ObjectiveTaking the cuproptosis/oxidative stress pathway as the entry point， this study investigated the effect and mechanism of Liangyi Paste on hepatic lipid deposition in naturally aged mice fed with a high-fat diet. MethodsAfter adaptive feeding， 80 ten-week-old male C57BL/6 mice were used. Thirty of them were randomly divided into three groups （10 mice per group）： The 12-month-old control group （12MCON）， the 15-month-old control group （15MCON）， and the 15-month-old group with a high-fat diet （15MHFD）. The 12MCON and 15MCON groups were continuously fed a standard diet， while the 15MHFD group started receiving a high-fat diet at 12 months of age. Tissue samples were collected at the corresponding time points for each group. The remaining 50 mice were randomly divided into five groups （10 mice per group）： the 20-month-old control group （20MCON）， the model group， and the low-， medium-， and high-dose Liangyi Paste groups （2.91 ， 5.82 ， 11.64 g·kg^-1·d^-1， respectively）. The 20MCON group was continuously fed a standard diet， while the other groups started receiving a high-fat diet at 15 months of age. At 18 months of age， the Liangyi Paste groups were administered the corresponding doses of Liangyi Paste by gavage， while the 20MCON and model groups were given an equal volume of saline by gavage. After 8 weeks of continuous gavage （when the mice reached 20 months of age）， tissue samples were collected. Hepatic TG levels were measured using assay kits； liver histology and lipid deposition were observed via hematoxylin-eosin （HE） and oil red O staining； reactive oxygen species （ROS） were detected by enzyme-linked immunosorbent assay （ELISA）； Cu²⁺， superoxide dismutase （SOD）， and malondialdehyde （MDA） levels were measured by colorimetry； mRNA and protein expression of genes related to cuproptosis and oxidative stress pathways were analyzed by Real-time polymerase chain reaction（Real-time PCR） and Wes automated protein expression system. ResultsCompared with 12MCON， the 15MCON group showed significantly increased hepatic TG， Cu²⁺， ROS， and MDA levels （P<0.01）， decreased SOD （P<0.01）， hepatocyte swelling， and disordered arrangement. The mRNA and protein levels of ferredoxin 1 （FDX1）， dihydrolipoamide S-acetyltransferase （DLAT）， heat shock protein 70 （HSP70）， dihydrolipoamide dehydrogenase （DLD）， pyruvate dehydrogenase E1 subunit-β （PDHB）， nuclear factor erythroid 2-related factor 2 （Nrf2）， and peroxisome proliferator-activated receptor γ （PPARγ） were significantly elevated （P<0.05， P<0.01）. Compared with 15MCON group， the 15MHFD and 20MCON groups exhibited further increases in TG， Cu²⁺， ROS， and MDA （P<0.01）， reduced SOD （P<0.01）， and aggravated hepatocyte swelling and disorder. There were increased lipid droplets with mild vacuolization in the 15MHFD group， and no significant lipid deposition was observed in the 20MCON group. FDX1， DLAT， HSP70， DLD， PDHB， Nrf2， and PPARγ mRNA and protein levels were significantly increased （P<0.05， P<0.01）. Compared with 20MCON group， the model group demonstrated markedly elevated TG， Cu²⁺， ROS， and MDA （P<0.01）， reduced SOD （P<0.01）， severe hepatic steatosis， and upregulated expression of FDX1， DLAT， HSP70， DLD， PDHB， Nrf2， and PPARγ mRNA and proteins （P<0.05， P<0.01）. All abnormalities were significantly reversed after Liangyi Paste treatment. ConclusionLiangyi paste can ameliorate hepatic lipid deposition in naturally aged mice with a high-fat diet by modulating the cuproptosis/oxidative stress pathway.

Malaria remains one of the most serious public health problems worldwide. After China achieved the target for malaria elimination, thousands of imported malaria cases are still reported annually. Timely and accurate diagnosis is critical to clinical treatment of cases and prevention of re-establishment of imported malaria. Detection of Plasmodium antigens is one of the criteria for definitive diagnosis of malaria. Malaria rapid diagnostic tests (RDTs) based on the immunochromatographic assay have become an important tool for clinical diagnosis of malaria due to convenient procedures and rapid detection. Nevertheless, there are still multiple misunderstandings pertaining to use of malaria RDTs among workers in medical and disease control and prevention institutions at all levels across China. To standardize technical guidelines and operational procedures for detection of Plasmodium spp., the National Disease Control and Prevention Administration has arranged the formulation of a recommended health industry standard Detection of Plasmodium spp. Immune-chromatographic test (WS/T 10029—2025), which has been officially iming immunochromatographic assays, including the testing principles, sample collection and detection procedures, and result interpretation, which provides the technical basis and operational specifications for detection of Plasmodium antigens in medical and disease control and prevention institutions at all levels. Based on analysis of the epidemiological characteristics of imported malaria in China, this article interprets the core content of this standard, aiming to promote its dissemination, implementation, and practical applications.

Integrin α _v β ₃ is overexpressed in various tumor cells and angiogenesis. To date, no drug has been proven to target it for therapy. A first-in-human study was designed to investigate the safety, pharmacokinetics, and dosimetry of ¹⁷⁷Lu-AB-3PRGD2, a novel integrin α _v β ₃-targeting radionuclide drug with an albumin-binding motif to optimize the pharmacokinetics. Ten patients (3 men, 7 women; aged 45 ± 16 years) with integrin α _v β ₃-avid tumors were recruited to accept ¹⁷⁷Lu-AB-3PRGD2 injection in a dosage of 1.57 ± 0.08 GBq (42.32 ± 2.11 mCi), followed by serial scans to obtain its dynamic distribution in the body. Safety tests were performed before and every 2 weeks after the treatment for 6-8 weeks. No adverse event over grade 3 was observed. ¹⁷⁷Lu-AB-3PRGD2 was excreted mainly through the urinary system, with intense radioactivity in the kidneys and bladder. Moderate distribution was found in the liver, spleen, and intestines. The estimated blood half-life was 2.85 ± 2.17 h. The whole-body effective dose was 0.251 ± 0.047 mSv/MBq. The absorbed doses were 0.157 ± 0.032 mGy/MBq in red bone marrow and 0.684 ± 0.132 mGy/MBq in kidneys. This first-in-human study of ¹⁷⁷Lu-AB-3PRGD2 treatment indicates its promising potential for targeted radionuclide therapy of integrin α _v β ₃-avid tumors. It merits further studies in more patients with escalating doses and multiple treatment courses.

Objective:To study and analyze the brain networks of hemiplegic stroke patients in a resting state or during virtual reality(VR)upper limb rehabilitation robot training by functional near-infrared spectroscopy(fNIRS).Method:Fourteen hemiplegic stroke patients were included in this study as the test group,while 14 healthy subjects were recruited as the control group.The fNIRS data of the two groups were collected during the rest-ing state or the VR upper limb rehabilitation robot training.The functional connectivity(FC)index of the brain network was calculated.Result:①No significant difference was found between the test group and the control group in FC in the rest-ing state(P>0.05).②The overall FC of the control group did not increase significantly in the VR task com-pared with the resting state(P>0.05).But the FC of the LSMA-RPFC increased significantly(P<0.05).③The overall FC of the test group decreased in the VR task compared with the resting state(P<0.05),of which the LSMA-RPFC decreased(P<0.05).④The overall FC of the test group was lower than that of the control group(P<0.05),in which there was a significant difference in FC between LSMA-RSMA,LSMA-LM1,LS-MA-RM1,LSMA-RS1,and LM1-RS1(P<0.05)when the test group and the control group performed the VR upper limb rehabilitation robot training task.Conclusion:VR upper limb rehabilitation robot training can induce plastic reorganization of the extensive sen-sorimotor network in hemiplegic patients with stroke.And the mechanism of improving upper limb function may be related to the FC changes between bilateral SMA and SMA and other brain regions.

Objective To investigate the current status and influencing factors of anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer by cross-sectional survey.Methods A total of 330 caregivers of young and middle-aged patients with advanced liver cancer who were admitted to The Third Affiliated Hospital of Naval Medical University from January 2023 to May 2023 were enrolled as research objects by convenience sampling.A questionnaire survey on general information,anticipatory grief and simple coping style was conducted on these caregivers one day before discharge.Results The score of anticipatory grief of the caregivers was 94.10±22.33.Multiple linear stepwise regression analysis was performed with statistically significant data from the characteristics of the research objects as independent variables and anticipatory grief as the dependent variable,and the result showed that gender,monthly income,educational level,personality self-assessment and coping were main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer(all P<0.05).The mean score for positive response was 2.23±0.14,which was negatively associated with anticipatory grief(P=0.041).The mean score for negative response was 1.31±0.24,which was positively associated with anticipatory grief(P<0.001).Conclusion The anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer is at a high level.The anticipatory grief is negatively related to positive coping,and positively related to negative coping.The main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer are gender,family economic status,educational level,and introverted personality.

Objective:To study and analyze the brain networks of hemiplegic stroke patients in a resting state or during virtual reality(VR)upper limb rehabilitation robot training by functional near-infrared spectroscopy(fNIRS).Method:Fourteen hemiplegic stroke patients were included in this study as the test group,while 14 healthy subjects were recruited as the control group.The fNIRS data of the two groups were collected during the rest-ing state or the VR upper limb rehabilitation robot training.The functional connectivity(FC)index of the brain network was calculated.Result:①No significant difference was found between the test group and the control group in FC in the rest-ing state(P>0.05).②The overall FC of the control group did not increase significantly in the VR task com-pared with the resting state(P>0.05).But the FC of the LSMA-RPFC increased significantly(P<0.05).③The overall FC of the test group decreased in the VR task compared with the resting state(P<0.05),of which the LSMA-RPFC decreased(P<0.05).④The overall FC of the test group was lower than that of the control group(P<0.05),in which there was a significant difference in FC between LSMA-RSMA,LSMA-LM1,LS-MA-RM1,LSMA-RS1,and LM1-RS1(P<0.05)when the test group and the control group performed the VR upper limb rehabilitation robot training task.Conclusion:VR upper limb rehabilitation robot training can induce plastic reorganization of the extensive sen-sorimotor network in hemiplegic patients with stroke.And the mechanism of improving upper limb function may be related to the FC changes between bilateral SMA and SMA and other brain regions.

Abstract: Objective To conduct genotyping and molecular tracing analysis on Plasmodium vivax samples from a cluster of P. vivax malaria outbreak in order to provide a reference for case geographical origin determination. Methods Blood samples from 4 patients in a vivax malaria cluster in Longhui County, Hunan Province from June to July 2018 were collected for species identification by qPCR, and 9 microsatellite molecular markers were used to genotype the parasite strains from four samples. The population genetic STRUCTURE analysis was performed based on the VivaxGEN-MS microsatellite genotype database of P. vivax in the Asia Pacific Malaria Elimination Network, to determine the genetic subgroups and geographical origin of the strains. Results By qPCR, all 4 cases were identified as Plasmodium vivax infection, and 9 microsatellite loci of the 4 cases were successfully typed, and the four samples had different genetic haplotypes, among which case 1, case 3, and case 4 were infected by a single clonal strain, and case 2 was infected by a polyclonal strain. When all P. vivax samples were divided into 2 subpopulations (K=2) by STURCTURE analysis, 4 Hunan samples were classified into tropical genetic subpopulations (comprising strains from Ethiopia, Iran, Bhutan, Malaysia, Indonesia, and southern China). When the samples were divided into 4 subgroups by STURCTURE analysis (K=4), the 4 Hunan samples were classified as South Asian/Southeast Asian genetic subgroups (originating from Bhutan, Malaysia, Indonesia, and southern China). Conclusions The results of molecular tracing do not support that the 4 P. vivax strains in this outbreak originated from the population of central China. The technology of molecular tracing of P. vivax can provide objective evidence for determining the source of infection in malaria cases during the stage of malaria elimination and post-elimination.

Objective To develop nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia,and test its reliability and validity.Methods Based on the evidence-based summary of the best evidence of medication management for patients with dysphagia,guided by the the-ory of knowledge,attitude and practice,the basic dimensions and item pool of the questionnaire were deter-mined through group discussion,Delphi expert consultation and pre-investigation.In order to revise the ques-tionnaire,437 nurses from 10 tertiary hospitals in Jiangsu Province were conveniently selected for investigation,and the reliability and validity of the questionnaire were tested according to the survey results.Results The nurses'knowl-edge,attitude and practice questionnaire on medication management for patients with dysphagia included 43 items in three dimensions.The three dimensions were analyzed by exploratory factors,and six common factors with characteristic roots>1 were extracted.Two factors were extracted from the knowledge dimension,and the cumulative variance contribution rate was 74.958%,One factor was extracted from the attitude dimen-sion,and the cumulative variance contribution rate was 77.655%.Three factors were extracted from the prac-tice dimension,and the cumulative variance contribution rate was 72.274%.The factor load of each item was 0.618-0.902,Cronbach's α coefficient of the total questionnaire was 0.949,and the test-retest reliability was 0.909.The overall content validity coefficient of the questionnaire was 0.922,and the content validity coeffi-cient for each item was 0.800-1.000.Conclusion The nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia developed in this study has good reliability and validi-ty,and could be used as an effective tool to evaluate the status quo of nurses'medication management for pa-tients with dysphagia.

Objective:To review the clinical status based on the best evidence of drug administration in patients with dysphagia, systematically analyze the obstacle factors and promoting factors in the process of evidence transformation, and formulate reform strategies.Methods:Based on the evidence-based nursing research method and the guidance of the Ottawa Model of Research Use (OMRU), the review indicators were developed based on the best evidence. The current status of clinical practice behaviors of 223 patients and 75 nurses in the Neurology, Neurosurgery and Geriatric departments of the Affiliated Hospital of Jiangsu University were reviewed from July to December 2021.Based on the results of the review, qualitative interviews were conducted with 32 potential adopters, and content analysis was used to assess the barriers and contributing factors to the clinical translation of evidence in three aspects: evidence-based change, potential adopters and practice environment, so as to develop effective strategies.Results:Based on the 22 best evidence selected, the evidence-based team developed 25 review indicators to carry out clinical review, showing that the compliance rate of 16 indicators were less than 60%. By analyzing and summarizing the interview results of potential adopters, the main obstacles leading to the low compliance rate of nurses were analyzed as follows: evidence-based reform changed the traditional work mode, and the application of evidence was not convenient; at the level of potential adopters, nurses had poor knowledge and practice, heavy work burden, and low awareness of patients and caregivers; at the level of practice environment, there was lack of nursing norms and procedures for clinical transformation of evidence, and the channels of multi-disciplinary collaboration and communication were not smooth. The main promoting factors were the perfect supervision mechanism of evidence-based nursing projects, the evidence-based group had rich experience in evidence transformation, the management was willing to change, and the practitioners were good at innovation.Conclusions:There is still a large gap between the clinical practice and the best evidence of drug administration in patients with dysphagia. The promoting factors should be fully utilized to overcome the obstacles and implement improvements to promote the effective transformation of evidence into clinical practice.