ObjectiveTo compare the protective effects of water extracts from fresh and dried Dendrobium huoshanense on gastric mucosa in chronic atrophic gastritis （CAG）. MethodsMale SD rats （n=72） were randomly divided into 9 groups， with 8 rats in each group， which were normal group， model group， Yangwei Shu （4 g·kg^-1） group， low-， medium-， and high-dose fresh D. huoshanense （3.5， 7， and 14 g·kg^-1） groups， and low-， medium-， and high-dose dried D. huoshanense （0.7， 1.4， 2.8 g·kg^-1） groups. The CAG rat model was successfully established by inducing with N-methyl-N'-nitro-N-nitrosoguanidine （MNNG） and other factors for a total of 11 weeks. Then， the rats were intervened with fresh and dried D. huoshanense for 4 weeks. The serum and gastric tissues of the rats were collected. The changes in gastric juice secretion volume and gastric acid pH value in each group were observed. The gastric mucosal injury was observed by naked eyes and hematoxylin-eosin（HE） staining. The gastric mucus secretion level was determined by Alcian blue and periodic acid-Schiff staining（AB-PAS） staining. The expression levels of tight junction proteins Occludin and ZO-1 in gastric tissues were determined by immunofluorescence. The expression levels of serum pepsinogen Ⅰ （PG Ⅰ）， pepsinogen Ⅱ （PG Ⅱ）， gastrin 17 （G-17）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） were determined by enzyme-linked immunosorbent assay （ELISA）. The expression levels of aquaporin 1 （AQP1）， aquaporin 3 （AQP3）， and aquaporin 4 （AQP4） in gastric tissues were determined by Western blot. ResultsCompared with the normal group， the model group showed an obviously reduced gastric juice secretion volume （P0.05）， significantly increased gastric acid pH value （P0.01）， gastric mucosa with obvious atrophy， and a significantly reduced gastric mucus secretion volume （P0.01）. The expression of Occludin and ZO-1 in the gastric mucosal barrier was significantly decreased （P0.01）. The levels of PG Ⅰ and PG Ⅱ in the serum were obviously decreased （P0.05， P0.01）， and the levels of G-17， IL-1β， IL-6， and TNF-α were significantly increased （P0.01）. The expression level of AQP1 in the gastric tissue was significantly upregulated （P0.01）， and the expression levels of AQP3 and AQP4 were significantly downregulated （P0.01）. Compared with the model group， each drug administration group could improve the gastric mucosal atrophy of CAG model rats to varying degrees， obviously increase the gastric juice secretion volume of the model rats （P0.05， P0.01）， significantly decrease the gastric acid pH value （P0.01）， obviously increase the gastric mucus secretion volume （P0.05， P0.01）， obviously decrease the expression levels of G-17， IL-6， IL-1β， and TNF-α （P0.05， P0.01）， obviously increase the expression levels of Occludin， ZO-1， PG Ⅰ， and PG Ⅱ （P0.05， P0.01）， obviously upregulate the expression levels of AQP3 and AQP4 （P0.05， P0.01）， and obviously downregulate the expression level of AQP1 （P0.05， P0.01）. ConclusionThe water extracts of fresh and dried D. huoshanense can exert therapeutic effects on CAG by improving gastric mucosal injury， reducing inflammation， and regulating water metabolism. Moreover， the dried D. huoshanense has a better effect.

Objective To explore the research progress, research hotspot and development trend of tigecycline resistance based on the quantitative analysis and visualization function of CiteSpace. Methods The data were collected from 4,263 Chinese and English articles on tigecycline resistance in CNKI, Wanfang, VIP and Web of Science (WOS) databases from 2012 to 2022. CiteSpace 5.8.R3 software was used to analyze the cooperative network of authors, the cooperative network of countries and institutions, the total citation times of journals, and keywords included in the literature, to reveal the hotspots and trends of tigecycline resistance research. Results The number of articles published in English literature was higher than that in Chinese literature. China had the largest number of published documents, showing a significant international academic influence in this research field. Countries all over the world were concerned about the resistance of tigecycline, but Chinese literatures focused more on the clinical infection and prevention of tigecycline resistance, while English literatures placed special emphasis on the research about the drug resistance mechanism of tigecycline. Conclusion The research direction at home and abroad is basically the same, but the research focus has gradually shifted from the clinical treatment and monitoring of tigecycline to the molecular level of drug resistance mechanism.

ObjectiveTo investigate the production, disposal, and disinfection management of medical waste in medical and healthcare institutions in Hefei City, so as to provide a basis for further improving the disposal work of medical waste in the city's medical and healthcare institutions. MethodsA stratified random sampling method was used to assess the current status of medical waste generation, disposal, and disinfection management in 145 medical and healthcare institutions in Hefei. ResultsThe daily disposal volume of medical waste in the 145 medical and healthcare institutions was 7 511.99 kg, of which the total daily production volume of medical waste in tertiary hospitals, secondary hospitals, primary hospitals, and ungraded medical and healthcare institutions were 4 686.37, 2 200.95, 418.40, and 206.27 kg, respectively. The medical waste production coefficients per bed were 0.40, 0.40, 0.33, and 0.27 kg·day⁻¹, respectively. The percentages of tertiary hospitals, secondary hospitals, primary hospitals and ungraded medical and healthcare institutions that had set up independent temporary storage rooms for medical waste were 100.0% (15/15), 97.4% (38/39), 100.0%（25/25）, and 80.3% (53/66), respectively, and the proportions of timely transfer of medical waste were 100.0% (15/15), 97.4% (38/39) , 92.0% (23/25) , 72.7% (48/66), respectively, with statistically significant differences (χ²=12.046 and 15.507, both P<0.01). ConclusionThe management of medical waste in primary medical and health institutions is weak, with lower rates of the setting up independent medical waste storage rooms and timely transfer of medical waste. Training and supervision should be strengthened to promote the establishment of a system for medical waste management at the grassroots level.

Objective To investigate the feasibility and early efficacy of transapical transcatheter aortic valve replacement (TAVR) combined with transcatheter mitral valve edge-to-edge repair (TEER) in patients with high-risk aortic valve lesions combined with severe mitral regurgitation. Methods The clinical data of patients who underwent "one-stop" transapical TAVR+TEER in our hospital from August 2022 to October 2023 were retrospectively analyzed. Results Five patients were collected, including 3 males and 2 females with a mean age of 66.6±1.8 years. Four patients had aortic valve insufficiency combined with mitral regurgitation and one had aortic valve stenosis and insufficiency combined with mitral regurgitation. All patients successfully completed transapical TAVR+TEER, and the immediate postoperative echocardiographic results revealed that none of them had more than mild perivalvular leakage and mitral regurgitation, and the prosthetic valves were in good position and function. At 1 week postoperatively, echocardiographic results showed 5 patients with no displacement of the prosthetic valve, detachment of the mitral clip, or damage to the leaflets. At 1 month postoperatively, cardiac function was improved to varying degrees in 4 patients, and 1 patient died of multiorgan failure. At 2 months postoperatively, 1 patient died of cerebrovascular accident, and at 3 months postoperatively the echocardiographic results of the remaining 3 patients revealed that there was no more than mild perivalvular leakage or mitral regurgitation, and the patients' postoperative cardiac function and daily life ability were significantly improved. Conclusion In high-risk aortic valve lesions combined with severe mitral regurgitation, "one-stop" transapical TAVR+TEER is feasible with favorable early efficacy and safety.

ObjectiveTo observe the effect of gastrodin on the steroid regulatory element-binding protein 1c （SREBP1c） signaling pathway in high-fat high-cholesterol diet （HFHC）-induced mice and explore the mechanism of gastrodin in the treatment of non-alcoholic fatty liver disease （NAFLD）. MethodEight-week-old male C57BL/6J mice were used in vivo and divided into the following four groups， with six mice in each group： normal group， gastrodin group （50 mg·kg^-1）， model group， and model + gastrodin group （50 mg·kg^-1）. NAFLD model was established by feeding mice with HFHC for four weeks， and the mice were euthanized and the liver tissues were collected after four weeks. In vitro experiments were performed using Huh7 cells which were divided into five groups， and induced with free fatty acids （FFA， 200 μmol·L^-1， oleic acid-palmitic acid 2∶1） to establish an NAFLD cell model. After 24 h， different concentrations of gastrodin （0， 5， 10， 20， and 40 μmol·L^-1） were added to each group and cultured for another 24 h. Oil red O staining was used to detect lipid accumulation in mouse liver and Huh7 cells. Hematoxylin-eosin （HE） staining was used to observe pathological changes in liver tissue. Levels of serum total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， and triglycerides （TG） were measured using an automatic biochemical analyzer. Relevant assay kits were used to detect liver TC， TG， and FFA levels. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the expression of lipid synthesis-related proteins fatty acid synthase （FASN）， acetyl-CoA carboxylase 1 （ACC1）， and stearoyl-CoA desaturase 1 （SCD1）. ResultCompared with the normal group， the model group showed significantly increased serum TC， LDL-C， and TG levels （P<0.01）， liver TC， TG， and FFA levels （P<0.01）， increased lipid accumulation in Huh7 cells （P<0.01）， and significantly increased expression levels of lipid synthesis-related genes SREBP1c， FASN， ACC1， and SCD1 in mice and Huh7 cells （P<0.01）. Compared with the model group， after gastrodin treatment， the serum TC， LDL-C， and TG levels in mice significantly decreased （P<0.05， P<0.01）， the severity of fatty liver disease improved significantly， liver TC， TG， and FFA levels decreased significantly （P<0.05， P<0.01）， lipid accumulation in Huh7 cells decreased significantly （P<0.05， P<0.01）， the expression levels of lipid synthesis-related genes SREBP1c， FASN， ACC1， and SCD1 in mice and Huh7 cells decreased significantly （P<0.05， P<0.01）. ConclusionGastrodin can reduce hepatic lipid accumulation and blood lipid levels， improve HFHC-induced NAFLD， and its mechanism of action may be related to the regulation of the SREBP1c lipid synthesis-related signaling pathway.

Objective In this study, a strain of colistin and tigecycline-resistant bacteria isolated in 2009 was analyzed, and the structure of drug-resistant plasmid and genetic environment were discussed, so as to provide basis for the prevention and control of multidrug-resistant bacteria. Methods A strain (GZ12244) with positive mcr and tet(M) was obtained by screening colistin and tigecycline resistance genes. Vitek-2 was used for strain identification, and the drug sensitivity test was carried out by broth dilution method. The molecular typing, drug resistance genes, insertion sequences, plasmid structure and genetic background were analyzed by genome-wide sequencing and bioinformatics. Results Strain GZ12244 is Klebsiella pneumoniae, which is resistant to colistin B, tigecycline, cefuroxime and tetracycline, and carries a variety of drug-resistant related genes such as mcr-1 and tet(M), and some of the drug-resistant genes with antibiotic efflux and antibiotic target change have amino acid substitution mutations. Mcr-1 and tet(M) coexist in a plasmid, and mcr-1 flanked by two insertion sequences ISApl1. There are insertion sequences such as IS15, IS1D and ISEc63 in the upstream and downstream of tet(M) gene. Conclusion Klebsiella pneumoniae GZ12244 is a multidrug-resistant strain. The drug-resistant gene exists in plasmid, and the mobile elements in upstream and downstream may spread the drug-resistant gene.

Objective To observe the application value of enhanced recovery after surgery (ERAS) in perioperative nursing for patients undergoing percutaneous endoscopic interlaminar discectomy based on three-dimensional visualized virtual surgical system. Methods Eighty-six patients with lumbar spinal stenosis were randomly divided into experimental group (receiving perioperative nursing based on ERAS) and control group (receiving conventional perioperative nursing) using a random number table method, with 43 patients in each group. The postoperative recovery, pain intensity [Visual Analogue Scale (VAS) score], lumbar function [Japanese Orthopaedic Association (JOA) scoring system for lumbar disorders], rehabilitation motivation [Pittsburgh Rehabilitation Participation Scale (PRPS) score], compliance[Adherence Rating Scale (ARS) score], quality of life [World Health Organization Quality of Life BREF (WHOQOL-BREF) score], complications, and satisfaction were compared between the two groups. Results The first ambulation time, first meal time, and hospital stay after surgery in the experimental group were shorter than those in the control group (P<0.05). The total incidence of complications in the experimental group was 9.30%, which was lower than 27.91% in the control group (P<0.05). Three days after surgery, the VAS score of the experimental group was (1.77±0.58), which was lower than (2.54±0.72) in the control group (P<0.05).After intervention, the JOA scoring system for lumbar disorders, PRPS score, WHOQOL-BREF score, and satisfaction score in the experimental group were higher than those in the control group, while the ARS score was lower(P<0.05). Conclusion The application of ERAS in perioperative nursing for patients undergoing percutaneous endoscopic interlaminar discectomy based on three-dimensional visualized virtual surgical system can not only shorten the first ambulation time, first meal time, and hospital stay after surgery for patients with lumbar spinal stenosis, improve rehabilitation motivation and compliance, significantly relieve pain, but also promote the recovery of lumbar function, reduce occurrence of complications, and effectively enhance quality of life and patients′ satisfaction.

ObjectiveTo explore the diagnostic value of fiberoptic endoscopic examination of swallowing (FEES) combined with dye test in patients with post-stroke dysphagia and silent aspiration. MethodsFrom December, 2021 to June, 2022, 50 stroke patients in the Rehabilitation Department of Xuzhou Central Hospital were selected. They were assessed with FEES and videofluoroscopic swallowing study (VFSS), and compared. ResultsThe detection rate of aspiration was higher with FEES than with VFSS (χ² = 7.000, P < 0.05), and especially for liquid food (χ² = 4.000, P < 0.05). There was a good consistency when consuming paste food (κ = 0.941, P < 0.001) and solid food (κ = 0.779, P < 0.001). There was a good consistency in the food residue site between two methods (κ = 0.818, P < 0.001), as well as for all the three food types (κ ≥ 0.862, P < 0.001). There was no significant difference in the scores of Penetration Aspiration Scale of three food types between two methods (Z < 0.667, P > 0.05). ConclusionFEES combined with dye test can be used for evaluating silent aspiration after stroke.

Humans ; Anemia, Aplastic/genetics* ; Red-Cell Aplasia, Pure ; Chromosome Disorders

Objective: To investigate the protective effect of vitamin D3 on alcoholic liver injury in mice. Methods: Forty mice were randomly divided into 4 groups : normal Control (Control) group , vitamin D3 (VitD3 ) group , alcohol model (EtOH) group and alcohol + vitamin D3 (EtOH + VitD3 ) group. The mice were fed with the DeCarlialcohol liquid diet to establish alcoholic liver injury model. Serum levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) and liver index were detected. HE staining was used to observe the pathological changes of liver. The relative expression levels of tumor necrosis factor α (TNF⁃α ) , transforming growth factor β (TGF⁃β) , interleukin⁃6 (IL⁃6) and interleukin⁃1β (IL⁃1β) mRNA were detected by quantitative real⁃time PCR (qRT⁃PCR) . The expressions of nuclear factor⁃kappa B (NF⁃κB) p65 and NF⁃κB p50 in liver were detected by Western blot. Results: The serum ALT , AST vitality , liver index and hepatic TNF⁃α , TGF⁃ β , IL⁃6 and IL⁃1β mRNA in EtOH group were significantly higher than those in Control group. EtOH group disorganized hepatocyte and hepatic lobules boundary was not clear, and the hepatocytes showed apparent inflammatory cells infiltration of liver cells and fat cavitation. NF⁃κB p65 and NF⁃κB p50 protein expression increased significantly. Compared with EtOH group ,the serum ALT , AST vitality , liver index and hepatic TNF⁃α , TGF⁃ β , IL⁃6 and IL⁃1β mRNA in EtOH + VitD3 group decreased significantly. The pathological staining results showed that inflammatory cells infiltration and decrease in the number of fat vacuoles , and the liver cells returned to normal liver cell structure. At the same time the NF⁃κB p65 and NF⁃κB p50 protein expression level decreased significantly. Conclusion Vitamin D3 has a certain protective effect on alcohol⁃induced liver injury in mice , and its main mechanisms are related to the inhibition of NF⁃κB pathway and the reduction of inflammatory response.