni Multiflori Radix Praeparata improved the newly hair area and hair length of mice （P<0.01）， and stewed Polygoni Multiflori Radix and Polygoni Multiflori Radix Praeparata at low and medium doses improved the weight of newly formed hair in mice （P<0.05， P<0.01）. The positive drug， low-， medium-， and high-dose stewed Polygoni Multiflori Radix， and low- and high-dose Polygoni Multiflori Radix Praeparata increased the ratio of hair follicles containing melanin to total hair follicles in the skin tissue （P<0.05， P<0.01）. Compared with Polygoni Multiflori Radix Praeparata at the same doses， the medium and high doses of stewed Polygoni Multiflori Radix increased the ratio of melanin-containing hair follicles to total hair follicles （P<0.05）. Compared with the model group， stewed Polygoni Multiflori Radix lowered the levels of T and DHT， down-regulated the expression level of GSK-3β （P<0.01）， and up-regulated the expression levels of β-catenin， p-GSK-3β， and p-GSK-3β/GSK-3β （P<0.05， P<0.01） in the skin tissue of the mice. ConclusionStewed Polygoni Multiflori Radix can ameliorate androgenic alopecia in mice by reducing the androgen level and promoting Wnt/β-catenin signaling.

The ethical dilemma in scientific research exists at all stages of the scientific research activities among medical graduate students,mainly involving conflicts of interest,clinical trials,animal experiments,and the relationship between teachers and students.If medical graduate students are in the ethical dilemma in scientific research for a long time,their research activities will be greatly affected.By discussing the connotation,evaluation tools,current situation,influencing factors,and improvement measures of ethical dilemmas in scientific research,this paper proposed some suggestions,such as comprehensively investigating the influencing factors of ethical dilemmas in scientific research,and formulating targeted improvement measures,with a view to helping medical graduate students identify and get rid of ethical dilemmas in scientific research,and promote the stability of research activities.

Purpose Hydrogen proton magnetic resonance imaging was used to study the brain metabolism of menstrual-related migraine(MRM)in different states,and to investigate its correlation with clinical features and estrogen and progesterone.Materials and Methods We recruited 36 patients with MRM diagnosed by neurology outpatient experts of the First Affiliated Hospital of Henan University of Science and Technology from April 2019 to August 2022,and also recruited 29 normal women with age-and education-matched.Proton magnetic resonance spectroscopy was used to assess neurochemical brain changes during interictal period(late follicular phase)and ictal period(perimenstrual phase)in them.The point resolved spectroscopic sequence was used to focus on the bilateral medial prefrontal cortex(mPFC)and bilateral thalamus.Sex hormone levels were collected on the same day of MRI acquisition.The ratios of NAA/Cr,GABA/Cr,Glx/Cr and Cho/Cr were observed.Metabolite changes and hormone levels were investigated among two groups.Furthermore,metabolite changes were investigated in a longitudinal design during the interictal period and ictal period.Results There were no significant differences in the levels of estrogen and progesterone both in the late follicular and perimenstrual periods.There were no significant differences in decline rate of them in perimenstrual periods between patients and normal people(P>0.05).During interictal period,the ratio of Cho/Cr in the region of left mPFC was lower significantly in the MRM group than that of control group(U=-2.957,P=0.003)and showed a significant negative correlation with attack frequency(r=-0.398,P=0.018).During ictal period,the women with MRM had significantly lower the ratio of GABA/Cr in the left mPFC and higher the ratio of Glx/Cr in the left thalamus compared to those of controls(U=-2.015,P=0.044;t=2.213,P=0.033).We found no significant correlations between these results and magraine characteristics(P>0.05).In addition,we found the ratio of GABA/Cr did not change(P>0.05),the ratio of Glx/Cr and Cho/Cr in right thalamus increased from interictal towards the ictal state for MRM patients(t=-2.181,P=0.038;Z=-2.414,P=0.016).Conclusion The present study suggests the existence of distinct cerebral metabolism states between MRM and control,and there are dynamic changes in cerebral metabolism with headache attacks.However,there is no significant difference in estrogen and progesterone from normal women,and its neural mechanism still needs to be further studied.

Objective:To analyze the clinical characteristics and neurophysiological features of patients with neuralgic amyotrophy (NA) and explore their neurological function status.Methods:Clinical data and neurophysiological findings of 90 patients diagnosed with NA at Beijing Tsinghua Changgung Hospital from September 2016 to January 2024 were collected and their clinical phenotypes and neurophysiological characteristics were systematically summarized and analyzed.Results:Among the 90 patients, males accounted for 60.0% (54 cases) and females accounted for 40.0% (36 cases). The duration of the disease was 12 (3, 36) months (ranged from 1 week to 5 years). The onset age of the patients was 58 (30, 70) (21-87) years. Unilateral involvement was noted in 94.4% (85/90) of patients, exhibiting a left-to-right ratio of 1∶1.3, while only 5.6% (5/90) had bilateral involvement. The majority of patients demonstrated a monophasic clinical course with a recurrence rate of just 2.2% (2/90). The primary clinical manifestations included upper limb pain in 70.0% (63/90) of patients, which progressed to muscle weakness and atrophy within 1 day to 1 month, whereas 30.0% (27/90) of patients without significant pain symptoms. Lesions predominantly affected the upper trunk of the brachial plexus, which accounted for 64.4% (58/90) of patients. Distal nerve injuries in the upper limb were observed in 14.4% (13/90) of patients, with 6.7% (6/90) demonstrating isolated anterior interosseous nerve involvement and another 6.7% (6/90) exhibiting isolated posterior interosseous nerve involvement; 1 case had concurrent anterior and posterior interosseous nerve damage. Additionally, 1 case presented with bilateral phrenic nerve involvement, and another patient had isolated posterior tibial nerve injury. Electrophysiological evaluations of patients with NA revealed that axonal damage to motor nerve fibers was a hallmark feature of the condition. Among patients undergoing motor nerve conduction studies, 68.8% (55/80) exhibited decreased compound muscle action potential amplitude, and 31.3% (25/80) had prolonged latency. Sensory nerve conduction was normal in 60.0% (48/80) of patients, while abnormalities included prolonged latency in 15.0% (12/80), reduced amplitude in 12.5% (10/80), slowed conduction velocity in 8.8% (7/80), and absent waveforms in 3.8% (3/80) of patients. The rates of abnormal nerve conduction findings in motor nerves were the highest in the suprascapular nerve (70.6%, 36/51), followed by the axillary nerve (58.3%, 35/60), musculocutaneous nerve (50.7%, 35/69), long thoracic nerve (6/17), and both anterior and posterior interosseous nerves (7.5%, 6/80 each). In sensory nerves, abnormalities were predominantly noted in the lateral antebrachial cutaneous nerve (30.0%, 12/40). Needle electromyography demonstrated neurogenic damage, most frequently affecting the infraspinatus muscle (69.2%, 18/26), biceps brachii (68.1%, 49/72), and deltoid muscle (65.3%, 47/72). The positive rate of magnetic resonance neurography (MRN) for NA was 62.1% (41/66), among which 63.4% (26/41) showed localized swelling of the brachial plexus, 51.2% (21/41) exhibited T 2 hyperintensity, and 4.9% (2/41) demonstrated denervated changes in the muscles. The positive rate of ultrasound for NA was 71.1% (59/83), with 91.5% (54/59) showing nerve swelling and 8.5% (5/59) exhibiting hourglass constriction .Conclusions:NA is a peripheral neuropathy characterized by spontaneous pain, limb weakness, and (or) muscle atrophy primarily. Its clinical phenotype predominantly involves damage to the upper trunk of the brachial plexus, which can also manifest as isolated mononeuropathy. Neurophysiological findings most commonly reveal the neurogenic damage to the muscles innervated by the upper trunk of the brachial plexus, mainly characterized by the axonal damage to the motor nerves, and pure motor nerve damage may also be observed. MRN and neuroultrasound can assist in qualitative diagnosis.

Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke. Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database's inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane's risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR). Results:A total of 24 trials,including 1 970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without severe influence. Conclusion:Acupuncture might be an effective and safe therapy for spastic hemiplegia after ischemic stroke,but more high-quality,large-sample objectively-evaluated RCTs are needed to validate the conclusion.

Objective:To explore the knowledge, attitude, and practice of insulin injection among nurses in Beijing and analyze its influencing factors.Methods:From July to August 2019, stratified-random-cluster multi-stage sampling was used to select 7 448 nurses from 30 hospitals of different levels in Beijing as the research subject. The survey was conducted using the General Information Questionnaire and the Insulin Injection Knowledge, Attitude, and Practice Questionnaire. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, attitude, and practice on insulin injection.Results:A total of 7 448 questionnaires were distributed and 7 448 valid questionnaires were collected, with an effective response rate of 100.00% (7 448/7 448). Among 7 448 nurses, 6 942 had no positions, and the scores of the belief dimension, behavior dimension, and the total score of questionnaire were calculated; the knowledge dimension score was calculated based on the overall sample. The total score of the Insulin Injection Knowledge, Attitude, and Practice Questionnaire was (115.22±10.75), and the scores for each dimension of the questionnaire were (14.14±2.97), (17.29±2.73), and (83.82±7.72), respectively. The proportion of nurses who scored well in all questionnaire dimensions was 19.01% (1 320/6 942). The excellent score rates of each dimension in the questionnaire, from high to low, were the practice dimension [92.71% (6 436/6 942) ], attitude dimension [76.40% (5 304/6 942) ], and knowledge dimension [22.35% (1 665/7 448) ]. Multiple linear regression analysis showed that the influencing factors of insulin injection knowledge, attitude, and practice among nurses were gender, age, professional title and department ( P<0.05). The influencing factors of knowledge were gender, age, years of work, education level, professional title, and department ( P<0.05). The influencing factors of attitude were gender, professional title, and department ( P<0.05). The influencing factors of practice were gender and age ( P<0.05). The above differences were statistically significant. Conclusions:Nurses at all levels of hospitals in Beijing have great beliefs and behaviors in insulin injection but lack knowledge. The knowledge of insulin injection among clinical nurses can be enhanced by improving the training and education standards on insulin injection, regularly providing insulin injection knowledge training and skill assessment to clinical nurses and other methods.

Objective:To develop an intervention program for symptom clusters in children with acute lymphoblastic leukemia (ALL) during the consolidation and reinforcement phase based on symptom management theory from a sociopsychological perspective.Methods:An initial draft of the intervention program for symptom clusters in children with ALL during the consolidation and reinforcement phase was prepared through literature review and group discussions. Purposeful sampling was used to select 20 experts as respondents for a Delphi method consultation. After two rounds of expert consultations, adjustments and improvements were made to the relevant indicators, resulting in the final version of the intervention program.Results:The effective response rates for the two rounds of expert consultations were 80% (16/20) and 100% (20/20), respectively. The authority coefficients for the experts were 0.816 and 0.838, while the Kendall's coordination coefficients were 0.207 and 0.397 ( P<0.01 for both rounds). The final intervention program comprised 3 primary items, 7 secondary items, and 27 tertiary items. Conclusions:The intervention program for symptom clusters in children with ALL during the consolidation and reinforcement phase, developed from a sociopsychological perspective, demonstrates scientific validity, reliability, and feasibility. It can offer guidance and reference for symptom management in children with ALL.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.