This study systematically reviews the modern research progress of sanjiao （三焦） theory in the past 20 years， and differentiates concepts such as membrane-source， membrane-interstices， and membrane-system in the study of sanjiao essence. On the basis of its core functions of transporting original qi and regulating water metabolism， the study further expands the theoretical connotation of transporting original qi， defines the application boundary of sanjiao syndrome differentiation， and clarifies the conceptual categories of "sanjiao qi-transformation" and "qi-transforming sanjiao"， which reconciles the contradictions between sanjiao as a six fu （腑） organ and sanjiao as a regional division to a certain extent， and provides a valuable exploration for the innovative development of the theoretical system of traditional Chinese medicine.

Objective To investigate the characteristic volatile organic compounds(VOCs)in exhaled breath and their diagnostic value in mice with early stage radiation injury.Methods The thermal desorption gas chromatography-mass spectrometry(TD-GC/MS)technique was used to analyze VOCs in exhaled breath of irradiated mice by 60Coγ-ray with 800 cGy.The characteristic VOCs in the early stage of radiation injury were identified,and a diagnostic model was established.Results The 30-day survival rate of mice was 4.2%.There were significant differences in characteristic VOCs at 7 hours after radiation injury,and thirty characteristic VOCs related to early-stage radiation injury were identified.The diagnostic value of differential metabolites in mice after irradiation was evaluated via the ROC curve,and the area under the ROC curve(AUC)of a single compound exceeded 0.8.The diagnostic model was constructed by screening 9 potential biomarkers of exhalation through Fisher discriminant analysis,and its sensitivity and specificity were close to 100%.Conclusion Analysis of VOCs in exhaled breath is expected to provide a non-invasive diagnostic method for early screening and diagnosis of radiation injury.

Objective Screening for sensitive biomarkers for predicting and analyzing drug-induced renal toxicity,accelerates drug early development.Methods Focuses on epithelial cells of proximal convoluted tubules in human renal cortex(human kidney-2,HK-2)cells as the research object,screening for highly sensitive biomarkers using three nephrotoxic drugs(cisplatin,gentamicin,and aristolochic acid Ⅰ).Results The sensitivity of biomarkers in intracellular fluid is higher than in extracellular fluid,compared to detecting a single biomarker in the intracellular fluid.The combined detection of β2-microglobulin(β2-MG)and neutrophil gelatinase-associated lipocalin(NGAL)improved the accuracy of renal toxicity evaluation.Conclusion Based on the HK-2 cell model,the combined detection of β2-MG and NGAL in intracellular fluid can be used to predict renal toxicity in the drug's early development stage.

Objective To systematically evaluate the qualitative studies on the care experience of caregivers for primary malignant bone tumors patients,in order to provide references for the construction of bone tumor support care system.Methods The Cochrane Library,PubMed,Embase,CNKI,Wanfang Database,VIP database,and China Biomedical Literature Database were searched by computer to collect qualitative studies on the care experience of caregivers of malignant bone tumors patients from the establishment of the databases to November 2022.The quality of the literature was evaluated using the Joanna Briggs Institute(JBI)Quality Evaluation Criteria for Quality Research in Evidence-Based Health Care Centers(2016),and the results were integrated by a pooled integration approach.Results A total of 12 studies were included;48 themes were extracted and summarized into 9 categories,which were combined into 3 integrated results.Integration result 1 is obvious physical and mental disturbance.Integration result 2 is multiple role maladaptation.Integration result 3 is positive growth after adjustment.Conclusion Caregivers of patients with malignant bone tumors have serious physical and mental burden and are eager for multiple support.It is suggested that medical staff pay attention to the multi-dimensional needs of patients,formulate personalized support strategies,help caregivers adapt and transform their roles,and promote the post-traumatic growth of caregivers.

Owing to incurable castration-resistant prostate cancer (CRPC) ultimately developing after treating with androgen deprivation therapy (ADT), it is vital to devise new therapeutic strategies to treat CRPC. Treatments that target programmed cell death protein 1 (PD-1) and programmed death ligand-1 (PD-L1) have been approved for human cancers with clinical benefit. However, many patients, especially prostate cancer, fail to respond to anti-PD-1/PD-L1 treatment, so it is an urgent need to seek a support strategy for improving the traditional PD-1/PD-L1 targeting immunotherapy. In the present study, analyzing the data from our prostate cancer tissue microarray, we found that PD-L1 expression was positively correlated with the expression of heterogeneous nuclear ribonucleoprotein L (HnRNP L). Hence, we further investigated the potential role of HnRNP L on the PD-L1 expression, the sensitivity of cancer cells to T-cell killing and the synergistic effect with anti-PD-1 therapy in CRPC. Indeed, HnRNP L knockdown effectively decreased PD-L1 expression and recovered the sensitivity of cancer cells to T-cell killing in vitro and in vivo, on the contrary, HnRNP L overexpression led to the opposite effect in CRPC cells. In addition, consistent with the previous study, we revealed that ferroptosis played a critical role in T-cell-induced cancer cell death, and HnRNP L promoted the cancer immune escape partly through targeting YY1/PD-L1 axis and inhibiting ferroptosis in CRPC cells. Furthermore, HnRNP L knockdown enhanced antitumor immunity by recruiting infiltrating CD8⁺ T cells and synergized with anti-PD-1 therapy in CRPC tumors. This study provided biological evidence that HnRNP L knockdown might be a novel therapeutic agent in PD-L1/PD-1 blockade strategy that enhanced anti-tumor immune response in CRPC.

OBJECTIVE: To investigate the expression of DNMT3b in human bladder cancer tissues and its correlation with postoperative survival of patients with bladder cancer. METHODS: Thirty-eight pairs of surgically resected human bladder cancer tissues and adjacent bladder tissues were detected by immunohistochemistry for DNMT3b expression, and the correlations of DNMT3b expression level were analyzed with the patients'age, gender, pathological grade, tumor size, T stage, lymph node metastasis and TNM stages. Kaplan-Meier survival analysis was performed to assess the effect of DNMT3b expression on survival outcomes of the patients. RESULTS: High DNMT3b protein expression was detected in 63.16% of the bladder cancer tissues and in 13.16% of the adjacent tissues ( < 0.05). The expression level of DNMT3b was associated with the pathological grade (=0.002), tumor size ( < 0.001), T stage ( < 0.001), lymphatic metastasis (=0.039) and TNM stage ( < 0.001), but not with gender or age of the patients. Multivariate logistic regression analysis showed that the protein expression level of DNMT3b was correlated with tumor size (=0.008) and TNM grades of the tumor (=0.042). Kaplan-Meier analysis showed that the patients with a high DNMT3b expression had a significantly shorter overall survival than those with a low DNMT3b expression (=0.021). CONCLUSIONS DNMT3b overexpression in bladder cancer is closely related to such clinicopathological factors as pathological grade, tumor size, T stage, lymphatic metastasis, and TNM stage and a shorter overall survival of the patients, suggesting the potential value of DNMT3b as a prognostic marker and a new therapeutic target for bladder cancer.

Objective: To explore the effect of mindfulness traits on sleep quality of college students, and to investigate the mediating mechanism of cognitive emotion regulation and anxiety for mindfulness trait factors, and sleep quality in college students. Methods: Totally 397 college students from five colleges were investigated using Five Facet Mindfulness Questionnaire, Cognitive Emotion Regulation Questionnaire, Self-Rating Anxiety Scale and Pittsburgh Sleep Quality Index.SPSS 22.0 version and Bootstrap method were used to analysis data and test intermediate effect. Results: (1)The total score of mindfulness trait and the score of describe, act with awareness and non-judge factors in mindfulness traits were(118.44±9.38), (24.82±3.87), (27.41±5.53) and (25.07±4.60), respectively.The total score of sleep quality was (5.57±2.62), and it was negatively related to the above three factors (r=-0.13--0.37, all P<0.05). (2)Anxiety played a complete mediating role between describe factor and sleep quality.Negative cognitive emotion regulation and anxiety played multiple mediating roles between the total score of mindfulness trait, the act with awareness factor and sleep quality.Negative cognitive emotion regulation and anxiety played a complete chain mediated role between non-judge factor and sleep quality. Conclusion The describe, act with awareness and non-judge factors in mindfulness traits can affect sleep quality through mediation of negative cognitive emotion regulation and / or anxiety.

with hyperbilirubinemia admitted to the Neonatology Department of the First Affiliated Hospital of Zhengzhou University from January 2016 to October 2018 were divided into the control group (n=51) and the observation group (n=51) by random number table method. Both groups underwent auditory brainstem response hearing screening. The control group was given routine nursing intervention, the observation group was given non-drug sedation nursing intervention. The sedative effects of the two groups were compared. The Score of Newborn Facial Coding System (NFCS) and effective rates of examination between the two groups were compared. Results? After intervention, mean heart rate and mean respiratory rate in the observation group were statistically lower than those in the control group (P＜0.05), and average sleep latency was significantly shorter than that in the control group with statistical difference(P＜0.05). After intervention, only NFCS score in the control group significantly increased compared with that before intervention, and the NFCS score of the observation group was significantly lower than that of the control group during and after screening with statistical difference (P＜0.05). The effective rate of examination in the observation group was 98.04%, significantly higher than that of the control group (86.27%) with statistical difference(χ2=4.883,P＜0.05). Conclusions? The application of non-drug sedative nursing intervention in auditory brainstem response in hyperbilirubinemia neonatal hearing screening has good sedative effect, can significantly reduce the stress response of children to the outside world, and improve the efficiency of examination. It has certain application value in neonatal medical examination.

Objective To investigate the application value of combined detection of enterovirus 71 type(EV71) nucleic acid and antibody in diagnosis of hand-foot-mouth disease(HFMD).Methods From Jan.to Nov.2015,a total of 180 children with suspected HFMD were divided into nucleic acid detection group,antibody detection group and combined detection group,with 36 subjects for each group.Viral nucleic acid was detected by using reverse transcription polymerase chain reaction.Antibody was detected by using enzyme linked immunosorbent assay.All detected results were analyzed.Results The positive rate of nucleic acid detection group was the highest(80.55%),while that of antibody detection group was the lowest(47.22%).Among various symptoms,the positive rates of nucleic acid,antibody and combined detection in subjects with skin rash were the highest.Conclusion Combined detection of EV71 nucleic acid and antibody could avoid the false positive result of nucleic acid detection and false negative result of antibody detection,thus could be helpful for increasing diagnostic accuracy rate of HFMD.

Gastroesophageal reflux (GER) was very common among preterm infants, which could cause several complications and severely affects the prognosis. The standardization of diagnosis and treatment of gastroesophageal reflux was very important for preterm infants. Due to less adverse reactions, nonpharmacological therapy was the most advisable choice in preterm infants with GER. In this paper, nonpharmacological therapies including body positioning, feeding frequency and modality, changing food patterns, gastric tube, and nonnutritive sucking were reviewed. Body positioning was the safest and most effective nonpharmacological therapy. Other nonpharmacological strategies such as changes of feeding frequency and modality might also be useful. The role of some strategies was still controversial, thereby needing to be further investigated. Selection of what kind of specific nonpharmacological therapy should be based on the specific conditions.