Objective: To investigate the effects of Zuogui Jiangtang Jieyu Formula (ZGJTJYF) on histone H3 lysine 18 lactylation (H3K18la) in the hippocampus of rats with diabetes mellitus complicated with depression (DD) and predict the regulatory genes of H3K18la. Methods: Male Sprague-Dawley rats were divided into control, model, and positive drug (metformin [0.18 g/kg] and fluoxetine [1.8 mg/kg]) groups, and the three groups were treated with high, medium, and low ZGJTJYF doses (20.52, 10.26, and 5.13 g/kg, respectively), with 10 rats per group. After treatment, the forced swimming and water maze tests were performed to assess depressive-like behaviors and cognitive function. An enzyme-linked immunosorbent assay was used to measure blood insulin, glycosylated hemoglobin, lactate levels, and lactate content in the hippocampus. Western blotting was used to detect H3K18la expression in the hippocampus. Cleavage Under Targets and lagmentation(CUT&Tag) experiments targeted hippocampal H3K18la epigenetic modification regions to analyze the transcription factors bound by H3K18la. Kyoto Encyclopedia of Genes and Genomes and Protein-Protein Interaction networks were constructed to identify key pathways and target genes regulated by H3K18la. Results: Compared with the normal group, the model group rats showed prolonged immobility time in the forced swim test, increased escape latency in the water maze experiment, decreased target quadrant distance ratio (P<0.01), increased serum lactate content, and decreased lactate content in hippocampal homogenate (P<0.01), as well as decreased H3K18la protein expression in the hippocampus (P<0.01). Compared with the model group, ZGJTJYF reduced the immobility time in the forced swim test and the escape latency in the water maze test (P<0.01), while the distance ratio in the target quadrant increased (P<0.01) in model rats. Lowered fasting blood glucose, insulin, and glycosylated hemoglobin levels (P<0.05, P<0.01) were also observed. ZGJTJYF also increased the lactate content and H3K18la protein expression in hippocampal homogenate (P<0.05, P<0.01). The DNA sequences bound by H3K18la were predominantly enriched at the transcription start sites. ZGJTJYF modulated H3K18la-associated pathways, including cell adhesion junctions, tumor growth factor-beta (TGF-β) signaling, stem cell pluripotency regulation, mitogen-activated protein kinase(MAPK) signaling pathway, and insulin resistance, leading to the identification of 12 target genes. Conclusion ZGJTJYF enhances hippocampal lactate levels and H3K18la modification in DD rats, which may regulate neural cell interactions, neurogenic stem cell function, TGF-β signaling, MAPK signaling, and insulin resistance pathways.

Objective:To explore the current status and trends in emergency nursing teaching methods based on CiteSpace software in China from 2012 to 2023, and to provide reference for subsequent research.Methods:Literature on teaching methods in emergency nursing was electronically searched in the China National Knowledge Infrastructure, WanFang Data, and VIP from January 2012 to December 2023. CiteSpace and Excel software were used to perform bibliometric analysis on the publication year, journal source, first author affiliation, keywords and clustering content.Results:An initial search yielded 1 550 articles and 936 relevant articles were screened and published in 194 journals. From 2012 to 2023, the number of publications on teaching methods in emergency nursing in China was relatively flat, the first author affiliations were mainly general hospitals, and the research methods were mainly quantitative. Keyword clustering showed that six themes were extracted, including exploration of professional skills, reform and application of teaching methods, nursing teaching and evaluation, teaching modes, teaching tools, and training modes.Conclusions:The trend of publications in emergency nursing teaching methods in China in the past 10 years has been relatively flat, and the quality of the literature needs to be improved. Emergency nursing teaching needs to focus on reforming teaching modes and methods, and further exploring the use of tools such as mind maps and teaching manuals to improve the quality of teaching.

Objective:To explore the current status and trends in emergency nursing teaching methods based on CiteSpace software in China from 2012 to 2023, and to provide reference for subsequent research.Methods:Literature on teaching methods in emergency nursing was electronically searched in the China National Knowledge Infrastructure, WanFang Data, and VIP from January 2012 to December 2023. CiteSpace and Excel software were used to perform bibliometric analysis on the publication year, journal source, first author affiliation, keywords and clustering content.Results:An initial search yielded 1 550 articles and 936 relevant articles were screened and published in 194 journals. From 2012 to 2023, the number of publications on teaching methods in emergency nursing in China was relatively flat, the first author affiliations were mainly general hospitals, and the research methods were mainly quantitative. Keyword clustering showed that six themes were extracted, including exploration of professional skills, reform and application of teaching methods, nursing teaching and evaluation, teaching modes, teaching tools, and training modes.Conclusions:The trend of publications in emergency nursing teaching methods in China in the past 10 years has been relatively flat, and the quality of the literature needs to be improved. Emergency nursing teaching needs to focus on reforming teaching modes and methods, and further exploring the use of tools such as mind maps and teaching manuals to improve the quality of teaching.

Objective:To discuss the alleviative effect of ginsenoside Rg1 on chronic intermittent hypoxia(CIH)-induced brain injury in the mice,and to clarify its possible mechanism.Methods:Forty male C57BL/6 mice were randomly divided into control group,model group,inhibitor group(treated with calpain-1 inhibitor),low dose of ginsenoside Rg1 group(treated with 10 mg·kg-1 ginsenoside Rg1),and high dose of ginsenoside Rg1 group(treated with 20 mg·kg-1 ginsenoside Rg1).Except for the control group,the mice in all other groups were placed in a hypoxic chamber with automatically regulated oxygen concentration to induce hypoxic brain injury.The peripheral blood oxygen saturation(SpO2)of tail of the mice in various groups was detected;the escape latencies and path lengths and the frequency of swimming route crossing the target quadrant of the mice in various groups were determined by Morris water maze test;the levels of blood urea nitrogen(BUN),lactate(LA),malondialdehyde(MDA),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)and the activities of superoxide dismutase(SOD)and lactate dehydrogenase(LDH)in serum of the mice in various groups were detected by kits;the degrees of brain tissue injury of the mice in various groups were observed by HE staining.The levels of reactive oxygen species(ROS)in CA1 region of hippocampus tissue of the mice in various groups were detected by dihydroethidium(DHE)probe;the expression levels of calpain-1,IL-6,and TNF-α proteins in brain tissue of the mice in various groups were detected by Western blotting method.Results:Compared with control group,the SpO2 of the mice in model group was significantly decreased(P＜0.01),indicating that the model was successfully established.Compared with model group,the SpO2 of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly increased(P＜0.01).The Morris water maze test results showed that compared with control group,the escape latency and path length of the mice in model group were significantly prolonged(P＜0.01),and the frequency of swimming route of crossing the target quadrant was significantly decreased;compared with model group,the escape latencies and path lengths of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly shortened(P＜0.01),and the frequency of swimming route of crossing the target quadrant was significantly increased.Compared with control group,the levels of BUN,LA,MDA,IL-6,and TNF-α in serum of the mice in model group were significantly increased(P＜0.01),while the activity of LDH was significantly increased(P＜0.01),and the activity of SOD was significantly decreased(P＜0.01);compared with model group,the levels of BUN,LA,MDA,IL-6,and TNF-α in serum of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly decreased(P＜0.01),while the activities of LDH were significantly decreased(P＜0.01),and the activities of SOD were significantly increased(P＜0.01).The HE staining results showed that compared with control group,the pyramidal neurons in CA1 region of hippocampus tissue of the mice in model group were loosely arranged,while some neurons were triangular,with nuclear pyknosis,cytoplasmic hyperchromasia,and a few neurons were lost,indicating obvious hypoxic neuronal injury;compared with model group,the hypoxic neuronal injury in CA1 region in hippocampus tissue of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group was effectively alleviated.The DHE probe detection showed that compared with control group,the level of ROS in CA1 region in hippocampus tissue of the mice in model group was significantly increased(P＜0.01);compared with model group,the levels of ROS in CA1 region in hippocampus tissue of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly decreased(P＜0.01).The Western blotting results showed that compared with control group,the expression levels of calpain-1,TNF-α,and IL-6 proteins in hippocampus tissue of the mice in model group were significantly increased(P＜0.01);compared with model group,the expression levels of calpain-1,TNF-α,and IL-6 proteins in hippocampus tissue of the mice in inhibitor group,low dose of GRg1 group and high dose of GRg1 group were significantly decreased(P＜0.01).Conclusion:Ginsenoside Rg1 can alleviate brain tissue injury of the mice induced by CIH;its mechanism may be related to the inhibition of brain tissue inflammatory response and oxidative stress,and the downregulation of calpain-1 expression.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Objective:This study aims to investigate the relationship between high-risk human papillomavirus (HR-HPV) infection and the composition of vaginal microecology. It will analyze the efficacy of integrated traditional Chinese and Western medicine intervention in treating HR-HPV infection, as well as the effects of this combined approach on vaginal microecology. Additionally, the study seeks to identify new methods to inhibit the malignant progression of cervical intraepithelial lesions.Methods:A prospective study was conducted involving 100 patients with HR-HPV infection who visited the Department of Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine from April to June 2023. The participants were randomly divided into a control group and an observation group, with 50 patients in each group using a random number table method. The control group received interferon treatment, while the observation group was treated with a combination of interferon and Yanfukang Lotion. High-throughput DNA sequencing of vaginal secretions was conducted to compare the differences in pre- and post-treatment vaginal microecological composition and the rate of HR-HPV clearance between the two groups. Results:In the observation group, both the diversity index and the abundance of vaginal microecology showed significant improvements compared with the control group, particularly in the abundance of dominant Lactobacillus species. These differences were statistically significant ( R = 0.124, 0.304, 0.030, all P < 0.05). The rates of HR-HPV clearance and overall effective rate (clearance + effective) in the observation group were 44% (22/50) and 68% (34/50), respectively, which were significantly higher than those in the control group [20% (10/50), 32% (16/50), χ2 = 12.98, both P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ2 = 1.76, P > 0.05). Conclusion:The combination of interferon and Yanfukang Lotion effectively treats HR-HPV infection by regulating the composition of vaginal microecology. This approach shows considerable efficacy and good safety, indicating its potential for further clinical application.

Objective:To determine the median effective dose (ED 50) of oliceridine for analgesia during induced abortion when combined with propofol. Methods:In this prospective study, 24 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 20-45 yr, with a body mass index of 18-26 kg/m 2, who underwent painless induced abortion surgery at Sir Run Run Hospital affiliated to Nanjing Medical University from September to October 2024, were selected. The modified Dixon sequential method was used for the study. The initial dose of oliceridine was 0.025 mg/kg, and 2 min later propofol 2 mg/kg was intravenously injected. The ratio between the two successive doses of oliceridine was 1.0∶1.1. If the patient experienced inadequate analgesia during cervical dilation (frowning, moaning, involuntary limb movements, increase in heart rate or mean arterial pressure greater than 20% of baseline), the next patient received a higher dose of oliceridine, or conversely, a lower dose was given. The study was terminated when 7 turning points from inadequate analgesia to adequate analgesia were achieved. Dixon sequential trial formula was used to calculate the ED 50 of oliceridine and the confidence interval. The occurrence of adverse reactions such as intraoperative hypoxemia, postoperative dizziness and nausea and vomiting was recorded. Results:Twenty-four patients were ultimately included in this study. When combined with propofol 2 mg/kg, the ED 50 of oliceridine for analgesia during painless induced abortion surgery was 0.019 mg/kg (95% confidence interval 0.018-0.021 mg/kg). One patient developed hypoxemia, and two patients experienced mild dizziness after surgery. All patients had no nausea or vomiting. Conclusions:When combined with 2 mg/kg of propofol, the ED 50 of oliceridine for analgesia during is 0.019 mg/kg induced abortion surgery.

Objective:To investigate the risk factors for severe hyperbilirubinemia complicated by acute bilirubin encephalopathy (ABE), and the value of total serum bilirubin (TSB) and bilirubin (B)/albumin (A) ratio in predicting ABE.Methods:Clinical data of children with severe hyperbilirubinemia admitted to the Affiliated Hospital of Inner Mongolia Medical University, Ordos Central Hospital, People's Hospital of Inner Mongolia Autonomous Region, the Fourth Hospital of Baotou, Tongliao Hospital, Maternal and Child Health Hospital of Hohhot, the Affiliated Hospital of Chifeng University, Manzhouli People's Hospital, and Chifeng Hospital from January 1, 2020, to December 31, 2021, were retrospectively collected. The subjects were divided into ABE and non-ABE groups based on the occurrence of ABE. Multivariate logistic regression analysis was used to identify high-risk factors for ABE. Statistical analysis was performed using t-test, Wilcoxon signed-rank test, or Chi-square tests. Indicators with statistically significant differences were included in the multivariate logistic regression model, and stepwise regression was used to analyze the influencing factors of ABE. Results:(1) A total of 543 children were included in this study, accounting for 3.7% (543/14 831) of the total admissions during the same period. Among the 543 children, 81 (14.9%) had ABE, and 462 (85.1%) did not. The age at admission was (7.2±2.1) d, and the length of hospital stay was (5.2±2.2) d. The breastfeeding initiation time was 2 d (1-4 d) after birth. The peak TSB of the 543 cases was (385.98±51.22) μmol/L, and the age at peak TSB was (4.4±2.1) d. Fourteen cases (2.5%) gradually reached the peak TSB after admission [(392.01±61.24) μmol/L], while 529 cases (97.5%) had already reached the peak TSB at admission [(386.42±50.22) μmol/L]. Among the 543 cases, 356 had a clear etiology (65.6%, with 278 cases having a single cause and 78 cases having more than two causes), and 187 cases (34.4%) had an unknown etiology. (2) Compared with the non-ABE group, the breastfeeding initiation in the ABE group was later [6 h (2-6 h) vs. 2 h (1-3 h), Z=－6.87] and the length of hospital stay was longer [(6.5±1.9) d vs. (5.0±2.1) d, t=0.55]. The proportions of breastfeeding, delayed meconium passage, isoimmune hemolysis, and maternal gestational diabetes, as well as peak TSB and B/A ratio at peak TSB, were higher in the ABE group than in the non-ABE group [64.2% (52/81) vs. 36.8% (170/462), χ2=21.96; 16.0% (13/81) vs. 2.4% (11/462), χ2=27.32; 27.2% (22/81) vs. 10.6% (40/462), χ2=16.61; 24.7% (20/81) vs. 13.6% (63/462), χ2=6.50; (442±68) vs. (375±39) μmol/L, t=－8.55; (11.9±1.6) vs. (9.8±1.2), t=－11.61; all P<0.05]. The admission weight, proportion of transfer from the hospital's obstetrics department, unknown etiology, and breast milk jaundice were lower in the ABE group than in the non-ABE group [(3 098±482) vs. (3 278±493) g, t=3.04; 12.3% (10/81) vs. 42.4% (196/462), χ2=30.48; 3.7% (3/81) vs. 39.8% (184/462), χ2=39.83; 0.0% (0/81) vs. 5.8% (27/462), χ2=3.81; all P<0.05]. (3) Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB were independent risk factors for ABE [ OR(95% CI) were 2.924 (1.209-7.073), 1.006 (0.997-1.014), and 2.647 (1.841-3.805), respectively]. When the peak TSB was 380.05 μmol/L and the B/A ratio at peak TSB was 10.45, the sensitivity for predicting ABE was 0.963, the specificity was 0.789, and the area under the receiver operating characteristic curve was 0.752. Conclusions:Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB are independent risk factors for ABE. The B/A ratio at peak TSB and peak TSB can effectively predict ABE.