Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.

Objective To explore the mechanism of Tongdu Xingshen acupuncture,the clinical efficacy,systemic inflammatory response,blood-brain barrier and intestinal flora in patients with cognitive impairment after ischemic stroke(IS)were studied.Methods Thirty patients(3 cases shedding)with cognitive impairment after IS were included as the disease group,including patients before treatment as the disease group,patients after Tongdu Xingshen acupuncture treatment as the electroacupuncture group,and 30 healthy controls(3 cases shedding)were included as the healthy group.In the electroacupuncture group,on the basis of the basic treatment,Tongdu Xingshen acupuncture was applied,which was 30 min each time,once a day for 14 days.The MMSE,MoCA and MBI scores of the three groups were observed.The fecal and serum samples from all study subjects were collected,and 16S rDNA sequencing technology and ELISA were used to detect the changes of proinflammatory factors IL-6,IL-1β,TNF-α and S100β in serum in intestinal flora and feces.Results Compared with the healthy group,the MMSE,MoCA,and MBI score of patients in the disease group decreased significantly(P<0.05),serum proinflammatory factors and S100β protein content increased significantly(P<0.05),and the Shannon index(P<0.01)and Simpson index(P<0.001)increased significantly.Compared with the disease group,the MMSE,MoCA,and MBI score of the EA group increased significantly(P<0.05),the serum levels of proinflammatory factors and S100β decreased significantly(P<0.05),Shannon index and Simpson index decreased(P>0.05).The dominant bacterial flora in the healthy group mainly included Bacteroides,Bifidobacterium,Bacteroides,Faecalibacterium,Bifidobacteriaceae,Ruminococcaceae,and Bacteroides and other beneficial bacteria(P<0.05).The dominant flora in the disease group included Proteobacteria,Enterobacteriaceae,Escherichia,Klebsiella and other opportunistic bacteria(P<0.05),while the dominant flora in the EA group was consistent with the healthy group,the relative abundance of beneficial bacteria increased significantly(P<0.05),and the relative abundance of opportunistic bacteria decreased significantly(P<0.05).Spearman correlation analysis found that beneficial bacteria were positively correlated with clinical efficacy related indicators,but with serum proinflammatory factors and the content of S100β was negatively correlated.Conclusion Tongdu Xingshen acupuncture can regulate the diversity of intestinal flora to increase the abundance of Bacteroides,Bifidobacterium,Faecalibacterium,and other beneficial bacteria,regulate the intestinal microecological balance,Thereby regulating systemic inflammation and blood-brain barrier function,which plays a role in improving cognitive function.

This paper　explored the disease mechanism of autism spectrum disorders （ASD） from the perspectives of “vital activity” and “qi configuration”， and it is believed that “vital activity” represents the internal regulatory mechanisms of the human body， while “qi configuration” represents the ability of the body to communicate and adapt to the external environment. Abnormal genetic factors lead to the extinction of vital activity in children with ASD， resulting in increased susceptibility to ASD. Environmental instability leads to the solitary qi configuration in ASD， triggering and exacerbating the manifestations of ASD on the basis of genetic susceptibility. In addition， epigenetic mechanisms also play an important role in the pathogenesis of ASD. Imbalances in vital activity and disruptions in qi configuration result in failure in qi transformation of zang-fu organs， with abnormal symptoms manifested through the five orifices. It is proposed that the treatment of ASD should aim to achieve a harmonious interaction between “vital activity” and “qi configuration” to accelerate the recovery of affected children.

Objective To explore the effect of the implementation of intelligent platform based on the BOPPPS model in the clinical nursing teaching of the department of plastic and reconstructive surgery.Methods Seventy-nine undergraduate nurs-ing students interned from July 2022 to September 2023 in the department of plastic and reconstructive surgery of a tertiary univer-sity hospital were recruited.Thirty-nine students were selected in the control group,and fourty students were in the observation group.The control group was implemented the traditional clinical nursing teaching mode,and the observation group was imple-mented the intelligent platform based on BOPPPS teaching mode.We compared the theoretical scores,independent learning abili-ty,and teaching satisfaction of the two groups.Results The observation group's theory achievement score,speciality operation score,independent learning ability score and teaching satisfaction score were higher than those of the control group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion In the clinical nursing teaching of plastic and cosmetic surgery,the intelligent platform based on the BOPPPS model can improve the interns'theoretical and operational performance,independent learning ability and teaching satisfaction.The education method is worth promoting.

Objective To explore the effect of the implementation of intelligent platform based on the BOPPPS model in the clinical nursing teaching of the department of plastic and reconstructive surgery.Methods Seventy-nine undergraduate nurs-ing students interned from July 2022 to September 2023 in the department of plastic and reconstructive surgery of a tertiary univer-sity hospital were recruited.Thirty-nine students were selected in the control group,and fourty students were in the observation group.The control group was implemented the traditional clinical nursing teaching mode,and the observation group was imple-mented the intelligent platform based on BOPPPS teaching mode.We compared the theoretical scores,independent learning abili-ty,and teaching satisfaction of the two groups.Results The observation group's theory achievement score,speciality operation score,independent learning ability score and teaching satisfaction score were higher than those of the control group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion In the clinical nursing teaching of plastic and cosmetic surgery,the intelligent platform based on the BOPPPS model can improve the interns'theoretical and operational performance,independent learning ability and teaching satisfaction.The education method is worth promoting.

Gallstone is a common and frequent disease and frequent incidence, secondary infection and cancer seriously affect the health of patients. Academic organizations in different regions have issued multiple guidelines and consensus to promote the normative diagnosis and treatment of gallstones. However, in clinical practice, most symptomatic gallstones are treated, while the formation and prevention process of gallstones are ignored, making the concept of treating without a disease has not been strengthened.This article reviews the risk factors and mechanisms of gallstone formation, and points out the importance of effective prevention during stone formation. In the stage of gallstone formation, the high risk factors of stone formation can be analyzed through two aspects of injury factors and protective factors, and the high risk groups of stone formation can be screened out. According to the pathophysiological progression of gallstones, personalized prevention and follow-up strategies can be developed for the stone formation stage of gallstones.

Objective To investigate the value of pulmonary ventilation/ perfusion (V/ Q) SPECT in evaluation of anticoagulant therapy for patients with pulmonary embolism (PE) and identify factors which may affect the therapy. Methods From July 2014 to December 2016, sixty-three patients (23 males, 40 females, age (60±14) years), who were clinically diagnosed as PE and underwent V/ Q SPECT before and after anticoagulant therapy, were recruited retrospectively in this study. According to the percentage of lung perfusion defect (PD) out of total lung volume, the patients were divided into mild (<20％) PE, moderate (20％-50％) PE, and severe (>50％) PE groups. The lung PD decreased≥50％ after anticoagulant thera-py and no new PD detected was defined as the standard of effective therapy, otherwise the treatment were defined as ineffective. Data of different groups were compared. Factors that may predict the severity of PD or affect the treatment were analyzed. χ2 test and logistic regression were used for data analysis. Results PE were detected in 476 pulmonary segments and sub segments. The distribution of PE in different lung lobes had no statistically significant difference ( χ2 = 4. 995, P > 0. 05). More pulmonary arterial hypertension (PAH) were detected in patients with severe PE (80％, 12/ 15) and moderate PE (66.7％,16/ 24) in comparison with patients with mild PE (41.7％,10/ 24; χ2 = 7.062, P<0.05). The occurrence of PAH was related to the severity of PD, with odds ratio (OR) value of 2.680 (95％ CI: 1.115-6.446, P<0. 05).PAH was an independent risk factor for treatment effect (OR value: 3.134(95％ CI: 1.341-7. 324), P<0. 05). Conclusions V/ Q SPECT has an important value for evaluating the effect of anticoagulant therapy and guiding individual therapy. The more extent of PE involved, the higher prevalence of PAH. Anticoagu-lant therapy may be ineffective in PE patients with moderate or severe PAH.

Objective To evaluate the therapeutic effects of magnetically labeled mononuclear stem cells (MR-MNC) and mesenchymal stem cells (MR-MSC) transplantation in a swine acute myocardial infarction (AMI) model by MR imaging.Methods AMI model was established in swines by balloon occlusion of the left anterior descending coronary artery,107 autologous MR-MSC (n=7),MR-MNC (n=6) or PBS(n=6) were delivered via intracoronary infusion within 1 week after AMI [(4.8±1.3) days].Changes of infarct size and cardiac function were assessed with the use of 3.0T MR scanner before AMI,at 1 and 8 weeks post AMI.Results Magnetically labeled stem cells could be identified in the region of AMI by cardiac MR imaging.Eight weeks post transplantation,infarct size was significantly reduced in MR-MSC transplantation group(8.5%±0.5% vs.24.7%±3.1%,P＜0.05) and in MR-MNC transplantation (12.3%±1.5% vs.26.1%±1.5%,P＜0.05) while infaret size remained unchanged in PBS group (P＞0.05) compared to values at 1 week post AMI,left yentricular ejection fraction (LVEF) was also significantly higher in MR-MSC transplantation group (56.9%±1.3% vs.40.7%±2.0%,P＜0.05) and MR-MNC transplantation group (52.8%±1.4% vs.41.9%±3.3%,P＜0.06) compared to LVEF at 1 week post AML LVEF increase was more significant in swines received MR-MSC transplantation than MRMNC transplantation(16.2%±1.2% vs.10.9%±3.0%,P＜0.05).Prussian blue staining identified stem cells in corresponding myocardial regions with as by MRI.Western blot analysis demonstrated that cardiac expressions of myosin heavy chain (MHC) in MR-MSC group (100.3±5.5) and in MR-MNCs group (95.5±4.2) were significantly higher than that in PBS group (75.7±5.7,P＜0.05),myocardial troponin T (cTNT) expression in MR-MSC group (124.0±5.8) and MR-MNC group (118.4±4.4) were also significantly higher than in PBS group (93.3±3.9,P＜0.05) while MMP2/TIMP1 ratios in MR-MSC group (0.6±0.1) and MR-MNC group (0.6±0.1) were significandy lower than that in PBS group (4.2±0.2,P＜0.05).Conclusions Magnetically labeled MR-MSC and MR-MNC homed to heart post myocardial infarction and reduced infarct size,improved cardiac function.MR-MSC is superior to MR-MNC on improving cardiac function.

BACKGROUND:Among many transplanted cells,adult autologous bone barrow-derived mononuclear cells have beenused in clinical practice because they are easy to be obtained,without immunological rejection and ethical disputationand other advantages.How to distinguish donor cells from receptors and observe the survival of donor cells following stem cell transplantation still trouble people.OBJECTIVE: superparamagnetic iron oxide (SPIO)particles-labeled bone marrow-derived mononuclear cells from minipigs were used to observe the feasibility of in vivo tracking with magnetic resonance imaging(MRI).DESIGN:A controlled observation experiment.SETTING:Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University.MATERIALS:This experiment was carried out in the Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University between April 2006 and August 2006.Healthy Chinese minipigs,aged 3 to 4 months,weighing from 20 to 30 kg,were provided by the Experimental Animal Center of Southeast University[SYXK(Su)2002-0012].METHODS: Autologous bone marrow-derived mononuclear cells of minipigs were isolated and cultured. Bone marrow-derived mononuclear cells in the suspension were traced with SPIO particles.Ferrum in the cells were shown by Prussian blue staining, and cell viability was evaluated by trypan blue exclusion method. Eleven minipigs used for preparation of model of myocardial infarction were divided into experimental group(n=9)and control group(n=2).By means of percutaneous left or right cervical artery or femoral artery puncturation, 1.5 to 2.0 mm balloon was used to occlude 1/3 left anterior descending branch,304 to 405 kPa,60 minutes later,ischemic preconditioning was conducted 3 tO 4 times before operation. When pig models of myocardial infarction were successful that was proved by surface electrocardiogram,bone marrow-derived mononuclear cells were percutaneously injected into coronary artery.Coronary arteriography was performed through femoral artery acupuncture at 24 hours after establishing infarction models.Suspension of bone marrow-derived mononuclear cells was perfused into coronary artery with OTW catheter.Then,the injector and OTW catheter for containing cells were rinsed with normal saline containing heparin and infused with the residual cells within 10 minutes.Non-labeled cells were perfused in 2 minipigs of control group by the same method.Postoperatively, bone marrow-derived mononuclear cells were traced by magnetic resonance and compared with Prussian blue-stained myocardial tissue sections.RESULTS: Seven minipigs of experimental group and one minipig of control group were Involved in the final analysis.One of each group was used for preparation of model of myocardial Infarction.One minipig of experimental group died from anesthetic accident before magnetic resonance.①Bone marrow-derived mononuclear cells all were nearly labeled by SPIO particles. Bone marrow-derived mononuclear cells could further proliferate in culture medium containing Fe2O3-PLL without obvious changes of cellular shape. ②T2+WI showed that 5 of 8 models of myocardial infarction presented fuzzy low-echo signal region in peripheral myocardial infarction after transplantation of labeled cells and the low-echo signal disappeared 4 weeks Iater. Ex vivo T2+WI sequence showed there was a dot-distributed low-echo signal region in the peripheral infarction region.③It was found in histological examination that 5 models(cell number over 106) had Prussian blue-positive cells,which distributed the same as those in magnetic resonance signal reducing region.CONCLUSION:SPIO particles-labeled bone marrow-derived mononuclear cells are safe and effective;T2+ WI is sensitive to tracing SPIO particles-labeled bone marrow-derived mononuclear cells;Magnetic resonance can in vivo trace SPIO particles-labeled stem cells transplanted through coronary artery,magnetic resonance signal change is related with the number of stem cells and division growth.

Objective To observe the effect of Silbinin Capsuon serum interleukin-8 and tumor necrosis factor-?in NAFLD patients.Methods 58 patients with NAFLD were randomized into two groups.The treatment group including 29 cases received 70mg of Silbinin Capsules each time,three times a day.The control group including 29 cases received 100mg of goucurolactone tablets each time,three times a day.At the same time,both groups control food and drink and proper physical exercises.One course of treatment was 30 days in the study.Observe the changes of serum ALT,AST,IL-8 and TNF-?before and after treatment.Results The serum level of ALT,AST,IL-8 and TNF-?were improved significantly in both groups after treatment(P