OBJECTIVE To explore the expression levels of microribonucleic acid-223(miR-223),nucleotide-bind-ing oligomerized domain-like receptor 3(NLRP3)and effect protein Caspase-1(Caspase-1)messenger ribonucleic acid(mRNA)in the thoracolumbar vertebral fracture patients with postoperative incision infections and analyze the diagnostic values.METHODS A total of 222 patients with thoracolumbar vertebral fracture who were treated in Jinan People's Hospital from Jan.2021 to Dec.2022 were enrolled in the study and were divided into the infection group with 25 cases and the no infection group with 197 cases according to the status of postoperative infections.The relative expression levels of peripheral blood miR-223,NLRP3 and Caspase-1 mRNA were detected by means of real-time fluorescent quantitative polymerase chain reaction(qPCR),the values of the three indexes in predic-tion of the postoperative incision infections were analyzed by means of receiver operating characteristic(ROC)curves,and Pearson correlation analysis was performed for the linear relationship between the miR-223,NLRP3 and Caspase-1 and the serum amyloid A(SAA)protein,monocyte chemoattractant protein-1(MCP-1)and Toll-like receptor-2(TLR-2).RESULTS There were significant differences in the levels of miR-223,NLRP3 and Caspase-1 mRNA between the infection group and the no infection group(P＜0.05);the levels of the above inde-xes of the infection group were 3.01±1.00,2.25±0.75 and 2.31±0.77,respectively.The area under the curve(AUC)of the joint detection of miR-223,NLRP3 and Caspase-1 was 0.935 in prediction of the postoperative inci-sion infections in the patients with thoracolumbar vertebral fracture,with the sensitivity 92.00％,the specificity 80.70％.There were significant differences in the levels of SAA,MCP-1 and TLR-2 between the infection group and the no infection group(P＜0.05);the levels of the above indexes of the infection group were(169.74±19.64)mg/L,(60.45±14.63)ng/L and(75.73±13.63)μg/L,respectively.The levels of miR-223,NLRP3 and Caspase-1 mRNA are positively correlated with SAA,MCP-1 and TLR-2(P＜0.05).CONCLUSIONS The chan-ges of miR-223,NLRP3 and Caspase-1 mRNA are associated with the postoperative incision infections in the pa-tients with thoracolumbar vertebral fracture.The joint detection of miR-223,NLRP3 and Caspase-1 mRNA may facilitate the diagnosis of postoperative incision infections,and the three indexes are positively correlated with SAA,MCP-1 and TLR-2.

OBJECTIVE To explore the expression levels of microribonucleic acid-223(miR-223),nucleotide-bind-ing oligomerized domain-like receptor 3(NLRP3)and effect protein Caspase-1(Caspase-1)messenger ribonucleic acid(mRNA)in the thoracolumbar vertebral fracture patients with postoperative incision infections and analyze the diagnostic values.METHODS A total of 222 patients with thoracolumbar vertebral fracture who were treated in Jinan People's Hospital from Jan.2021 to Dec.2022 were enrolled in the study and were divided into the infection group with 25 cases and the no infection group with 197 cases according to the status of postoperative infections.The relative expression levels of peripheral blood miR-223,NLRP3 and Caspase-1 mRNA were detected by means of real-time fluorescent quantitative polymerase chain reaction(qPCR),the values of the three indexes in predic-tion of the postoperative incision infections were analyzed by means of receiver operating characteristic(ROC)curves,and Pearson correlation analysis was performed for the linear relationship between the miR-223,NLRP3 and Caspase-1 and the serum amyloid A(SAA)protein,monocyte chemoattractant protein-1(MCP-1)and Toll-like receptor-2(TLR-2).RESULTS There were significant differences in the levels of miR-223,NLRP3 and Caspase-1 mRNA between the infection group and the no infection group(P＜0.05);the levels of the above inde-xes of the infection group were 3.01±1.00,2.25±0.75 and 2.31±0.77,respectively.The area under the curve(AUC)of the joint detection of miR-223,NLRP3 and Caspase-1 was 0.935 in prediction of the postoperative inci-sion infections in the patients with thoracolumbar vertebral fracture,with the sensitivity 92.00％,the specificity 80.70％.There were significant differences in the levels of SAA,MCP-1 and TLR-2 between the infection group and the no infection group(P＜0.05);the levels of the above indexes of the infection group were(169.74±19.64)mg/L,(60.45±14.63)ng/L and(75.73±13.63)μg/L,respectively.The levels of miR-223,NLRP3 and Caspase-1 mRNA are positively correlated with SAA,MCP-1 and TLR-2(P＜0.05).CONCLUSIONS The chan-ges of miR-223,NLRP3 and Caspase-1 mRNA are associated with the postoperative incision infections in the pa-tients with thoracolumbar vertebral fracture.The joint detection of miR-223,NLRP3 and Caspase-1 mRNA may facilitate the diagnosis of postoperative incision infections,and the three indexes are positively correlated with SAA,MCP-1 and TLR-2.

Objective: To evaluate the therapeutic potential and underlying mechanisms of action of propolis in db/db mice. Methods: The chemical composition of propolis was analyzed using UHPLC-MS/MS. Thirty mice, including six wt/wt and 24 db/db mice, were randomly assigned to four groups (n = 6 per group): control, model, metformin (250 mg/kg), low dose propolis (100 mg/kg), and high dose propolis (HDP; 400 mg/kg). Treatments were administered orally for four weeks. Body weight and FBG levels were recorded weekly, and an oral glucose tolerance test was conducted on the 25th day. Serum levels of FIN, GSP, connecting peptide, AST, ALT, HDL, LDL, TG, and TC were quantified using ELISA. Liver histopathology was assessed using H&E and PAS staining. Western blotting was performed to examine the expression levels of NF-κB, phosphorylated NF-κB, IκBα, pIκBα, and AKT in liver tissues. Results: The top 10 metabolites of propolis were identified in positive and negative ion modes. The HDP group exhibited a significant reduction in FBG levels, body weight, connecting peptide levels, homeostatic model assessment of β-cell function scores, and homeostasis model assessment of insulin resistance scores (all P < .05). GSP levels were significantly reduced in both treatment groups (all P < .001). The HDP group also exhibited a reduction in TC and LDL levels (both P < .05), whereas HDL levels increased in both treatment groups (all P < .05). Liver weight, AST levels, and ALT levels were reduced in both treatment groups (all P < .05). Histological analysis revealed improved liver morphology. Protein analysis demonstrated downregulation of phosphorylated NF-κB and phosphorylated IκB, alongside upregulation of AKT. Conclusion Propolis exhibited significant antihyperglycemic effects in db/db mice, potentially by modulating the AKT and NF-κB signaling pathways, highlighting its potential as a therapeutic agent for diabetes management.

ObjectiveTo observe the effects of the South African herb Hoodia gordonii （HG） on glucolipid metabolism in diabetic db/db mice and explore the possible mechanisms of HG on the liver of db/db mice based on the phosphoinositide-3 kinase （PI3K）/protein kinase B （Akt）/factor forkhead protein O1 （FoxO1） signaling pathway. MethodA total of 30 db/db mice were randomly divided into five groups according to fasting blood glucose： model group， metformin group （0.195 g·kg^-1）， and low dose （0.39 g·kg^-1）， medium dose （0.78 g·kg^-1）， and high dose （1.56 g·kg^-1） HG groups， with six m/m mice in each group， and another six m/m mice were set as normal group. The mice in the normal and model groups were given saline of 9 mL·kg^-1 by gavage. Body weight， water intake， and fasting blood glucose of the mice in each group were measured weekly. After six weeks of continuous administration， serum insulin （FINS）， low-density lipoprotein cholesterol （LDL）， total cholesterol （TC）， triglyceride （TG）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， urea， and creatinine （CREA） were measured， and liver sections were embedded and stained with hematoxylin-eosin （HE）， periodic acid-Schiff （PAS）， and oil red O. Protein expression of PI3K p85， p-Akt， and p-FoxO1 in liver was detected by immunohistochemistry. The mRNA expression of PI3K， Akt， and FoxO1 in liver tissue was detected by real-time polymerase chain reaction （Real-time PCR）. ResultAfter six weeks of administration intervention， it was found that fasting blood glucose was significantly downregulated in mice in the three HG groups （P<0.05）. The level of islet resistance index was significantly reduced in both the low and medium dose HG groups （P<0.05）. The expression levels of TC， TG， and LDL were reduced in all HG groups （P<0.05， P<0.01）. Pathologically， HG could alleviate hepatocyte steatosis， reduce the volume and content of lipid droplets in liver， and increase the distribution of glycogen granules in liver to some extent in mice. Immunohistochemical assays revealed that PI3K p85 protein expression was significantly increased in the low， medium， and high dose HG groups compared with the model group （P<0.01）. p-Akt protein expression was significantly increased in the medium and high dose HG groups （P<0.05， P<0.01）. p-FoxO1 protein expression was significantly increased in the low， medium， and high dose HG groups （P<0.05， P<0.01）. Compared with the model group， PI3K mRNA was increased in low dose， medium dose， and high dose HG groups （P<0.05）， and Akt mRNA was increased in high dose HG group （P<0.05）. FoxO1 mRNA was decreased in low dose， medium dose， and high dose HG groups （P<0.05）. ConclusionHG can ameliorate the disorder of glucolipid metabolism in db/db mice， which may be related to its activation of the hepatic PI3K/Akt/FoxO1 signaling pathway.

Objective To analyze the prefrontal electroencephalogram characteristics of patients with emergence delirium(ED)after hip or knee arthroplasty.Methods Sixty-four patients undergoing elective hip or knee arthroplasty were selected,12 males and 52 females,aged≥60 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅱ or Ⅲ.The confusion assessment method-intensive care unit(CAM-ICU)and the Richmond agitation-sedation scale(RASS)were used to determine the occurrence of ED dur-ing postoperative anesthesia.The patients were divided into two groups according to whether delirium oc-curred during emergence from anesthesia:the emergence delirium group(ED group)and the non-emergence delirium group(non-ED group).The patients'raw EEG data during the emergence phase were recorded by the EEG monitor,and the data from before(5-10 minutes after discontinuation of the drug)and after emergence(15-20 minutes after removal of the laryngeal mask)were intercepted and spectrally analyzed.Results Twenty-eight patients(44％)developed ED.EEG changes during emergence from anes-thesia were consistent in both groups:the spectral edge frequency(SEF)was increased,the β and y wave power was increased,and the peak α wave frequency was decreased.Compared with the pre-emergence state,the θ and α wave power were significantly lower and the peak α wave power was significantly lower in the non-ED group during full awakening(P＜0.05),and the difference between the α wave power and the peak α wave power was not statistically significant in the ED group during full awakening.Sample entropy and alignment entropy of patients in the ED group before emergence and in full awakening were significantly higher than those in the non-ED group(P＜0.05).Conclusion The θ wave power,α wave power,and peak α wave power were significantly lower during emergence from anaesthesia in patients with no delirium.In patients who developed ED,there was no significant change in α wave power or peak α wave power dur-ing emergence from anesthesia,but there was an increase in sample entropy and alignment entropy.

Objective: To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation. Methods: A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function. Results: The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1. Conclusion The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Humans ; Muscular Dystrophy, Duchenne/epidemiology* ; Prevalence ; Myocardium

Objective:To evaluate the effect of multimodal non-drug treatment during induction of general anesthesia on emergence delirium (ED) in the preschool children.Methods:A total of 210 pediatric patients of either sex, aged 3-6 yr, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, undergoing elective operation for snoring with expected operation time <2 h, were involved in this study. The patients were divided into 2 groups according to the parity of the numbers randomly generated by the computer: multimodal non-drug treatment group (group N, n=102) and control group (group C, n=108). In group N, multiple modes of non-drug intervention (including parents′ company, carrying favorite toys, watching favorite video programs with portable multimedia devices, etc) were used during anesthesia induction, and the children left their parents and entered the operating room after completion of general anesthesia. The children directly entered the operating room with the medical staff for anesthesia induction (without parents′ company and other intervention measures) in group C. The patients were endotracheally intubated and received combined intravenous-inhalational anesthesia and general anesthesia in both groups. The anxiety was evaluated by modified Yale preoperative anxiety scale (m-YPAS) score at 24 h before operation (T 0) and immediately before induction of general anesthesia (T 1). The Pediatric Anesthesia Emergence Delirium scale score (PAED score, ED was defined as PAED score > 12), FLACC scale score and Ramsay Sedation Scale score were recorded when orientation recovered after admission to postanesthesia care unit (T 2) and at 6, 24 and 72 h after operation. The patients were divided into ED group and non-ED group (NED group) according to the occurrence of ED, and the risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify ED-related risk factors and construct the prediction model. The accuracy of the prediction model was evaluated by the receiver operating characteristic curve. Results:Compared with group C, the m-YPAS at T 1 and PAED score and incidence of ED at T 2 were significantly decreased ( P<0.05), and no significant change was found in FLACC score and Ramsay sedation score at all time points in group N ( P>0.05). Age, m-YPAS score at T 1, multimodal non-drug treatment during anesthesia induction, FLACC score at T 2 and Ramsay sedation score at T 2 were the risk factors for ED ( P<0.05). The area under the receiver operating characteristic curve was 0.944, the 95% confidence interval was 0.914-0.974, with a Yonden index of 0.779, sensitivity of 94.9%, specificity of 83%, and the cutoff value of 0.14. Conclusions:Multimodal non-drug treatment during induction of general anesthesia can effectively reduce the development of ED in the preschool children.

With the aggravation of global aging process and the strengthening of patients’ awareness of rights, the realization of the elderly and end-of-life patients’ right to know and autonomy, and the satisfaction of physical and mental needs have become new indicators to measure social development. Advance care plan focuses on the discussion process of patients, their families and medical staff on end-of-life medical decisions and death intentions, which greatly promotes the development concept of palliative care and optimal death. To promote this process in the context of traditional Chinese culture, it is also necessary to combine with the local family concept and collectivism. Therefore, this paper introduced a sustainable social support system involving multiple subjects such as families, communities, social workers, and legal workers, with a view to benefiting the elderly and end-of-life patients.

Objective : To explore the frontal EEG characteristics of elderly patients with postoperative delirium (POD) after spinal surgery under conscious and general anesthesia． Methods : he inclusion criteria were patients aged≥65 years who underwent elective spinal surgery．POD was evaluated using The Confusion Assessment Method ( CAM) 1－7 days after surgery．Patients were divided into two groups based on whether POD occurred : Postoperative Delirium Group (POD group) and Non Postoperative Delirium Group (Non POD group) ．The raw EEG data of two groups of patients in the EEG monitoring instrument were extracted，and the data of two time periods of wakefulness and anesthesia were intercepted for spectral analysis．The EEG data that did not meet the requirements were excluded，and ultimately 80 patients were included，including 32 in the POD group and 48 in the Non-POD group. Results : Compared with the Non-POD group，patients in the POD group were found to be under anesthesia the power of θ、α、β waves (5 －18 Hz) significantly decreased，the peak α frequency of the wave was slower (P = 0. 038) ，the peak power of α (P＜0. 001) and the total power were lower (P＜0. 001) ．Comparing the EEG chan- ges between two groups from wakefulness to anesthesia，the study found that the increase of α power in POD group was not significant． Conclusion The characteristic electroencephalograms associated with POD in elderly patients during the perioperative period can help anesthesiologists to identify high-risk patients with POD in the early .