BACKGROUND:Synthetic polymers,such as polypropylene and polyester,used for the treatment of abdominal wall defects not only lack biodegradability and bioactivity but also fail to meet the demands of complex and irregular wounds.Therefore,finding bioactive materials with low immunogenicity and good histocompatibility has become a hot spot in the repair of abdominal wall defects. OBJECTIVE:To prepare methacryloyl modified dermal extracellular matrix hydrogel and explore its potential application in abdominal wall defect. METHODS:(1)The porcine dermis was acellular with 0.25%trypsin and 1%Triton X-100 in turn to obtain the dermal extracellular matrix.After pepsin digestion and methacrylic anhydride modification,the methacrylated dermal extracellular matrix hydrogel was formed by photocrosslinking.The microscopic morphology of the hydrogel was observed by scanning electron microscope,and its rheological properties,swelling properties and other physical and chemical properties were tested.(2)Mice fibroblasts(L929)were inoculated into methacrylated dermal extracellular matrix hydrogel to detect the cell compatibility.(3)Totally 12 SD rats were randomly divided into two groups(n=6)to create abdominal wall defect model with peritoneum preserved.The defect site of the polypropylene group was filled with polypropylene material,and the hydrogel group was filled with methacrylated dermal extracellular matrix hydrogel.The wound skin of both groups was covered with polypropylene material.The wound healing was observed and histological analysis was carried out. RESULTS AND CONCLUSION:(1)Enzymatic hydrolysis had a good decellularization effect on porcine dermis after decellularization,and the original glycosaminoglycans and collagen were well retained.Scanning electron microscope observation revealed that the dermal extracellular matrix hydrogel presented loose and porous structure.The aperture was between 70 and 120 μm.The swelling ratio was(16.88±3.24)%and the water absorption was(94.24±1.11)%.The rheological property test showed that the methacrylated dermal extracellular matrix hydrogel was stable and had shear thinning characteristics,with injectability.(2)CCK-8 assay and live/dead staining showed that methacrylated dermal extracellular matrix hydrogel had good cell compatibility.(3)The results of animal experiments showed that the skin wound healing rate of the experimental group was higher than that of the control group at 7,10,and 14 days after operation(P<0.05).Hematoxylin-eosin and Masson staining of skin and muscle tissue exhibited that compared with the polypropylene group,the skin wound epithelialization,hair follicle formation,collagen fiber arrangement,and neovascularization were better in the hydrogel group 14 days after surgery.The skin wound new tissue structure was similar to the normal tissue at 28 days after surgery,and scar hyperplasia was less.A small amount of muscle regeneration was observed on day 28 after operation.(4)The results show that the methacrylated dermal extracellular matrix hydrogel can promote wound skin healing and muscle tissue regeneration in rats with abdominal wall defect.

Gastrointestinal motility disorder is an important cause of digestive system diseases. Patients often suffer from nausea， vomiting， gastric retention， gastroparesis， constipation， and many other symptoms， and their quality of life is seriously reduced. Prokinetic agents are routinely used in clinical practice， but their long-term use is prone to problems such as reduced efficacy and increased adverse reactions. Since the incidence of gastrointestinal diseases has continued to rise globally in recent years， there is an urgent need for clinical development of safe and effective treatment strategies. Aurantii Fructus， a traditional Chinese medicine， has the effect of smoothing Qi and eliminating distention， and it has been used to treat gastrointestinal diseases for thousands of years. In modern clinical practice， it is mainly used for the treatment and auxiliary treatment of various gastrointestinal diseases such as functional dyspepsia， functional constipation， and irritable bowel syndrome. The efficacy is remarkable， and no adverse reactions have been reported at conventional doses. Therefore， it can greatly improve the symptoms of patients with gastrointestinal diseases and improve their quality of life. Modern research has revealed that there are many active components in Aurantii Fructus， among which flavonoids have the highest content and the most types. Flavonoids are the main active components in Aurantii Fructus to regulate gastrointestinal motility. Aurantii Fructus and its active components can affect gastrointestinal hormones， neural pathways， Cajal mesenchymal cells， and other multiple mechanisms. They can adjust gastrointestinal motility and correct gastrointestinal motility disorders， showing potential application value in the treatment of gastrointestinal motility disorders. However， a comprehensive analysis of Aurantii Fructus in this aspect is still lacking. This study summarized the pharmacological activities of active components of Aurantii Fructus extract and its flavonoids， volatile oils， alkaloids， and coumarin on the regulation of gastrointestinal motility and explored the latest research progress on its mechanism. Finally， the adverse reactions of Aurantii Fructus were summarized. It aims to provide a scientific basis for the research and clinical application of Aurantii Fructus and its active components in the regulation of gastrointestinal motility.

Polygonum multiflorum （PM）， a commonly used Chinese herbal medicine in clinical practice， has been associated with frequent reports of liver injury in recent years， and the medication safety of PM has attracted more and more attention in China and globally. This article reviews the recent research advances in the signaling pathways and mechanisms of PM in causing drug-induced liver injury （DILI） and aims to provide new ideas for the proper and rational use of PM in clinical practice. The results show that PM is involved in the regulation of various signaling pathways， and it leads to the death of hepatocytes by destroying mitochondrial function， exacerbating bile acid accumulation， and inducing immune response， oxidative stress， and endoplasmic reticulum stress， thereby inducing the development and progression of DILI through multiple targets， pathways， and levels.

Objective To evaluate the value of intrathecal synthetic related markers in patients with mild cognitive impairment(MCI),Alzheimer's disease(AD),and other types of dementia.Methods Retrospec-tively collect the clinical data of 577 patients diagnosed with MCI(MCI group,178 cases),AD(AD group,131 cases),and other types of dementia(other types group,268 cases)from June 2019 to July 2023 in Beijing Tiantan Hospital,Capital Medical University.Oligoclonal zone electrophoresis(OCB)and 24 h intrathecal pro-tein synthesis rate(ISR)of each group were investigated,and the difference of different indexes among the groups was compared to evaluate the value of related indexes in the differential diagnosis of different diseases.Results Compared with AD group and other groups,AD group had a higher proportion of females,more patients were＞50-70 years old,and the incidence of abnormal lipid metabolism was higher,with statistical significance(P＜0.05).There were significant differences in OB(S),cerebrospinal fluid albumin,serum albumin and cerebrospinal flu-id IgG in different disease groups(P＜0.05).IgG index and ISR in patients with positive SOB(CSF)were higher than those in negative and weakly positive patients,and the differences were statistically significant(P＜0.001).IgG index was positively correlated with ISR(r=0.878,P＜0.001).Conclusion Intrathecal synthetic mark-ers such as IgG index,SOB(CSF)and 24 h ISR have synergistic effects in the diagnosis of cognitive dysfunction and various dementias,which can be collectively utilized in the diagnosis of diseases.

Purpose To detect the expression of PP1A and GSDME and the abundance of CD8+T lymphocytes in colorectal cancer,and to explore the correlation and clinical significance of PP1A and GSDME mediated pyroptosis.Methods GEPIA da-tabase was applied to analyze the mRNA expression of PP1A and GSDME in colorectal cancer and normal tissues.Western blot assay was used to detect the expression of PP1A in colorectal cancer and the corresponding normal mucosa.Immunohisto-chemistry was applied to detect the expression of PP1A and GS-DME and CD8+T lymphocytes abundance in 107 colorectal car-cinomas and normal mucosa adjacent to the carcinomas.Spearman rank correlation was used to analyze the correlation between PP1A,GSDME and CD8+T cells abundance.Results The GEPIA database search showed that mRNA expression of PP1A and GSDME in colorectal cancer differed compared to normal tissues(P＜0.05).Western blot analysis showed that the relative expression of PP1A in colorectal cancer tissue was significantly higher than that in para-cancerous tissues(0.937 vs 0.643,P＜0.001).Immunohistochemical results showed that the expression of PP1A in colorectal cancer tissues was signifi-cantly higher than that in normal mucosa(P＜0.05).The ex-pression of GSDME in cancer tissue was closely correlated with patients'age,clinical stage and mismatch repair proteins(P＜0.05),and the distribution of CD8+T cells in the cancer infil-tration front was significantly higher than that in the normal mu-cosa,and the distribution of CD8+T cells in the cancer was cor-related with pT stage,clinical stage and lymph node metastasis.Spearman correlation analysis showed that PP1A was negatively correlated with GSDME expression(r=-0.196,P＜0.05).The overall survival PP1A-positive colorectal cancer patients was worse than that of PP1A-negative patients(P＜0.05),and the prognosis of patients was correlated with the degree of differentia-tion,lymph node metastasis,pT stage and clinical stage.Posi-tive expression of PP1A,degree of differentiation,clinical stage,pT stage and lymph node metastasis are independent risk factors affecting the prognosis of colorectal cancer patients.Conclusion PP1A is highly expressed in colorectal cancer and negatively correlated with GSDME-mediated cell pyroptosis,and the differ-ential expression of both is closely related to the progression and prognosis of colorectal cancer,which can be used as a potential indicator for judgment of the prognosis of colorectal cancer pa-tients.The differential distribution of CD8+T cells may be asso-ciated with GSDME-mediated cell pyroptosis and tumor develop-ment.

Objective:To study the magnetic resonance imaging (MRI) and clinical manifestations of intraspinal echinococcosis.Methods:The general conditions, MRI and clinical manifestations of 23 patients with intraspinal echinococcosis diagnosed by pathology at the First Affiliated Hospital of Xinjiang Medical University from September 2011 to May 2023 were retrospectively analyzed.Results:There were 10 males and 13 females of the 23 patients with intraspinal echinococcosis. The age of the patients was (44.1 ± 13.9) years old, with a median age of 41 years old and a range of 25 to 72 years old. Eleven patients (47.8%) had a history of echinococcosis in the spine or other parts of the body. Among the 23 patients with intraspinal echinococcosis, 12 cases (52.2%) involved thoracic segment, 6 cases (26.1%) involved lumbar segment, 1 case (4.3%) involved sacral segment, 1 case (4.3%) involved thoracolumbar segment, 2 cases (8.7%) involved lumbosacral segment, and 1 case (4.3%) involved cervical and lumbar segment. There were 2 cases (8.7%) involving the intramedullary, 9 cases (39.1%) involving the extramedullary subdural, and 12 cases (52.2%) involving the extramedullary epidural. At the same time, 18 cases (78.3%) involved adjacent vertebral bodies, accessories or surrounding soft tissues. Intramedullary cystic echinococcosis was characterized by multiple nodules at the lower end of the spinal cord and the cauda equina nerve on MRI, with equal or low signal on T1WI, slightly high signals on T2WI and short time of inversion recovery (STIR), accompanied by small vesicles with high signal on T2WI. Intramedullary alveolar echinococcosis was characterized by nodular T1WI signals, slightly lower signals on T2WI and STIR, and circular enhancement on enhanced scan. Extramedullary subdural echinococcosis was mostly manifested as oval small vesicles with low signal on T1WI and high signal on T2WI, with a grape string-like appearance, and the capsular wall with low signal on T2WI could be seen at the edge. Extramedullary epidural echinococcosis was manifested as slightly low signal on T1WI, high signals on T2WI and STIR, accompanied by single or multiple small vesicles with high signal on T2WI, and compression of the dural sac. The clinical manifestations were chest and back, lumbosacral pain in 21 cases (91.3%), and lower limb dysfunction in 6 cases (26.1%).Conclusions:Intraspinal echinococcosis is relatively rare compared with other sites. When MRI features are clear, typical clinical manifestations are present, or there is a history of echinococcosis in other sites, intraspinal echinococcosis should be considered.

Objective:To investigate the status of nursing practice and organizational management for reperfusion therapy in ischemic stroke across medical institutions in Beijing.Methods:In June 2023, a survey was conducted among nursing managers from 62 medical institutions under the jurisdiction of the Beijing Stroke Treatment Quality Control and Improvement Center. The survey aimed to assess the current nursing practices and organizational management for reperfusion therapy in ischemic stroke.Results:Among the 62 medical institutions, 16.13% (10/62) had dedicated reperfusion therapy nurses for stroke, and 87.10% (54/62) had established specific nursing protocols and procedures for stroke reperfusion therapy within their departments. However, 27.42% (17/62) of these institutions based the development and updates of their protocols on experiential summaries rather than standardized guidelines. In terms of nursing practice, there was room for improvement in emergency identification and triage of suspected stroke patients, assistance with intravenous thrombolysis, patient condition monitoring, early rehabilitation, and related health education. Regarding nursing quality control, significant differences were observed between institutions that regularly conducted quality control of stroke reperfusion therapy nursing and those that organized regular training sessions for nurses in this area ( P<0.05) . Conclusions:While nursing practices and quality for stroke reperfusion therapy in Beijing are progressing, there are disparities in regional development. There is a high demand for specialized stroke nursing and targeted technical training.

Objective To explore the value of portovenous phase enhanced CT texture analysis of hepatic alveolar echinococcosis(HAE)for predicting extrahepatic metastasis.Methods A total of 105 patients with HAE confirmed by pathology were retrospectively collected.The patients were divided into metastatic group(n=55)and non-metastatic group(n=50)according to findings of preoperative imaging.Based on preoperative abdominal portovenous phase enhanced CT images,the grayscale histogram texture feature parameters of intrahepatic lesions,including mean,variance,skewness,kurtosis,and the 1,10,50,90,and 99th percentiles(recorded as Perc1,Perc10,Perc50,Perc90,and Perc99)were extracted using MaZda software.Univariate and multivariate logistic regression were used to analyze the histogram texture parameters and screen independent predictors of extrahepatic metastasis of HAE.Then receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each independent predictor alone and their combination for predicting extrahepatic metastasis of HAE.Results The mean and skewness were both independent predictors of extrahepatic metastasis of HAE(both P＜0.05),with AUC of 0.853 and 0.850 for predicting HAE extrahepatic metastasis,respectively,while the AUC of their combination was 0.902.Conclusion Portovenous phase enhanced CT texture analysis of HAE could be used to effectively predict extrahepatic metastasis.

Objective To investigate the value of CT calcification type of hepatic alveolar echinococcosis(HAE)for predicting its lymph node metastasis.Methods Totally 100 patients with HAE confirmed by surgical pathology were retrospectively collected,among them 50 with lymph node metastases were divided into metastasis group,while the other 50 with lymph node reactive hyperplasia into non-metastasis group.Patients'general data,as well as preoperative CT findings,including the number,location,the maximum diameter and calcification type of lesions were compared between groups.Multivariate logistic regression analysis was performed for clinical and CT features being significant different between groups to screen the independent predictors of HAE lymph node metastasis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of CT calcification type alone and combining with other independent predictors for predicting node metastasis of HAE.Results A total of 62 groups of lymph node metastases were detected in 50 patients in metastasis group,including 39 cases with single group lymph node metastasis,10 cases with 2 groups lymph node metastasis and 1 case with 3 groups lymph node metastasis.There were significant differences of location,the maximum diameter and CT calcification type of HAE lesions within liver between groups(all P＜0.05),which were all independent predictors of HAE lymph node metastasis(all P＜0.05).The AUC of CT calcification type alone and combining with other independent predictors for predicting node metastasis of HAE was 0.757 and 0.859,respectively,which were significant different(P=0.002).Conclusion CT calcification type of HAE could effectively predict lymph node metastasis,and the predictive efficacy might be improved by combining location and maximum diameter of HAE lesions.

Objective:To investigate the performance of a predictive model based on fat suppression (FS)-T2WI sequence combined with machine learning in the differential diagnosis of brucellar spondylitis (BS) and tuberculous spondylitis (TS).Methods:The clinical and imaging data of 74 patients with BS and 81 patients with TS diagnosed clinically or pathologically in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to January 2022 were retrospectively analyzed, and all patients underwent spinal magnetic resonance imaging (MRI) examination before treatment. Patients were randomly divided into a training group ( n = 123) and a testing group ( n = 32) in an 8 ∶ 2 allocation ratio, and radiomics feature extraction and dimensionality reduction analysis were performed on FS-T2WI sequence images. Four machine learning algorithms, including K-nearest neighbor (KNN), support vector machine (SVM), random forest (RF) and logistic regression (LR), were used to construct a radiomics model, and receiver operating characteristic (ROC) curve was used to analyze the differential diagnostic performance of each model for BS and TS. Results:A total of 1 409 radiomics features were extracted, and 7 related features were screened and included for identification of BS and TS, among which the Maximum2DDiameterColumn feature value showed a strong correlation, and there was a statistically significant difference between BS and TS patients ( P < 0.001). In the testing group, the area under the ROC curve (AUC) value of the SVM model for identifying BS and TS was 0.886, with a sensitivity of 0.53, a specificity of 0.88, and a diagnostic accuracy of 0.81; in the training group, the AUC value of the SVM model for identifying BS and TS was 0.811, the sensitivity was 0.68, the specificity was 0.72, and the diagnostic accuracy of the model was 0.78. Conclusion:The prediction model based on FS-T2WI sequence combined with machine learning can be used to identify BS and TS, and the diagnostic performance of SVM model is prominent and stable.