Interactions between brain-resident and peripheral infiltrated immune cells are thought to contribute to neuroplasticity after cerebral ischemia. However, conventional bulk sequencing makes it challenging to depict this complex immune network. Using single-cell RNA sequencing, we mapped compositional and transcriptional features of peri-infarct immune cells. Microglia were the predominant cell type in the peri-infarct region, displaying a more diverse activation pattern than the typical pro- and anti-inflammatory state, with axon tract-associated microglia (ATMs) being associated with neuronal regeneration. Trajectory inference suggested that infiltrated monocyte-derived macrophages (MDMs) exhibited a gradual fate trajectory transition to activated MDMs. Inter-cellular crosstalk between MDMs and microglia orchestrated anti-inflammatory and repair-promoting microglia phenotypes and promoted post-stroke neurogenesis, with SOX2 and related Akt/CREB signaling as the underlying mechanisms. This description of the brain's immune landscape and its relationship with neurogenesis provides new insight into promoting neural repair by regulating neuroinflammatory responses.
Humans ; Ischemic Stroke ; Brain/metabolism* ; Macrophages ; Brain Ischemia/metabolism* ; Microglia/metabolism* ; Gene Expression Profiling ; Anti-Inflammatory Agents ; Neuronal Plasticity/physiology* ; Infarction/metabolism*

OBJECTIVE To establish a high-performance liquid chromatography method for the simultaneous determination of 14 components including geniposide, mangiferin, baicalin, berberine hydrochloride, wogonoside, baicalein, aloe-emodin, rhein, wogonin, emodin, praeruptorin A, chrysophanol, physcion and praeruptorin B in Qingfei Yihuo tablets. METHODS Titank C18 (250 mm×4.6 mm, 5 μm) column was used; 0.1% phosphoric acid solution(A)-acetonitrile(B) was used as the mobile phase with gradient elution; detection wavelengths: geniposide at 238 nm, aloe-emodin, rhein, emodin, chrysophanol, physcion and mangiferin at 254 nm, berberine hydrochloride at 265 nm, baicalin, wogonoside, baicalein, and wogonin at 280 nm, praeruptorin A and praeruptorin B at 321 nm. The flow rate was 1.0 mL·min−1 and the column temperature was 35 ℃; the injection volume was 10 μL. RESULTS The linear ranges of geniposide, mangiferin, baicalin, berberine hydrochloride, wogonoside, baicalein,aloe-emodin, rhein, wogonin, emodin, praeruptorin A, chrysophanol, physcion and, praeruptorin B were 4.96−223.17, 0.84−42.22, 18.76−938.16, 4.46−223.17, 4.86−243.10, 1.59−79.32, 0.76−38.17, 1.03−51.49, 1.59−79.40, 1.21−60.72, 1.80−90.06, 0.91−45.48, 1.04−51.83 and 0.86−43.23 μg·mL−1, with r all ≥ 0.999 9. The RSDs of instrument precision, stability and reproducibility tests were <3%, and the average recoveries in sample(n=6) were >90%, with the RSDs <3%. CONCLUSION The method is simple and reproducible and can provide a scientific basis for improving the quality standard of Qingfei Yihuo tablets.

Objective To investigate the clinical effect of respiratory trainer in the patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) undergoing non-invasive positive pressure ven-tilation.Methods A total of 85 patients with COPD undergoing non-invasive positive pressure ventilation ad-mitted and treated in the Affiliated Minda Hospital of Hubei Nationalities University during 2019-2023 were selected as the study subjects and divided into the experiment group and the control group through random number table method.The control group adopted the symptomatic and supportive treatment such as routine non-invasive positive pressure ventilation,anti-infection,preparation aspiration for spasmolysis and eliminating phlegm,while on the base of the control group,the experiment group adopted respiratory trainer (K5) for re-spiratory training each once in the morning and at night.The differences in the related indexes were compared between the two groups.Results The percentage of forced expiratory volume in the first second (FEV1％),forced expiratory volume in 1 second/forced lung capacity (FEV1/FVC),COPD assessment test (CAT) score,modified Medical Research Council Dyspnea Scale (mMRC) score,6-min walking distance (6MWD),SGRQ score,maximum inspiratory pressure (MIP),maximum expiratory pressure (MEP),partial pressure of carbon dioxide (PaCO2) and PaO2 on 3,7 d after treatment in both groups had statistically significant differ-ence compared with before treatment (P<0.05),and the improvement of the above indicators in the experi-ment group was more significant compared with the control group (P<0.05).Conclusion Respiratory train-er could improve the clinical effect and pulmonary ventilation function in the patients with acute exacerbation of COPD undergoing non-invasive positive pressure ventilation.

Objective To construct a scientific and practical core literacy training system for nurses working in bleeding centers so as to provide reference for the training and curriculum design of nurses working in bleeding centers.Methods A computerized retrieval of academic papers concerning the core literacy training system for nurses working in bleeding centers from the databases of PubMed,Web of Science,China Biomedical Literature Service(CBM),China Knowledge Network(CNKI),Wanfang and other databases was conducted.Combined with the results of interviews with patients,family members and medical staff,and through organizing the group discussion,a training system for nurses working in bleeding centers was preliminary formulated.Finally,the Delphi method was used to make two rounds of inquiries to 21 experts from 12 provinces,and a three-level index system was determined.Results The first round of expert inquiry questionnaires effectively collected 21/21 consultation letters,and the second round of expert inquiry questionnaires effectively collected 19/21 consultation letters.The expert consultation and judgment coefficient of the core literacy training system for nurses working in bleeding centers was 0.99,the authority coefficient was 0.89;the Miller pyramid theory expert consultation and judgment coefficient was 0.72,the authority coefficient is 0.85,and the familiarity level was 0.80.Finally,the training system for bleeding center nurses covered four levels,including theory,application,skills and practical performance ability,and consisted of three parts,including training content,training management,and exam assessment.The training content included 22 first-level indicators,96 second-level indicators and 78 third-level indicators;the training management included 4 first-level indicators,8 second-level indicators and 12 third-level indicators;and the exam assessment included 5 first-level indicators and 16 second-level indicators.Conclusion The Miller pyramid theory-based core literacy training system for nurses working in hemorrhage centers fully adopts the expert opinions and suggestions,and it carries a high degree of credibility,therefore,it can provide reference for the training of the nurses working in bleeding centers.(J Intervent Radiol,2024,33:664-673)

Objective To evaluate the application effect of standardized communication mode, which was based on the situation, background, assessment and recommendation (SBAR communication mode), in interventional ward. Methods SBAR communication mode was implemented in interventional ward. Through the discussion of doctors and nurses, the SBAR communication template of common symptoms of specialized diseases was revised. The training, examination, utilization and evaluation of the SBAR communication template were conducted for all nurses. The medical adverse events caused by poor medical and nursing communication, the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction with nurses were recorded before and after the implement of SBAR communication mode, and the results were compared. Results After the implementation of SBAR communication mode, both the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses were significantly improved, the differences were statistically significant (P<0.05); and the incidence of medical adverse events caused by poor medical and nursing communication was remarkably decreased, the difference was statistically significant (P<0.05) . Conclusion The implementation of SBAR communication mode in the intervention ward can significantly improve the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses, and decrease the incidence of medical adverse events caused by poor medical and nursing communication, thus, the safety of patients can be guaranteed, meanwhile, the establishment of a harmonious medical and nursing team is promoted.

Objective To make a further recognition of the real quality of life of post-discharge patients who carry a percutaneous transhepatic biliary drainage (PTBD) tube due to malignant obstructive jaundice in order to formulate the corresponding scheme of health education and continued nursing. Methods By using qualitative research with phenomenological method, the interventional specialized nurse made a indepth interview with the post-discharge patients who carried a PTBD tube due to malignant obstructive jaundice. Colaizzi seven-step analysis method was adopted to collate and analyze the clinical data. Results A total of 10 patients were finally enrolled in this study. The main considerations of patients carrying a PTBD tube in daily life included the changes of self-care ability in daily life, intensification or absence of a patient's role; worrying about prolapse and infection of the tube; disordered self-image and social phobia; different degrees of physical discomfort and negative emotion with psychological pressure; hoping improvement of the drainage bag and fixed materials and way; hoping more convenient way of dressing, etc. Conclusion The post-discharge patients carrying a PTBD tube live in different levels of stress. The medical staff should carry out targeted health education and extension care to help them and make research to improve equipment, so as to improve self-care ability, reduce complications as well as psychological pressure, thus, to improve the quality of life.

Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.

Objective To explore the clinical efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute heart failure(AHF) by observing the changes of hemodynamic parameters,cardiac function and inflammatory factors before and after treatment in the patients with AHF.Methods A total of 96 patients with AHF in our hospital from June 2012 to December 2015 were enrolled in this study and divided into the control group and observation group(n-48).The two groups were given the routine anti-heart failure treatment combined with sodium nitroprusside or rhBNP by intravenous dripping for 24 h.Fifteen cases were selected from each group for monitoring the hemodynamic change.The clinical effect was observed.The changes of heart rare,blood pressure,urine volume,cardiac function,plasma of NT-proBNP,IL-6 and hs-CRP before and after medication were observed.The occurrence of adverse reactions was also observed.Results The total effective rate of the observation group was significantly higher than that in the control group (P＜0.05).The PAP and PCWP at various time points after treatment in the observation group were significantly lower than those before treatment (P＜0.05).PAP and PCWP at various time points had statistical difference between two groups (P＜0.05).The levels of heart rate,systolic blood pressure,NT-proBNP,IL-6 and hsCRP levels after medication were significantly decreased in both groups,and the urine volume and LVEF were significantly increased (P＜0.05),and the difference between the two groups was statistically significant(P＜0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups (P＞0.05).Conclusion The short-term efficacy of rhBNP in treating AHF is better than sodium nitroprusside,which can improve hemodynamics and cardiac function,reduces the level of inflammatory factors.

Objective To investigate the role of mylin basic protein,S100B and arterial blood gas analysis's levels in early diagnosis of brain injury in premature infant.Methods A total of 95 premature infants treated in our hospital were enrolled in the study.Experimental group was 45 premature infants with brain injury.Control group was 50 premature infants without brain injury were the.All patients were detected with arterial blood gas analysis,MBP and S100B on the 1st day and 7th day after birth.Results The pH,PCO2,BE,lactic acid,MBP and S100B's levels in experimental group were significantly different between the 1st day and 7th day after birth.In the 1st day after birth,compared with the control group,the pH,PCO2,BE,lactic acid,MBP and S100B in the experimental group were obviously high than that of control group.Conclusion On the 1st day after birth,monitoring arterial blood gas analysis,S100B protein and MBP's levels could be useful in early diagnosis of brain injury in preterm infants.

Objective To discuss the clinical application of the nursing management mode of doctornurse same group responsibility system in treating patieuts who are receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods A total of 70 TIPS patieots,who were admitted to a certain level Ⅲ hospital during the period from January 2016 to December 2016,were enrolled in this study.Using the table of random number,the patients were equally divided into the control group and the study group with 35 patients in each group.Traditional nursing group management mode was adopted in the control group,while doctor-nurse same group responsibility system was carried out in the study group (including the hospitalization period and the follow-up visit after discharge).Complications during hospitalization,postdischarge incidence of hepatic encephalopathy,readmission rate,and patient's satisfaction with medical staff were calculated,and the results were compared between the two groups.Results After the implementation of doctor-nurse same group responsibility system,the post-TIPS complications,the post-discharge incidence of hepatic encephalopathy and the readmission rate were significantly decreased and the patient's satisfaction with medical staff was remarkably improved,the differences were statistically significant (P＜0.05).Conclusion The implementation of doctor-nurse same group responsibility management mode for TIPS patients in the interventional ward can effectively reduce postoperative complications,post-discharge incidence of hepatic encephalopathy and the readmission rate,meanwhile,the patient's satisfaction with medical staff are obviously improved.Therefore,the implementation of doctor-nurse same group responsibility management mode for TIPS patients is of great value in clinical practice.