Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) in patients undergoing replantation of severed fingers, and analyze their influencing factors.Methods:From January 2022 to December 2023, convenience sampling was used to select 335 patients who underwent replantation of severed fingers at the Hand and Foot Surgery of Taizhou Hospital of Zhejiang Province as research subjects. The survey was conducted using the General Information Questionnaire, PTSD Checklist-Civilian Version, Event Related Rumination Inventory, Chinese version of the Perceived Social Support Scale, and the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese. Potential profile analysis was used to explore the potential categories of PTSD in patients undergoing replantation of severed fingers, and ordered Logistic regression was used to analyze the influencing factors of PTSD categories.Results:A total of 335 questionnaires were distributed, and 328 valid questionnaires were collected, with a valid response rate of 97.91%. Potential profile analysis showed that PTSD of 328 patients undergoing severed finger replantation were divided into three latent categories, including low PTSD-high avoidance type ( n=67, accounting for 20.43%), moderate PTSD-high alertness type ( n=178, accounting for 54.27%), and high PTSD-high alertness type ( n=83, accounting for 25.30%). There were statistically significant differences in the number of severed fingers, incidence of postoperative vascular crisis, rumination, perceived social support, and personality trait scores among patients with different types of severed finger replantation ( P<0.05). Taking low PTSD-high avoidance type as a reference, ordered Logistic regression analysis showed that invasive rumination, purposive rumination, and personality types (introversion, neuroticism, psychoticism) were potential influencing factors for the moderate PTSD-high alertness type ( P<0.05). The number of severed fingers, postoperative vascular crisis, invasive rumination, purposive rumination, perceived social support, and personality type (introversion, neuroticism, psychoticism) were potential influencing factors of high PTSD-high alertness type ( P<0.05) . Conclusions:There is significant population heterogeneity in PTSD among patients undergoing severed finger replantation, which can be divided into "low PTSD-high avoidance type", "moderate PTSD-high alertness type", and "high PTSD-high alertness type". Nursing staff should conduct targeted interventions in the early stage based on factors such as the number of severed fingers, whether vascular crisis occurs after operation, level of rumination, personality type, to prevent and improve the occurrence of PTSD.

To investigate the effects of Pithecellobium clypearia extract on the tissue structure,in-flammatory lesions as well as microbial diversity in the intestinal of yellow-feathered broilers.2401-day-old yellow-feathered broilers were randomly divided into four groups(groups A,B,C and D),groups A,B and C were supplemented with Pithecellobium clypearia extract in basal diets with concentrations of 0.5,1.0 and 2.0 g/kg,respectively.Group D served as the control group without adding Pithecellobium clypearia extract in diets,and the full trial period lasted for 70 d.Duodenum and jejunum samples were collected on the 20th,40th and 70th days of the test,the vil-lous/crypt ratio of duodenum and jejunum were calculated,and the mRNA expression level of in-flammatory cytokine as well as related pathways were detected in each group,respectively.In addition,the contents of cecum were collected at 70 th day of the experiment and the microbial di-versity in cecum were also analysed by 16S rDNA sequencing.The results showed that adding 0.5 and 1.0 g/kg of Pithecellobium clypearia extract in the diet could significantly increase the veloci-ty height/crypt depth ratio of duodenum and jejunum(P＜0.05)compared to control group,as well as the mRNA expression level of tight junction protein(CLDN1 and CLDN5)in jejunum,which further improved the structure of mucous of intestinal.Pithecellobium clypearia extract could significantly(P＜0.05)decrease the mRNA expression level of inflammatory cytokine inclu-ding IL-1β,IL-8 and TNF-α,as well as the related pathway genes such as TLR4,MyD88 and NF-κB in jejunum,thus reduced the inflammatory lesions in intestinal.Pithecellobium clypearia ex-tract also could significantly increase the abundance of beneficial microbial such as Parabacteroide and Prevotellaceae,while significantly decrease the abundance of pathogenic microbial such as Proteobacteria in cecum(P＜0.05)and improve the microbial diversity in intestinal.In summary,Pithecellobium clypearia extract could improve the structure of intestinal tissue and the gut barri-er function,as well as the microbial diversity in cecum,and also decrease the inflammatory lesions in jejunum,which is helpful to the intestinal health for yellow-feathered broilers.The present study provides scientific basis for the development of Pithecellobium clypearia as a safe feed additive in the future.

Atherosclerosis(AS)is a chronic inflammatory disease of large and medium-sized arteries that leads to ischemic heart disease,stroke,and peripheral vascular disease.Despite the current treatments,mortality and disability still remain high.Sonodynamic therapy(SDT),a non-invasive and localized methodology,has been developed as a promising new treatment for inhibiting atherosclerotic progression and sta-bilizing plaques.Promising progress has been made through cell and animal assays,as well as clinical trials.For example,the effect of SDT on apoptosis and autophagy of cells in AS,especially macrophages,and the concept of non-lethal SDT has also been proposed.In this review,we summarize the ultrasonic parameters and known sonosensitizers utilized in SDT for AS;we elaborate on SDTs therapeutic effects and mechanisms in terms of macrophages,T lymphocytes,neovascularization,smooth muscle cells,lipid,extracellular matrix and efferocytosis within plaques;additionally,we discuss the safety of SDT.A comprehensive summary of the confirmed effects of SDT on AS is conducted to establish a framework for future researchers.

Objective To explore the possible mechanisms by which fibroblast growth factor(FGF)23 promoted atrial fibrosis in circulation of chronic kidney disease(CKD)by binding to atrial tissue fibroblast growth factor receptor(FGFR)4.Methods Twenty-two healthy male Sprague-Dawley(SD)rats were selected.Rats were randomly selected to undergo 5/6 nephrectomy and fed for 15 weeks to establish a CKD model(n=14).The remaining 8 rats were used as the sham group.The sham group(n=8)underwent the same surgery without removing renal tissue.Body weight,blood pressure,renal function,cardiac ultrasound,epicardial electrocardiography and pathological indices were monitored in both groups.Enzyme-linked immunosorbent assay(ELISA)method was used to determine the circulating levels of FGF23 in the two groups of rats.Transcriptomic analysis of left atrial tissue was performed to search for differentially expressed genes.Rat atrial fibroblasts were divided into the control group,the FGFR inhibitor group,the transforming growth factor-β(TGF-β)group and the TGF-β+FGFR inhibitor group.The expression levels of α-smooth muscle actin(α-SMA),collagenⅠ(Col Ⅰ)and phosphorylated protein kinase B(p-AKT)protein were detected by Western blot assay.Results Systolic blood pressure,blood urea nitrogen and creatinine were elevated in the CKD group of rats.Cardiac electrophysiological study showed that CKD could promote the occurrence of atrial fibrillation(AF)and atrioventricular block.Cardiac ultrasound suggested that the internal diameter of the left atrium was significantly increased in rats of the CKD group.Pathological findings showed that the left atrium in the CKD group underwent significant fibrosis,and epicardial electrical markers showed that left atrial electrical conduction velocity was significantly slower and conduction heterogeneity was significantly increased in the CKD group.These changes were accompanied by higher circulating FGF23.Western blot results showed that FGFR4 expression was upregulated in the CKD group.After blocking the FGF23/FGFR4 signaling pathway in atrial fibroblasts,the fibrosis-related proteins α-SMA,Col Ⅰ and p-AKT/AKT were decreased.Conclusion CKD promotes the occurrence of AF by inducing both structural and electrical remodeling.Increased circulating FGF23 promotes atrial fibrosis by activating the downstream AKT pathway binding to FGFR4 in atrial tissue.

Circular RNA(circRNA)is a novel class of endogenous non-coding RNA with complex biological func-tions,participating in various physiological and pathological processes.Due to their relatively stable stucture and tissue-specific and temporal expression patterns,circRNA have become a recent focus of biomedical research.Heart failure(HF)is characterized by impaired ventricular filling and/or ejection function caused by primary myocardial injury and car-diac overload,leading to the inability of the heart to meet the metabolic demands of the body's tissues.It is the end stage of numerous cardiac diseases.Studies have found that circRNA may play a crucial regulatory role in the progression of HF,particularly in cardiomyocyte hypertrophy,cardiomyocyte apoptosis,autophagy and myocardial fibrosis.This review summarizes the formation,classification,functional forms,and roles in HF of circRNA,aiming to provide new insights for the prevention and treatment of HF.

Objective:To explore the impact of nursing intervention in strengthening the implementation of ultrasound drug penetration therapy on postoperative rapid recovery of patients with digestive tract tumors after surgery, and to provide reference for the formulation of intervention plans for postoperative rapid recovery of digestive tract tumor patients.Methods:A randomized controlled trial was used. From April to July 2021, 120 postoperative patients with digestive tract tumors admitted to the Second Affiliated Hospital of Dalian Medical University were selected and divided into a control group, a dispersed treatment group, and a concentrated treatment group according to the random number table method, with 40 patients in each group. The control group mainly received routine accelerated rehabilitation surgical care, supplemented by early rehabilitation training; the dispersed treatment group received nursing intervention with ultrasound drug penetration therapy on the basis of the control group, once a day in the morning and once in the afternoon, lasting for 30 min each time; on the basis of the control group, the concentrated treatment group received nursing intervention of one-time concentrated ultrasound drug penetration therapy for 60 min. The gastrointestinal reactions, intestinal function recovery, hospitalization, postoperative complications, and nursing satisfaction of each group of patients were observed and compared using one-way ANOVA, LSD- t test, and χ2 test. Results:There were 27 males and 13 females in the control group, aged (61.85 ± 16.85) years old. while 23 males and 17 females in the dispersed treatment group aged (60.90 ± 16.88) years old, and 23 males and 17 females in the concentrated treatment group aged (59.80 ± 13.58) years old. The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the dispersed treatment group and concentrated treatment group were (38.58 ± 2.74), (17.45 ± 1.92), (38.76 ± 3.34), (50.04 ± 2.57) h and (36.79 ± 2.58), (16.48 ± 1.85), (36.98 ± 2.28), (48.25 ± 3.07) h, respectively, which were lower than those in the control group (43.13 ± 3.56), (21.24 ± 2.50) (42.65 ± 3.78), (52.21 ± 3.15) h, the differences were statistically significant ( t values were 3.38-9.68, all P<0.05). The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the concentrated treatment group were shorter than those in the dispersed treatment group, and the differences were statistically significant ( t values were 2.31-3.01, all P<0.05). The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were (5.83 ± 1.20) h, (9.90 ± 2.12) d and (7.35 ± 2.13) h, (8.30 ± 1.42) d, respectively. The control group was (4.39 ± 1.53) h and (14.93 ± 2.56) d, respectively. The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were better than those in the control group, while the time to get out of bed activity and hospitalization of patients in the concentrated treatment group were better than those in the dispersed treatment group, the differences were statistically significant ( t values were -7.14-14.34, all P<0.05). The incidence of intestinal obstruction was 15.0% (6/40) in the control group, 5.0% (2/40) in the dispersed treatment group, and 0 in the concentrated treatment group, with a statistically significant difference ( χ2=7.50, P<0.05). The nursing satisfaction of patients in the concentrated treatment group reached 100.00% (40/40), which was 92.5% (37/40) and 85.0% (34/40) in the dispersed treatment group and control group, with a statistically significant difference ( χ2=6.49, P<0.05). Conclusions:Nursing intervention through ultrasound drug penetration therapy, especially centralized treatment, can significantly improve postoperative intestinal function, reduce postoperative gastrointestinal reactions, shorten hospitalization time, reduce postoperative complications, accelerate patient recovery, and provide effective nursing intervention plans for clinical practice. It is worth promoting and applying.

Objective In this study,we analyzed the transcriptome sequences of Kupffer cells exposed to simulated microgravity for 3 d and conducted biological experiments to determine how microgravity initiates apoptosis in Kupffer cells. Methods Rotary cell culture system was used to construct a simulated microgravity model.GO and KEGG analyses were conducted using the DAVID database.GSEA was performed using the R language.The STRING database was used to conduct PPI analysis.qPCR was used to measure the IL1B,TNFA,CASP3,CASP9,and BCL2L11 mRNA expressions.Western Blotting was performed to detect the level of proteins CASP3 and CASP 9.Flow cytometry was used to detect apoptosis and mitochondrial membrane cells.Transmission electron microscopy was used to detect changes in the ultrastructure of Kupffer cells. Results Transcriptome Sequencing indicated that simulated microgravity affected apoptosis and the inflammatory state of Kupffer cells.Simulated microgravity improved the CASP3,CASP9,and BCL2L11 expressions in Kupffer cells.Annexin-V/PI and JC-1 assays showed that simulated microgravity promoted apoptosis in Kupffer cells.Simulated microgravity causes M1 polarization in Kupffer cells. Conclusion Our study found that simulated microgravity facilitated the apoptosis of Kupffer cells through the mitochondrial pathway and activated Kupffer cells into M1 polarization,which can secrete TNFA to promote apoptosis.

Objective To explore the effect of eversion carotid endarterectomy(eCEA)on the cog-nitive function in elderly carotid artery stenosis patients with different ages.Methods A total of 56 elderly patients undergoing eCEA in Department of Vascular Surgery of No.920 Hospital of Joint Logistics Support Force from May 2019 to May 2022 were enrolled and divided into a 60-69 year old group(31 cases)and a 70-80 year old group(25 cases).Mini-mental state examination(MMSE)Scale was used to analyze the patients within 1 week before surgery and 1 and 6 months after surgery.Results In the 60-69 years old group,their MMSE scores in 1 and 6 months after surgery were significantly higher than those before surgery(24.71±3.67 vs 23.52±3.70,P＜0.05;25.48±3.19 vs 23.52±3.70,P＜0.01).For the 70-80 year old group,the MMSE score in 6 months after surgery was obviously higher than that before surgery and that in 1 month after sur-gery(25.44±3.42 vs 23.76±3.81,P＜0.01;25.44±3.42 vs 23.90±3.65,P＜0.01).The improve-ment of MMSE score between 1 month after surgery and before surgery was notably more obvi-ous in the 60-69 year old group than the 70-80 year old group,but the improvement between 6 months and 1 month after surgery was statistically declined in the 60-69 year old group than the 70-80 year old group(P＜0.05).Conclusion eCEA can significantly improve cognitive function in elderly patients with carotid artery stenosis,and obvious efficacy is observed in the early stage in the 60-69 years old patients.

Objective : To observe the dynamic expression of recombinant lysyl oxidase like protein 1 ( LOXL1) in the lysine oxidase family in the liver of C57BL/6 mice infected with Schistosomajaponicum and explore its role in hepatic fibrosis． Methods: Mice were infected subcutaneously with cercariae of S．japonicum，and sacrificed with euthanasia in 6，9 and 12 weeks after infection．The sera and liver tissues were collected．The levels of liver fibrosis in mice was dynamically evaluated by HE and Sirius red staining，and the serum transaminases were detected．The dynamic expression levels of collagen type Ⅰ ( Col1) ，LOXL1 and α-smooth muscle actin( α-SMA) in liver tissues were determined respectively by Western blot and qPCR. Finally，the dynamic levels of soluble and insoluble collagens were detected. Results: The result of HE and Sirius red staining showed that hepatic fibrosis levels increased at 6 weeks，peaked at 9 week，and decreased at 12 week in response to S．japonicum infection．Western blot and q-PCR showed that the expression levels of LOXL1，Col1 α1，Col3 α1 and α-SMA was significantly up regulated and reached maximum at the 9th week in response to S．japonicum infection．Soluble collagen protein levels reached maximum at the 9th week．and decreased at 12 week，however insoluble collagen protein levels continued to increase． Conclusion There may be a correlation between LOXL1 and fiber cross-linking in the process of hepatic fibrosis in S．japonicum，and it plays a role in promoting hepatic fibrosis.

Objective:To evaluate EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder (ADHD) using the integrated visual and auditory integration continuous performance test (IVA-CPT).Methods:Children with ADHD who completed more than 60 times of EEG biofeedback training in Hangzhou Seventh People's Hospital from July 2018 to September 2020 were selected as the research subjects. According to the results of IAV-CPT before treatment, all the children were divided into three subtypes: attention deficit type ( n=21), impulse hyperactivity type ( n=11), and mixed type ( n=30). The differences of symptom improvement between the three subtypes before and after training were compared by SPSS 23.0 software. Results:(1) In terms of response control (a total of 9 items), there was no statistical significance in the attention deficit group before and after treatment (all P>0.05). In the hyperactivity group, the scores of visual and auditory response control, full scale response control, auditory prudence and auditory consistency, visual focus quotient and visual consistency before treatment were significantly lower than those after treatment(all P<0.05). In the mixed group, the scores of visual and auditory response control, full scale response control, auditory prudence, visual consistency, and visual prudence before treatment were significantly lower than those after treatment(all P<0.05). In terms of attention (a total of 9 items), the scores of auditory vigilance, auditory attention, visual attention, full scale attention, visual vigilance and visual speed in the attention deficit group before treatment were significantly lower than those after treatment(all P<0.05). The scores of visual attention, full scale attention, visual focus quotient (all P<0.01), auditory attention and visual speed (all P<0.05) in hyperactivity group before treatment were significantly lower than those after treatment. In the mixed group, the scores of the other 8 items before treatment were significantly lower than those after treatment (all P<0.01, auditory focus quotient were P<0.05), except that the auditory speed had no statistical significance before and after treatment.(2)After EEG biofeedback training, the changes of IVA-CPT scores of the three groups before and after treatment(visual response control (-2.76±24.39), (19.55±19.94), (12.93±25.30), F=3.932, P=0.025), (full scale response control (2.38±20.77), (21.27±15.86), (15.43±25.69), F=3.158, P=0.050), (full scale attention (18.43±27.44), (11.36±11.40), (26.23±18.41), F=4.692, P=0.016), (auditory vigilance (20.23±42.65), (6.55±10.20), (33.63±36.30), F=7.160, P=0.002), (visual vigilance (19.48±28.55), (5.27±10.62), (33.27±28.26), F=10.876, P<0.001), (visual focus quotient (-2.24±23.67), (14.45±13.79), (12.83±21.91), F=3.669, P=0.031) were statistically significant. After LSD comparison, the changes of visual control and total control scores in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group (all P<0.05) and the mixed group (all P<0.05). In the three items of total attention score, auditory vigilance and visual vigilance, the changes of impulsivity hyperactivity group before and after treatment were significantly lower than those of mixed group ( P=0.050, P<0.05, P<0.01, respectively). The changes of visual attention quotient in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group and the mixed group (all P<0.05). Conclusion:EEG biofeedback has clinical efficacy in the three groups of subtypes of ADHD, but the efficacy is different, and individualized EEG training programs should be developed for different subtypes of children on the basis of standard TBR therapy protocol.