BACKGROUND: Regulatory dendritic cell (DCreg) subset exhibits a unique capacity for inducing immune tolerance among the variety subsets of dendritic cells (DCs) within gut-associated lymphoid tissues (GALTs). Fms-like tyrosine kinase 3 ligand (FLT3L) is involved in the differentiation of DCregs and the subsequent expansion of regulatory T-cells (Tregs) mediated by DCregs, though the precise mechanism remains poorly understood. This study aimed to explore the expansion mechanism of Treg induced by DCreg and the role of FLT3L in this process. METHODS: DCregs were distinguished from other DC subsets isolated from GALTs of BALB/c mice through a mixed lymphocyte reaction assay. The functions and mechanisms by which FLT3L promoted Treg expansion via DCregs were investigated in vitro through co-culture experiments involving DCregs and either CD4 + CD25 - T-cells or CD4 + CD25 + T-cells. Additionally, an in vivo experiment was conducted using a dextran sulfate sodium (DSS)-induced colitis model in mice. RESULTS: CD103 + CD11b + DC exhibited DCreg-like functionality and was identified as DCreg for subsequent investigation. Analysis of Foxp3 + Treg percentages within a co-culture system of CD4 + CD25 - T-cells and DCregs, with or without FLT3L, demonstrated the involvement of the FLT3/FLT3L axis in driving the differentiation of precursor T-cells into Foxp3 + Tregs induced by DCregs. Cell migration and co-culture assays revealed that the FLT3/FLT3L axis enhanced DCreg migration toward Tregs via the Rho pathway. Additionally, it was observed that DCregs could promote Treg proliferation through the Notch pathway, as inhibition of Notch signaling by DAPT (N-[N-(3,5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester) suppressed Treg expansion within the co-culture system of DCregs and CD4 + T-cells or CD4 + CD25 + T-cells. Furthermore, the FLT3/FLT3L axis influenced JAG1 expression in DCregs, indirectly modulating Treg expansion. In vivo experiments further established that FLT3L promoted DCreg expansion and restored Treg balance in DSS-induced colitis models, thereby ameliorating colitis symptoms in mice. CONCLUSION The FLT3/FLT3L axis is integral to the maintenance of DCreg function in Treg expansion.
Animals ; T-Lymphocytes, Regulatory/immunology* ; Dendritic Cells/immunology* ; Mice ; Mice, Inbred BALB C ; Membrane Proteins/metabolism* ; Receptors, Notch/metabolism* ; Lymphoid Tissue/metabolism* ; Signal Transduction/physiology* ; Coculture Techniques ; Flow Cytometry

ObjectiveTo explore the method of establishing a disease-syndrome combined model of irritable bowel syndrome （IBS-D） with spleen and kidney yang deficiency in mice. MethodsModel establishment： Twenty mice were randomly divided into a normal group and a model group， with 10 mice in each group. The model group was given 50 mg/（kg·d） of 0℃ ice adenine suspension by gavage for 14 days， plus tail-clamping stimulation and restrained in centrifuge tubes for 7 days， and 10 g/（kg·d） of 0 ℃ ice senna decoction by gavage for 5 days to prepare IBS-D spleen and kidney yang deficiency syndrome model. The normal group was given 0.4 ml of sterile water by gavage once a day for 14 days. Behavioral characteristics， food intake， fecal water content， body weight， and rectal temperature were observed in both groups. Pain threshold， gastric residual rate， intestinal propulsion rate， and the content of short-chain fatty acids （SCFAs）， serotonin （5-HT）， adrenocorticotropic hormone （ACTH）， corticosterone （CORT）， and D-xylose in the serum were detected after modeling. Model validation： Forty mice were randomly divided into a blank group （n=10） and a modeling group （n=30）. After successful modeling using the above method， the modeling group was divided into a model control group， Sishen Pill （四神丸） group， and pinaverium bromide group， with 10 mice in each group. The Sishen Pill group was given 5 g/（kg·d） of Sishen Pill decoction by gavage， and the pinaverium bromide group was given 21.63 mg/（kg·d） of pinaverium bromide solution by gavage， while the blank group and the model control group were given 0.70 ml/d of sterile water by gavage， all for 7 days. The indicators were detected as the same with model establishment. ResultsMice in the model group had poor mental status， lethargy， dull hair and loose feces. Compared with the normal group， the model group exhibited reduced food intake and increased fecal water content ； on the 14th day of modeling， the model group showed a slower body weight gain rate and decreased rectal tempe-rature； after 14 days， the model group had increased small intestinal propulsion rate， and serum SCFAs and 5-HT levels with reduced serum levels of ACTH， CORT， and D-xylose （P＜0.05 or P＜0.01）. Model validation indicated that the Sishen Pill group showed improvements in mental state， activity levels， fur smoothness and curling and gathering symptoms， while these symptoms in the pinaverium bromide group were not significantly improved. Compared to the model control group， the Sishen Pill group and pinaverium bromide group had reduced fecal water content and increased food intake， as well as increased body weight gain and elevated rectal temperature on day 4. On the 7th day of administration， the pinaverium bromide group showed lower rectal temperature than Sishen Pill group， and Sishen Pill group showed decreased serum SCFAs and 5-HT levels with increased ACTH， CORT， and D-xylose levels （P＜0.05 or P＜0.01）， while the pinaverium bromide group exhibited reduced 5-HT and elevated CORT level （P＜0.01）. ConclusionA combination of ice adenine plus ice senna leaf gavage， tail clamping， and centrifuge tube restraint can successfully establish a disease-syndrome combined mouse model of IBS-D with spleen-kidney Yang deficiency.

Objective To analyze the characteristics of newly-diagnosed occupational diseases among female workers in Foshan City from 2013 to 2023. MethodsClinical data of newly-diagnosed occupational diseases among female workers in Foshan City from 2013 to 2023 were collected from the "Occupational Disease and Hazardous Detection Information System" subsystem of the "China Disease Prevention and Control Information System", and their distribution characteristics were analyzed using descriptive epidemiology. Results A total of 218 cases of newly-diagnosed occupational diseases among female workers in Foshan City were reported from 2013 to 2023, categorized into seven categories and 17 types. The median age and median length of exposure to occupational hazards among female workers were 45.1 and 7.8 years, respectively. The top three categories of newly-diagnosed cases were occupational diseases of the ear, nose, throat, and oral cavity (90 cases, all related to occupational noise-induced hearing loss), occupational chemical poisoning (61 cases), and occupational pneumoconiosis and other respiratory diseases (51 cases, including 50 cases with occupational pneumoconiosis). The newly-diagnosed cases were concentrated in Nanhai District, Shunde District, and Gaoming District, accounting for 75.2%. The newly-diagnosed cases were found in non-metallic mineral products manufacturing industry, metal products industry, and electrical machinery and equipment manufacturing industry, accounting for 50.9%. Enterprises of newly-diagnosed cases were mainly distributed in private enterprises and foreign-invested enterprises, accounting for 80.3%. The scale of enterprises of newly-diagnosed cases was mainly small- and medium-sized, accounting for 79.4%. Among the 218 cases, there were 21 cluster cases, involving 16 cases of occupational silicosis and five cases of occupational acute n-hexane poisoning, involving six manufacture industries, with 81.3% cases worked in sanitary ceramic products industry. Conclusion Occupational noise-induced deafness should be listed as a key occupational disease for female workers in Foshan City. Attention should be paid to the prevention of occupational diseases among middle-aged female workers in the non-metallic mineral products industry and small and medium-sized enterprises, and the cluster outbreaks of occupational pneumoconiosis.

Objective:To construct the quality evaluation scale of specification of management for humanistic caring in outpatients and test its reliability and validity.Methods:Referring to the group standards in Specification of Management for Humanistic Caring in Outpatients released by the China Association for Life Care,as well as relevant guidelines and literature,a pool of items for the quality evaluation scale of specification of management for humanistic caring in outpatients was formed.After expert consultation and expert argumentation,a quality evaluation scale of specification of management for humanistic caring in outpatients was constructed.From January to February 2024,243 hospital managers from 5 hospitals in Zhengzhou were selected as survey subjects to conduct item analysis,and reliability and validity testing on the scale.Results:Two rounds of expert inquiry and two rounds of expert argumentation were conducted,with questionnaire response rates of 92.00%and 100.00%,respectively,and expert authority coefficients of 0.952.In the second round of the expert inquiry scale,the mean importance score of the first-level indicators was 4.80 to 5.00,the full score ratio was 88.00%to 100.00%,the coefficient of variation was 0.04 to 0.17,and Kendall's coefficient of concordance was 0.857(P＜0.001);the mean importance score of the second-level indicators was 4.60 to 5.00,the full score ratio was 80.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.775(P＜0.001);the mean importance score of the third-level indicators was 4.60 to 5.00,the full score ratio was 76.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.830(P＜0.001).Finally,a quality evaluation scale of specification of management for humanistic caring in outpatients was formed,including 5 first-level indicators,25 second-level indicators,and 58 third-level indicators.Exploratory factor analysis produced 5 common factors with a cumulative variance contribution rate of 74.628%.The Pearson correlation coefficients between the five-factor scores ranged from 0.648 to 0.798,and the correlation coefficients between the factor scores and the total score of the scale ranged from 0.784 to 0.938.The scale-level content validity index(S-CVI)of the scale was 0.945,the item-content validity index(I-CVI)was 0.725 to 1.000,the Cronbach's alpha coefficient of the total scale was 0.973,and the retest reliability coefficient was 0.934.Conclusion:The constructed quality evaluation scale of specification of management for humanistic caring in outpatients has good scientific validity and reliability,and can be used as an evaluation tool for specification of management for humanistic caring in outpatients.

Objective:To investigate the clinical efficacy of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers.Methods:Totally, 100 infants and preschoolers with pigmented facial lesions were enrolled from the Department of Dermatology, Hanzhong Central Hospital and the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2019, and their clinical data were analyzed retrospectively. Among these patients, there were 59 males and 41 females, and their age ranged from 3 months to 5 years, with an average age of 15 months. All patients underwent outpatient surgery under local anesthesia, and sedative drugs were used before operation. The skin lesions were excised once or in stages according to their areas, and incisions were closed by using a subcutaneous asymmetric suture-based tension reduction technique, followed by dermal buried angular mattress sutures. After surgery, medical silicone gels and tension reduction devices were used for 6 months to 1 year, and postoperative follow-up was performed.Results:All patients were followed up for more than 1 year after surgery. Four patients showed suture rejection reaction within two months after surgery, and the incisions completely healed after the suture knots were discharged; cat′s ear-shaped scars were formed at the upper and lower ends of the incisions in 3 cases when the sutures were removed 1 week after surgery, no treatment was given, and the cat′s ear-shaped scars gradually became flat after 1 year of follow-up; fat liquefaction occurred in 1 case 4 days after surgery, re-suturing of the incision was done 1 week after the removal of internal sutures and drainage, and the incision healed well; 1 case developed infection 3 days after surgery, and then received the removal of internal sutures, drainage, and anti-infection treatment, re-suturing was performed after complete regression of the incision swelling, and the incisions healed well; scar hyperplasia occurred in 4 cases 3 to 6 months after surgery, and the scars became flat after the local injection of triamcinolone acetonide. In the remaining children, fine white linear scars were formed after the healing of incisions, the depressions and ridges at both ends of the incisions became flat, and there was no obvious pulling sensation in facial organs or formation of cat′s ear-shaped scars.Conclusions:Subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture can effectively reduce tension twice during delicate facial surgery in infants and preschoolers, and help to avoid incision widening and scar hyperplasia. The follow-up showed favorable long-term efficacy and aesthetic effect.

Objective:To explore the effect of motivational enhancement group intervention conducted by nur-ses on the motivation of self-improvement,relapse tendency and self-esteem in the recovering male amphetamine addicts.Methods:Ninety-eight recovering male amphetamine addicts in the Compulsory Detoxification Center were randomly divided into control group(n=54)and motivational enhancement group(n=44).The addicts in the con-trol group received routine education while those in the motivational enhancement group received routine education combined with a 12-week motivational enhancement group intervention conducted by nurses.The Stages of Change Readiness and Treatment Eagerness Scale(SOCRATES),Relapse Tendency Questionnaire,and Rosenberg Self-es-teem Scale(RSES-T)were applied to measure the effect,before and after the intervention.Results:In both two groups,the scores of RSEST,questionnaire of relapse tendency,and self-confidence of detoxification were lower af-ter 12-week intervention than at the baseline(Ps＜0.05).After 12-week intervention,all the above scores were lower in the motivational enhancement group than in the control group(Ps＜0.05).Conclusion:Compared with routine education,the motivational enhancement group intervention conducted by nurses may be more effective to improve their self-confidence in drug rehabilitation and prevention of relapse in recovering male amphetamine ad-dicts,however,the improvement on self-esteem is limited.

Diffuse large B-cell lymphoma(DLBCL)in the oral gums is very rare and is prone to misdiagnosis and mistreatment.In this paper,2 cases of oral gingival DLBCL were reported.Their clinicopathological features,diagnosis,and differential diagnosis were discussed based on the literature of 21 cases of gingival DLBCL reported at home and abroad from 2008 to 2023.

Objective:To evaluate the efficiency of the four domestic language models,ERNIE Bot,ChatGLM2,Spark Desk and Qwen-14B-Chat,all with a massive user base and significant social attention,in response to consultations about PCa-related perio-perative nursing and health education.Methods:We designed a questionnaire that includes 15 questions commonly concerned by patients undergoing radical prostatectomy and 2 common nursing cases,and inputted the questions into each of the four language models for simulation consultation.Three nursing experts assessed the model responses based on a pre-designed Likert 5-point scale in terms of accuracy,comprehensiveness,understandability,humanistic care,and case analysis.We evaluated and compared the performance of the four models using visualization tools and statistical analyses.Results:All the models generated high-quality texts with no mis-leading information and exhibited satisfactory performance.Qwen-14B-Chat scored the highest in all aspects and showed relatively sta-ble outputs in multiple tests compared with ChatGLM2.Spark Desk performed well in terms of understandability but lacked comprehen-siveness and humanistic care.Both Qwen-14B-Chat and ChatGLM2 demonstrated excellent performance in case analysis.The overall performance of ERNIE Bot was slightly inferior.All things considered,Qwen-14B-Chat was superior to the other three models in con-sultations about PCa-related perioperative nursing and health education.Conclusion:In PCa-related perioperative nursing,large language models represented by Qwen-14B-Chat are expected to become powerful auxiliary tools to provide patients with more medical expertise and information support,so as to improve the patient compliance and the quality of clinical treatment and nursing.

AIM To explore the clinical effects of Modified Buzhong Yiqi Decoction combined with Dihuang Decoction on patients with chronic obstructive pulmonary disease in relief period due to Lung-Kidney Qi Deficiency.METHODS One hundred and sixteen patients were randomly assigned into control group(58 cases)for 8-week intervention of conventional treatment,and observation group(58 cases)for 8-week intervention of Modified Buzhong Yiqi Decoction,Dihuang Decoction and conventional treatment.The changes in clinical effects,IL-6,CX3CL1,MMP-9,MCP-1,a1-AT,nutritional indices(ALB,HGB,PALB),pulmonary function indices(FEV1,FEV1/FVC),blood gas indices(PaO2,PaCO2),TCM symptom score and CAT score were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased IL-6,CX3CL1,MMP-9,MCP-1,a1-AT,PaCO2,TCM symptom score,CAT score(P＜0.05),and increased nutritional indices,PaO2,pulmonary function indices(P＜0.05),especially for the observation group(P＜0.05).CONCLUSION For the patients with chronic obstructive pulmonary disease in relief period due to Lung-Kidney Qi Deficiency,Modified Buzhong Yiqi Decoction combined with Dihuang Decoction can alleviate inflammatory responses,improve blood gas indices,correct nutritional disorders,and promote lung function improvement.

AIM:To investigate the effects of exercise preconditioning(EP)combined with electroacupunc-ture(EA)on learning and memory ability of rats with vascular dementia(VD),and to explore role of hippocampal ferrop-tosis in this process.METHODS:Seventy-two male SD rats were randomly divided into non-EP group and EP group,with 36 rats in each group.The rats were subjected to EP,and subsequently to establish the VD model.The rats from non-EP group were randomly divided into sham group,model group(VD group)and VD-EA group,each with 12 rats,while those in EP group were randomly divided into EP-sham group,EP-VD group and EP-VD-EA group,each with 12 rats.All rats in EP group underwent 4 weeks of swimming exercise training,5 d per week,30 min per day.At the end of the 4th week,the rats in VD,EP-VD,EP-VD-EA and VD-EA groups were used to induce the VD model,and the rats in sham and EP-sham groups received a sham surgery to simulate the VD model.On the 7th day after successful modeling,the rats in EP-VD-EA and VD-EA groups were treated with EA for 4 weeks,6 d per week,30 min per day.At the end of the inter-vention,the learning and memory ability of the rats was evaluated using Morris water maze.Neuron morphology in the CA1 area of rat hippocampus was observed through Nissl staining.Ferrous ion(Fe2+),malondialdehyde(MDA)and re-duced glutathione(GSH)contents in the rat hippocampal tissues were quantified using the colorimetric assay.The expres-sion levels of ferroptosis-related proteins,nuclear factor E2-related factor 2(Nrf2)and glutathione peroxidase 4(GPX4),in the hippocampal tissues were quantified by Western blot method.RESULTS:Compared with sham group,the rats in VD group exhibited longer mean evasion latency and decreased number of traversals across the plateau(P<0.01).The neurons in the CA1 region of the hippocampus were loose and disorganized,exhibiting an irregular cellular morphology.The hippocampal Fe2+and MDA content was elevated,and the GSH content was reduced(P<0.01).The protein levels of hippocampal Nrf2 and GPX4 were decreased(P<0.01).Compared with VD group,the rats in EP-VD,EP-VD-EA and VD-EA groups showed a shorter average escape latency and an increased number of traversals across the plateau(P<0.05).Neurons in the hippocampal CA1 area were more neatly arranged,showing regular cellular morphology.The hip-pocampal Fe2+and MDA contents of the rats in EP-VD group were significantly reduced(P<0.01),while the GSH content was elevated(P<0.05).Hippocampal Fe2+and MDA contents were significantly reduced and GSH contents were signifi-cantly increased in EP-EA and EA groups(P<0.01).The protein levels of hippocampal Nrf2 and GPX4 in EP-VD,EP-VD-EA and VD-EA groups were significantly increased(P<0.01).CONCLUSION:Exercise preconditioning combined with EA improves learning and memory ability in VD rats by reducing hippocampal intra-neuronal iron overload,maintain-ing organismal redox homeostasis,and inhibiting ferroptosis.