Objective To observe the effect of pirfenidone on myocardial fibrosis in rats and inves-tigate its underlying mechanism.Methods Twenty-four SD rats were randomly divided into sham-operation group,model group,low-and high-dose pirfenidone groups,with 6 rats in each group.Rat model of myocardial fibrosis was established by injecting isoprenaline into the tail vein,while normal saline was given to the sham operation group.Pirfenidone of 150 and 300 mg/(kg·d)were infused gastrically to the rats of low-and high-dose pirfenidone groups after modeling.Mas-son staining was used to observe the severity of myocardial fibrosis,immunohistochemical assay was employed to detect the expression of Collagen-1,NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome,cysteinyl aspartate-specific protease-1(Caspase-1),and Western blotting was performed to detect the protein levels of Collogen-1 and atrial desmo-plakin D(gasdermin D,GSDMD).Results The model group showed obvious myocardial fibrosis,and elevated expression of Collogen-1,NLRP3,Caspase-1 and GSDMD when compared with the sham operation group(P＜0.05).Low-and high-dose pirfenidone treatment resulted in signifi-cantly reduced myocardial fibrosis and reduced expression of Collogen-1,NLRP3,Caspase-1 and GSDMD[(8.14±1.40)％,(6.56±0.75)％vs(22.15±2.57)％,P＜0.05;0.14±0.03 vs 0.33±0.05,0.42±0.13,P＜0.05;(10.34±1.40)％,(10.33±3.40)％vs(23.22±1.99)％,P＜0.05;(15.67±0.56)％,(17.33±0.78)％vs(22.87±1.92)％,P＜0.05;0.43±0.06,0.46±0.11 vs 0.65±0.03,P＜0.05].Conclusion Pirfenidone inhibits cardiomyocyte pyroptosis and attenuates myocar-dial fibrosis through the NLRP3/Caspase-1/GSDMD signaling axis.

Objective To observe the effect of pirfenidone on myocardial fibrosis in rats and inves-tigate its underlying mechanism.Methods Twenty-four SD rats were randomly divided into sham-operation group,model group,low-and high-dose pirfenidone groups,with 6 rats in each group.Rat model of myocardial fibrosis was established by injecting isoprenaline into the tail vein,while normal saline was given to the sham operation group.Pirfenidone of 150 and 300 mg/(kg·d)were infused gastrically to the rats of low-and high-dose pirfenidone groups after modeling.Mas-son staining was used to observe the severity of myocardial fibrosis,immunohistochemical assay was employed to detect the expression of Collagen-1,NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome,cysteinyl aspartate-specific protease-1(Caspase-1),and Western blotting was performed to detect the protein levels of Collogen-1 and atrial desmo-plakin D(gasdermin D,GSDMD).Results The model group showed obvious myocardial fibrosis,and elevated expression of Collogen-1,NLRP3,Caspase-1 and GSDMD when compared with the sham operation group(P＜0.05).Low-and high-dose pirfenidone treatment resulted in signifi-cantly reduced myocardial fibrosis and reduced expression of Collogen-1,NLRP3,Caspase-1 and GSDMD[(8.14±1.40)％,(6.56±0.75)％vs(22.15±2.57)％,P＜0.05;0.14±0.03 vs 0.33±0.05,0.42±0.13,P＜0.05;(10.34±1.40)％,(10.33±3.40)％vs(23.22±1.99)％,P＜0.05;(15.67±0.56)％,(17.33±0.78)％vs(22.87±1.92)％,P＜0.05;0.43±0.06,0.46±0.11 vs 0.65±0.03,P＜0.05].Conclusion Pirfenidone inhibits cardiomyocyte pyroptosis and attenuates myocar-dial fibrosis through the NLRP3/Caspase-1/GSDMD signaling axis.

Insomnia disorder is a common disease in acupuncture clinics.There is a tendency for the theory to solidify and lag behind the clinic.In this paper,we examined insomnia disorder from the perspective of acupuncture and moxibustion theory.Based on the general law of acupuncture and moxibustion to recognize the disease,we concerned that the basic understanding of the disease has commonality between ancient and modern medical practitioners,and the theory can be deconstructed as follows:the theory of"yin and yang"is the starting point and the root of the theory,the theory of"spirit regulars the sleep"is the directly related theory,the theory of internal organs is the basis of the disease mechanism,the theory of meridians and acupoints is the key to diagnosis and treatment,and the theory of acupuncture and moxibustion is the key to treatment.The improvement and development of the theory of acupuncture for insomnia disorder can be carried out on this basis.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Insomnia disorder is a common disease in acupuncture clinics.There is a tendency for the theory to solidify and lag behind the clinic.In this paper,we examined insomnia disorder from the perspective of acupuncture and moxibustion theory.Based on the general law of acupuncture and moxibustion to recognize the disease,we concerned that the basic understanding of the disease has commonality between ancient and modern medical practitioners,and the theory can be deconstructed as follows:the theory of"yin and yang"is the starting point and the root of the theory,the theory of"spirit regulars the sleep"is the directly related theory,the theory of internal organs is the basis of the disease mechanism,the theory of meridians and acupoints is the key to diagnosis and treatment,and the theory of acupuncture and moxibustion is the key to treatment.The improvement and development of the theory of acupuncture for insomnia disorder can be carried out on this basis.

Objective To explore the performance of domestic and international large language models(LLMs)in the context of ques-tion banks for clinical examination knowledge.Methods The performance of six domestic or international LLMs,in the question banks with a set of 330 questions for intermediate-level of clinical medical laboratory technology were assessed.The differences in accuracy and consistency among the different LLMs were evaluated using chi-square tests,Fisher's exact tests and logistic regression.Results The accuracy results for the four English LLMs along with 95％confidence intervals(95％CI)were as follows:the accuracy rates of ChatGPT,BingAI,Claude and GPT-4 were demonstrated as 0.56(95％CI:0.527-0.601),0.61(95％CI:0.572-0.644),0.64(95％CI:0.607-0.678)and 0.80(95％CI:0.767-0.833)respectively,while the performance of Xinghuo and Tiangong yielded accuracy rates of 0.52(95％CI:0.479-0.561)and 0.45(95％CI:0.408-0.482)respectively.Using ChatGPT as the reference model,we found that the odds ratios(OR)of correct answers of BingAI,Claude and GPT-4 were 1.272(95％CI:1.020-1.588),1.397(95％CI:1.119-1.743)and 3.270(95％CI:1.904-2.729)respectively.The differences of LLMs performance were statistically significant(P＜0.05)for all the three models.In terms of consistency,Tiangong and BingAI showed poor consistency,while GPT-4 appeared better.Conclusion A-mong the six LLMs,GPT-4 demonstrated the highest overall accuracy and consistency in each question category.

Objective To explore the effect of meditation training on postoperative pain, anxiety and reduce the incidence of constipation in patients with lower limb fracture. Methods The enrolled 106 patients with lower extremity fractures were randomly divided into the observation group and control group 53 cases respectively according to the odd even method. The control group was implemented with fracture surgery routine care, while the observation group was implemented with meditation training on the basis of the control group, the two groups were compared by postoperative pain score, anxiety, constipation, and satisfaction. Results Before intervention, the postoperative pain Visual Analogue Scale (VAS) scores and anxiety scores of the two groups were not significantly different (P>0.05). After intervention, the postoperative pain scores of observation group and control group were (2.06 ± 0.85) points and (4.15 ± 0.62) points respectively, the difference was statistically significant (t = 4.103, P <0.05). The anxiety scores of observation group and control group were (28.95 ± 3.83) points and (56.13 ± 3.52) points respectively, the difference was statistically significant (t= 2.353, P < 0.05). The first defecation time and the cases number of observation group patients were as follows:day 1st:20.75%(11/53), day 2nd: 52.83% (28/53), day 3rd: 18.87% (10/53), day 4th: 7.55% (4/53). While the data of the control group were day 1st: 1.89% (1/53), day 2nd: 26.42% (14/53), day 3rd 37.74% (20/53), day 4th:33.96%(18/53), the difference between the two groups was statistically significant (χ2=4.022-5.629, P<0.05). The satisfaction of observation group and control group patients were 94.34%(50/53), 77.36%(41/53) respectively, the difference was statistically significant (χ2=4.543, P < 0.05). Conclusions Meditation training can effectively reduce postoperative pain, reduce the incidence of anxiety and constipation, and improve the satisfaction of patients to nursing service, and promote the recovery of patients after surgery.

OBJECTIVE: To compare the features of caloric tests in vestibular migraine (VM) and Menière's disease (MD) patients, and provide objective evidence for differentiating the 2 groups of patients. METHOD: This case-control study included 11 MD patients with left ear involved and mild to moderate impaired hearing, and 18 matched cases with VM. All participants received caloric tests. Maximum slow phase velocities (SPVmax) were used to describe horizontal and vertical nystagmus respectively and were compared between the 2 groups. Horizontal and vertical canal parasis(CP) were calculated according to respective SPVmax. Unilateral (UW-VR) or bilateral (BW-VR) weakness of vestibular response, and positive unilateral (UVR) or bilateral (BVR) vertical response or negative bilateral vertical response (NBVR) were judged by the boundary point of SPVmax of 5°/s respectively. Total left (LV) or right (RV) Vertical reactions were calculated accoeding to vertical SPVmax,and inter ears difference of vertical responses (IED-VR) calculated from LV minus RV. RESULT: There were no significant differences in age and gender between the 2 groups. Horizontal SPVmax of all of caloric tests of VM group,except the left cold (LC), were statistically larger than that of MD group (P < 0.05) and the maximum responses of right warm (RW) caloric test in VM group (34.50 ± 17.77) were significantly greater than that in MD group (12.82 ± 6.69) (P < 0.01). Only the vertical SPVmax of RW of all caloric tests has statistically difference between the 2 groups (P < 0.01), and the maximum responses of RW caloric test in VM group (6.00 ± 4.45) were significantly stronger than that of LC in MD group (1.27 ± 2.00) (P < 0.01). Horizontal CP ≥ 25% of the 2 groups(VM: 72.22%, MD: 54.55%) were not statistically different, while the proportions of UW-VR and BW-VR in VM group (5.56%, 0) were significantly lower than that in MD group (27.27%, 18.18%) (P < 0.05). Vertical CP ≥ 25% of the 2 groups (VM: 94.44%, MD: 27.27%) were significantly different (P < 0.01), and the proportions of positive UVR (left: 5.56%, right: 77.78%) and BVR (0) and NBVR (16.67%) in VM group were significantly different from that in MD group (UVR (left: 9.09%, right: 0), BVR (0), NBVR (90.91%)) (P < 0.01). There was statistically difference between LV and RV in VM group (P < 0.01, LV < RV), while no difference were showed in MD group. IED-VR in VM group (left intenser: 16.67%, right intenser: 83.33%) was statistically different from that in MD group (left intenser: 36.36%, right intenser: 9.09%, both no difference: 54.55%) (P < 0.01). CONCLUSION Vestibular responses of caloric test are more sensitive, and vertical reactions are more easily induced in VM patients than in MD. Caloric test can be used to differentiate the 2 groups of diseases.
Caloric Tests ; Case-Control Studies ; Diagnosis, Differential ; Humans ; Meniere Disease ; diagnosis ; physiopathology ; Migraine Disorders ; diagnosis ; physiopathology

Objective To explore the effect of erythropoietin (EPO) on cognition and neuron apoptosis in CA1 region of hippocampus in vascular dementia (VaD) rats.Methods 54 Wistar rats were randomly divided into three groups:sham control group,VaD group,VaD+ EPO group (n=18,each).The bilateral common carotid arteries of Wistar rats were permanently ligated to establish VaD models.Spatial study and memory were observed by Y maze test at 4,8 and 12 weeks after operation.Neuron apoptosis in CA1 area of hippocampus was measured by terminal deoxynucleotidyl-transferase (TdT) mediated dUTP-biotin nick end labeling (TUNEL) method.The protein and mRNA expressions of Bcl 2 and Bax in CA1 region of hippocampus were detected by immunohistochemistry and RT-PCR at 4,8,12 weeks after operation.Results Compared with VaD group,the VaD+ EPO group had better performances including less error reaction times and shorter total reaction time in Y-maze (both P＜0.05) at 4,8,12 weeks after operation.The apoptotic neuronal cells in CA1 region of hippocampus was decreased in VaD+ EPO group than in VaD group at 4,8,12 weeks after operation [(10.50±±2.43) vs.(20.50±± 3.29),(23.92±±3.18) vs.(33.58±3.48) and (36.92±4.10) vs.(54.17±4.26),t=4.23,3.54,5.05,P=0.013,0.024,0.007,respectively].The Bcl-2-positive cells and Bcl-2 mRNA expression were increased,and the Baxpositive cells and Bax mRNA expression were decreased in VaD+ EPO group than in VaD group (all P ＜0.05).Conclusions Erythropoietin can improve cognitive function by inhibiting neuron apoptosis through regulation of Bcl-2 and Bax expression in CA1 region of hippocampus.

In this research,enzyme linked immunoassay (ELISA) was used to assay the fibrinogen (FIG) adsorbed on the Ti-O films and on the low temperature isotropic carbon (LTIC) films which were planted in the femoral arteries of 6 mongrel dogs for six months, respectively. The Ti-O films were planted in the dogs' left femoral arteries; the LTIC films as controls were planted in the dogs' right femoral arteries. The contents adsorbed in these two kinds of films were examined by scanning electron microscopy (SEM). The quantities of FIG adhered or denatured on the Ti-O films or LTIC films determined by ELISA, and the platelets adhered on the two kinds of films examined by SEM were of significant difference between the two groups. In the blood vessel, the amount of FIG adhered on biomaterial was related to its component and construction. FIG released electron to the biomaterial and induced the unfolding of C term of the gamma-chain of FIG, and the conjugation point and effect point were exposed. In conclusion, the biomaterial, which has the capability for resisting the electron release from FIG as well as for maintaining the invariable electric condition, will have excellent hemocompatibility.
Adsorption ; Animals ; Dogs ; Fibrinogen ; metabolism ; Heart Valve Prosthesis ; Histocompatibility ; Molecular Conformation ; Platelet Adhesiveness ; Prostheses and Implants ; Surface Properties ; Titanium ; chemistry