Objective To investigate the effects of cucurbitacin B (CucB) on alleviating skin lesions and inflammation in psoriasis mice via the cGAS-STING signaling pathway. Methods The expression of genes associated with the cGAS-STING signaling pathway in psoriatic lesions and non-lesional skin was analyzed, and hallmark gene set enrichment analysis was performed. The cytotoxicity of CucB on BMDMs was evaluated using the CCK-8 assay. The expression levels of genes and proteins related to the cGAS-STING signaling pathway, along with the secretion of inflammatory cytokines, were measured at different concentrations of CucB using quantitative PCR, Western blotting, and ELISA. Imiquimod-induced psoriasis BALB/c mice were divided into four groups: normal group, model group, low-dose CucB group [0.1 mg/ (kg.d)], and high-dose CucB group [0.4 mg/ (kg.d)], with five mice per group. PASI scoring was performed to assess the severity of psoriasis after 6 days of treatment, and HE staining was conducted to observe pathological damage. Meanwhile, the mRNA levels of inflammatory cytokines and their secretion were detected by qPCR and ELISA. Results Most cGAS-STING signaling-related genes were upregulated in lesional skin of psoriasis patients, and the hallmark gene set enrichment analysis revealed that the most significantly upregulated genes were primarily associated with immune response signaling pathways. CucB inhibited dsDNA-induced phosphorylation of interferon regulatory factor 3 (IRF3) and STING proteins in both bone-marrow derived macrophages(BMDMs) and THP-1 cells. CucB also suppressed dsDNA-induced mRNA expression of IFNB1, TNF, IFIT1, CXCL10, ISG15, and reduced the secretion of cytokines such as IFN-β, IL-1β, and TNF-α in THP-1 cells. In the imiquimod-induced psoriasis mouse model, CucB treatment reduced psoriatic symptoms, alleviated skin lesions, and attenuated inflammation. ELISA and qPCR results showed that CucB significantly reduced serum secretion levels of IL-6, TNF-α, and IL-1β, as well as the mRNA levels of IL23A, IL1B, IL6, TNF, and IFNB1. Conclusion CucB inhibits cytoplasmic DNA-induced activationc of the GAS-STING pathway. CucB significantly attenuates skin lesions and inflammation in IMQ-induced psoriatic mice, and the potential molecular mechanism may be related to the down-regulation of the cGAS-STING pathway.
Animals ; Psoriasis/pathology* ; Signal Transduction/drug effects* ; Membrane Proteins/genetics* ; Mice ; Nucleotidyltransferases/genetics* ; Disease Models, Animal ; Mice, Inbred BALB C ; Skin/metabolism* ; Triterpenes/therapeutic use* ; Humans ; Cytokines/metabolism* ; Inflammation/drug therapy* ; Male

Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.

Objective To understand the nursing practice of prone position ventilation for patients with moderate to severe acute respiratory distress syndrome(ARDS)in intensive care unit(ICU)in Shandong province,so as to provide basis for standardizing the nursing practice process of prone position ventilation and carrying out training for hospitals.Methods A self-made questionnaire was used,and convenience sampling was adopted.From September 15th to November 5th,2023,ICU nurses were selected from various hospital levels in Shandong province to investigate the obstructive factors of prone ventilation implementation,the weak links in nursing practice and status,and the occurrence of complications.Results A total of 1 188 questionnaires were collected,of which 991 were valid.92.8%(920/991)of nurses had performed prone position ventilation.The biggest obstacle to the implementation of prone position ventilation was the complexity of patient treatments and multiple devices involved[74.6%(686/920)].Regarding the status of training,90.5%(897/991)of nurses had received training on prone position ventilation and 77.0%(763/991)of nurses felt that training was needed.As for pre-operation assessment,more than 80.0%of nurses evaluated patients'vital signs,airway and secretions and so on,among which the evaluation awareness of analgesia was the worst[81.6%(751/920)].As for the main points of implementation,only 14.0%(129/920)of nurses chose the opposite side of the most important pipeline as the turning direction;48.6%(447/920)of nurses chose the anti-Trendelenburg position;36.3%(334/920)of nurses chose to ventilate≥12 hours.Facial edema[81.7%(752/920)],skin pressure injury[78.9%(726/920)]and eye complication[75.8%(697/920)]were the top 3 most frequent complications.Conclusions ICU nurses'prone position ventilation practices were generally line with the nursing team standard for prone position of adult mechanically ventilated patients and the best evidence recommendation,and needs to be further standardized in aspects of turning direction,position management,ventilation duration,and enteral nutrition management.It is recommended that nursing managers at all levels of hospitals further improve the quality of nursing practice of prone position ventilation according to relevant evidence-based evidence and the actual situation of hospitals.

BACKGROUND:The use of assistive devices and technologies for blindness is a common intervention for people with visual impairment today,improving participation in activities of daily living and work-learning abilities,and facilitating return to family and society.The forms,technologies and functions of assistive devices for blindness in the age of digital information and intelligence vary,and their classification has not yet been effectively discussed and evaluated in a uniform manner.OBJECTIVE:To classify and evaluate the compensation function of intelligent guide devices for the people with visual impairment in China based on the International Classification of Functioning,Disability and Health(ICF).METHODS:CNKI,CQVIP and WanFang databases were searched for relevant literature.The time frame for the search was from January 1,2013 to December 31,2023.Based on the ICF theoretical model and framework structure,the terminology structure and coding procedure were applied to summarize the relevant visual impairment assessment categories,collate and analyze the research and classification of the compensation function of intelligent assistive devices for the people with visual impairment in China.RESULTS AND CONCLUSION:(1)A total of 197 articles were finally included.There was 1 article on body function,containing b2(b210);1 article on body structure,containing s2(s220);119 articles addressing activity and participation,containing d1(10 articles involving d110,d115,d120,d140,and d166,)d3(4 articles involving d315,d325,d345,and d360),d4(102 articles involving d465,d470),and d8(3 articles involving d820,d825);76 articles addressing environmental factors,including e1(72 articles involving e115,e120,e125,e130,e140,e150,e155,e160)and e2(4 articles involving e210 and e240).(2)The ICF-based research classification of the compensation function of intelligent guide devices for the people with visual impairment contains 4 parts,8 classifications and 25 categories,with areas related to physical compensation,daily necessities,education and learning,traveling and blindness guidance,and layout planning.

Objective To understand the nursing practice of prone position ventilation for patients with moderate to severe acute respiratory distress syndrome(ARDS)in intensive care unit(ICU)in Shandong province,so as to provide basis for standardizing the nursing practice process of prone position ventilation and carrying out training for hospitals.Methods A self-made questionnaire was used,and convenience sampling was adopted.From September 15th to November 5th,2023,ICU nurses were selected from various hospital levels in Shandong province to investigate the obstructive factors of prone ventilation implementation,the weak links in nursing practice and status,and the occurrence of complications.Results A total of 1 188 questionnaires were collected,of which 991 were valid.92.8%(920/991)of nurses had performed prone position ventilation.The biggest obstacle to the implementation of prone position ventilation was the complexity of patient treatments and multiple devices involved[74.6%(686/920)].Regarding the status of training,90.5%(897/991)of nurses had received training on prone position ventilation and 77.0%(763/991)of nurses felt that training was needed.As for pre-operation assessment,more than 80.0%of nurses evaluated patients'vital signs,airway and secretions and so on,among which the evaluation awareness of analgesia was the worst[81.6%(751/920)].As for the main points of implementation,only 14.0%(129/920)of nurses chose the opposite side of the most important pipeline as the turning direction;48.6%(447/920)of nurses chose the anti-Trendelenburg position;36.3%(334/920)of nurses chose to ventilate≥12 hours.Facial edema[81.7%(752/920)],skin pressure injury[78.9%(726/920)]and eye complication[75.8%(697/920)]were the top 3 most frequent complications.Conclusions ICU nurses'prone position ventilation practices were generally line with the nursing team standard for prone position of adult mechanically ventilated patients and the best evidence recommendation,and needs to be further standardized in aspects of turning direction,position management,ventilation duration,and enteral nutrition management.It is recommended that nursing managers at all levels of hospitals further improve the quality of nursing practice of prone position ventilation according to relevant evidence-based evidence and the actual situation of hospitals.

BACKGROUND:The use of assistive devices and technologies for blindness is a common intervention for people with visual impairment today,improving participation in activities of daily living and work-learning abilities,and facilitating return to family and society.The forms,technologies and functions of assistive devices for blindness in the age of digital information and intelligence vary,and their classification has not yet been effectively discussed and evaluated in a uniform manner.OBJECTIVE:To classify and evaluate the compensation function of intelligent guide devices for the people with visual impairment in China based on the International Classification of Functioning,Disability and Health(ICF).METHODS:CNKI,CQVIP and WanFang databases were searched for relevant literature.The time frame for the search was from January 1,2013 to December 31,2023.Based on the ICF theoretical model and framework structure,the terminology structure and coding procedure were applied to summarize the relevant visual impairment assessment categories,collate and analyze the research and classification of the compensation function of intelligent assistive devices for the people with visual impairment in China.RESULTS AND CONCLUSION:(1)A total of 197 articles were finally included.There was 1 article on body function,containing b2(b210);1 article on body structure,containing s2(s220);119 articles addressing activity and participation,containing d1(10 articles involving d110,d115,d120,d140,and d166,)d3(4 articles involving d315,d325,d345,and d360),d4(102 articles involving d465,d470),and d8(3 articles involving d820,d825);76 articles addressing environmental factors,including e1(72 articles involving e115,e120,e125,e130,e140,e150,e155,e160)and e2(4 articles involving e210 and e240).(2)The ICF-based research classification of the compensation function of intelligent guide devices for the people with visual impairment contains 4 parts,8 classifications and 25 categories,with areas related to physical compensation,daily necessities,education and learning,traveling and blindness guidance,and layout planning.

Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.

ObjectiveTo explore the protective effects of Dahuang Tangluo pills on early diabetic kidkdey disease （DKD） in db/db mice. MethodEight db/m mice were selected as the control group. Forty male db/db mice were selected and blood samples were collected via tail vein to measure fasting blood glucose （FBG）. Mice with FBG ≥ 16.7 mmol·L^-1， increased urine output， and persistent albuminuria were considered successful in model establishment. After successful modeling， they were randomly divided into a model group， a dapagliflozin group （1.5 mg·kg^-1·d^-1）， and high， medium， and low dose groups of Dahuang Tangluo pills （3.6， 1.8， 0.9 g·kg^-1·d^-1， respectively）， with eight mice in each group. All medication groups were administered orally， while the control and model groups were given an equal amount of distilled water by gavage daily. After continuous administration for 10 weeks， the survival status of the mice was observed， and their body weight， FBG， and kidney function-related indicators were measured. Inflammatory indicators in renal tissues were determined by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining， Masson staining， and electron microscopy were used to observe the pathological changes in renal tissues in each group. Immunofluorescence was employed to examine the expression of advanced glycation end products （AGEs） and receptors for advanced glycation end products （RAGE） proteins. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were utilized to detect the gene and protein expression levels of AGEs， RAGE， inhibitor of nuclear factor-κB （NF-κB） kinase （IKK）， and NF-κB in the renal tissues of mice in each group. ResultCompared with control group， the model group showed a significant increase in body weight， FBG， serum creatinine （SCr）， urinary microalbumin/urine creatinine ratio （ACR）， total cholesterol （TC）， and triglycerides （TG） （P<0.05）. The levels of intercellular adhesion molecule-1 （ICAM-1）， interleukin-6 （IL-6）， and tumor necrosis factor-alpha （TNF-α） in renal tissues were significantly elevated （P<0.05）. Renal histopathological staining and electron microscopy revealed loose arrangement， gaps， structural disarray， mesangial proliferation， and significant fibrosis in renal tissues. Real-time PCR results showed a significant increase in the expression of RAGE， IKK， and NF-κB genes in renal tissues （P<0.05）. Immunofluorescence results demonstrated a significant increase in the expression of AGEs and RAGE proteins in renal tissues （P<0.05）. Western blot results showed a significant increase in the expression of AGEs， RAGE， IKK， and NF-κB proteins in renal tissues （P<0.05）. After drug intervention， compared with model group， the dapagliflozin group and the high-dose Dahuang Tangluo pills group showed significant reductions in body weight， FBG， SCr， and ACR （P<0.05）， and a significant decrease in TC in mouse serum （P<0.05）， while the high-dose Dahuang Tangluo pills group showed a significant decrease in TG in mouse serum （P<0.05）. All treatment groups showed a significant reduction in ICAM-1， IL-6， and TNF-α in renal tissues （P<0.05）. Renal histopathological staining and electron microscopy showed improved kidney injury， decreased collagen fiber deposition， and reduced mesangial proliferation in all treatment groups. Real-time PCR results showed a significant decrease in the expression of RAGE， IKK， and NF-κB genes in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. Immunofluorescence results demonstrated a significant decrease in the expression of AGEs and RAGE proteins in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. Western blot results showed a significant decrease in the expression of AGEs， RAGE， IKK， and NF-κB proteins in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. ConclusionDahuang Tangluo pills can improve the pathological structure of the kidneys and reduce renal inflammation in DKD mice， possibly through inhibiting the AGEs/RAGE/IKK/NF-κB pathway.

ObjectiveTo construct a research framework for systematic review of health and functional outcomes of whole body vibration training in children and adolescents with cerebral palsy based on the theory and method of World Health Organization Family of International Health Classifications (WHO-FICs), and to systematically review the major health conditions and physical functions, intervention programs of whole body vibration training, and health and functional outcomes of vibration intervention in children and adolescents with cerebral palsy. MethodsBased on the WHO-FICs method, the PICO architecture of systematic reviews was constructed, and the databases of CNKI, Wanfang Data, PubMed, Web of Science, EBSCO, and Embase were searched to collect randomized controlled trials about the health and functional effects of whole body vibration training on children and adolescents with cerebral palsy from the establishment to September 30th, 2022, and a systematic review was conducted. ResultsEight articles, seven in English and one in Chinese, from five countries, were included, mainly from journals in clinical rehabilitation, neurorehabilitation, physical medicine and rehabilitation, etc., published mainly after 2010, involving 227 participants (three to 12.3 years old). The quality of the articles was evaluated using the Physical Therapy Evidence Database scale with a mean score of six. The ICD-11 codes included 08 diseases of the nervous system, 8D20 spastic cerebral palsy, 8D20.1 spastic bilateral cerebral palsy, 8D20.10 spastic quadriplegia cerebral palsy and 8D2Z unspecified cerebral palsy. The primary functioning of cerebral palsy was characterized as muscle spasticity, abnormal skeletal development, joint deformities and muscle weakness, decrease of selective motor control and gait abnormalities; for the activity and participation, the functioning included walking difficulties, decrease of mobility and weight loading, and low levels of physical activities. The main intervention was whole body vibration, in postures of lying, squatting or standing, mainly standing, in the mode of vertical vibration. The frequency was 5 to 30 Hz, and the amplitude was below 9 mm, three to five times a week for eight weeks to six months. The intervention settings include medical institutions, schools and families; mainly for therapeutics and recovery. The health and health-related outcomes were mainly involved s7 structures related to movement, b710 mobility of joint functions, b730 muscle power functions, b735 muscle tone functions, b760 control of voluntary movement functions, d410 changing basic body position, d415 maintaining a body position, d450 walking, d455 moving around, and d420 transferring oneself; such as improvements of neuromusculoskeletal and joint functions, muscle spasm, static balance, muscle strength, and control of movement, the control of body posture and walking, range of activities and self-care. ConclusionWhole body vibration training is effective on cerebral palsy, mainly in standing position, 5 to 30 Hz, and amplitude below 9 mm; three to five times a week for eight weeks to six months. The outcomes of whole body vibration training are mainly reflected in the improvement of body-motor functions, and activity and participation.

ObjectiveTo analyze the content and psychological measurement indicators of the commonly used motor function assessment tools for children and adolescents, based on the theory and method of International Classification of Function, Disability and Health-Children and Youth Version (ICF-CY). MethodsBased on the ICF-CY classification framework and coding system, four commonly used functional evaluation tools for children and adolescents were selected, and their motor function measurement methods and psychological measurement indicators were analyzed by applying ICF coding rules and matching principles. ResultsFinally, nine English articles and two Chinese articles were included, from four countries including South Korea, Spain, China and Brazil. They were mainly published in the journals of clinical medicine, neuroscience, public health, rehabilitation science and other fields from 2011 to 2021. The age of the subjects was 0 to 16 years old involving 987 subjects; the health condition included spastic cerebral palsy, neurodevelopmental disorder, etc. Among the eleven articles included, six articles used Gross Motor Function Measure (GMFM-88), two articles used Fine Motor Function Measure Scale (FMFM), two articles used Peabody Developmental Motor Scales Second Edition (PDMS-2), and two articles used Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS), and three articles used Pediatric Evaluation of Disability Inventory (PEDI). The measurement methods were objective evaluation, subjective evaluation, and subjective observation, etc. The number of measurements was two to six. The measurement indicators of motor function mainly involved two levels. The first was the physical activity level, including gross movement, fine movement and motor control ability. The second was the functional level of activities, mainly including activities of daily living and functional independence. ConclusionBased on ICF-CY, the evaluation of children's motor function and activity and participation was mainly divided into two levels. At the body function level, the main evaluation indicators included b730, b760, b770, etc. At the level of activities and participation, the main evaluation indicators were d410, d440, d445, etc. GMFM-88 focuses on the evaluation of children's body movement and activity functions, such as sitting, standing, lying, walking and running, mainly involving b760, d410, d455, etc. FMFM focused on autonomous movement, motor motivation and motor coordination, and was mainly used to assess the functional status of upper limbs of children with cerebral palsy aged 0 to 3 years, mainly involving b760, d155, d440, etc. PDMS-2 payed more attention to evaluating the overall motor development level and motor function status of children and adolescents, mainly involving b750, b760, d415, etc. PEDI-FSS move partition focused on children's actual motor function performance in activities of daily living, and evaluated the application and practicability of children's motor function in activities of daily living, mainly involving b760, d410, d450, etc. In terms of measurement methods, the measurement of motor function mainly included objective evaluation and subjective evaluation; the measurement of activity function mainly included objective evaluation and subjective observation. These assessment tools have established norms varies with different age groups according to the movement development. Evaluators need accept professional training before using the above assessment tools to improve the reliability, validity and adaptability of the assessment.