OBJECTIVES: Neuropathic pain (NP) is one of the most common forms of chronic pain, yet current treatment options are limited in effectiveness. Peripheral nerve injury activates spinal microglia, altering their inflammatory response and phagocytic functions, which contributes to the progression of NP. Most current research on NP focuses on microglial inflammation, with relatively little attention to their phagocytic function. Early growth response factor 2 (EGR2) has been shown to regulate microglial phagocytosis, but its specific role in NP remains unclear. This study aims to investigate how EGR2 modulates microglial phagocytosis and its involvement in NP, with the goal of identifying potential therapeutic targets. METHODS: Adult male Sprague-Dawley (SD) rats were used to establish a chronic constriction injury (CCI) model of the sciatic nerve. Pain behaviors were assessed on days 1, 3, 7, 10, and 14 post-surgery to confirm successful model induction. The temporal and spatial expression of EGR2 in the spinal cord was examined using real-time quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. Adeno-associated virus (AAV) was used to overexpress EGR2 in the spinal cord, and behavioral assessments were performed to evaluate the effects of EGR2 modulation of NP. CCI and lipopolysaccharide (LPS) models were established in animals and microglial cell lines, respectively, and changes in phagocytic activity were measured using RT-qPCR and fluorescent latex bead uptake assays. After confirming the involvement of microglial phagocytosis in NP, AAV was used to overexpress EGR2 in both in vivo and in vitro models, and phagocytic activity was further evaluated. Finally, eukaryotic transcriptome sequencing was conducted to screen differentially expressed mRNAs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses to identify potential downstream effectors of EGR2. RESULTS: The CCI model successfully induced NP. Following CCI, EGR2 expression in the spinal cord was upregulated in parallel with NP development. Overexpression of EGR2 via spinal AAV injection enhanced microglial phagocytic activity and increased pain hypersensitivity in rats. Both animal and cellular models showed that CCI or LPS stimulation enhanced microglial phagocytosis, which was further amplified by EGR2 overexpression. Transcriptomic analysis of spinal cord tissues from CCI rats overexpressing EGR2 revealed upregulation of numerous genes associated with microglial phagocytosis and pain regulation. Among them, Lag3 emerged as a potential downstream target of EGR2. CONCLUSIONS EGR2 contributes to the maintenance of NP by enhancing microglial phagocytosis in the spinal dorsal horn.
Animals ; Microglia/metabolism* ; Phagocytosis/physiology* ; Rats, Sprague-Dawley ; Neuralgia/physiopathology* ; Early Growth Response Protein 2/metabolism* ; Male ; Rats ; Spinal Cord/metabolism* ; Sciatic Nerve/injuries*

The plant AT-rich sequence and zinc-binding protein (PLATZ) family is composed of plant-specific zinc finger-like transcription factors, which play important roles in plant growth, development, and stress tolerance. In this study, to gain a better understanding of the PLATZ gene in C. sinensis and elucidate its response under drought and high temperature conditions, the PLATZ gene family of the C. sinensis cultivar 'Tieguanyin' was systematically identified, and a total of 12 CsPLATZ family members were identified. Expasy online and other bioinformatics tools were used to analyze the members of the PLATZ gene family in terms of protein physicochemical properties, phylogenetic relationships, cis-acting elements, gene structures, and intra- and inter-species collinearity. The results of phylogenetic analysis classified the CsPLATZ family members into 2 subfamilies. The conserved domains and gene structures of PLATZ family members within the same subfamily had a high degree of consistency, whereas a certain degree of diversity was observed among the subfamilies. Twelve PLATZ genes were unevenly distributed across 7 chromosomes of C. sinensis and the promoter regions of these genes had multiple cis-acting elements related to hormone and stress responses. The collinearity analysis showed that there were 4 pairs of duplication events in the CsPLATZ gene family, all of which were segmental duplications. Based on this gene family, C. sinensis had a closer evolutionary relationship with A. thaliana than with O. sativa. The transcriptome analysis showed that the expression levels of CsPLATZ family members varied in different tissue samples of C. sinensis. 6 genes (CsPLATZ-1, CsPLATZ-2, CsPLATZ-3, CsPLATZ-4, CsPLATZ-6, and CsPLATZ-8) with high expression in shoots, young leaves, and roots were selected for high temperature and drought stress treatments, and their expression was quantified by qRT-PCR. The results indicated that the six genes might play important roles in the response to drought stress. In addition, CsPLATZ-2 and CsPLATZ-8 might have important functions in the response to high temperature stress. The results of this study will contribute to a better understanding of the biological functions of PLATZ genes and their possible roles in the growth, development, and stress responses of C. sinensis.
Droughts ; Camellia sinensis/physiology* ; Phylogeny ; Gene Expression Regulation, Plant ; Plant Proteins/genetics* ; Stress, Physiological/genetics* ; Multigene Family ; Transcription Factors/genetics* ; Hot Temperature ; Genes, Plant

Objective:To understand the loss to follow-up of children born to pregnant women with HIV infection (HIV-exposed children) and analyze its influencing factors in China in 2019.Methods:The data were collected from the follow-up records of pregnant women with HIV infection and their children reported by the national "Management Information System for the Prevention of HIV, syphilis and Hepatitis B Mother-to-Child Transmission" in 2019. HIV-exposed children were defined as those who were not followed up after birth or who were not followed up at 18 months of age and who were not followed up at 21 months of age. The univariate and multivariate influencing factors of loss to follow-up of children born to HIV-infected pregnant women were analyzed by χ2 test and logistic regression model. SPSS 25.0 software was used for statistical analysis. Results:The number of HIV-infected pregnant women was 5 039, the number of live-born children was 5 035, the number of loss to follow-up children within 18 months of age was 283, and the loss to follow-up rate children was 5.62%(283/5 035). The results of multivariate logistic regression analysis showed that the rate of loss to follow-up of exposed children born to pregnant women who worked as farmers (animal husbandry and fishery) (a OR=0.34, 95% CI: 0.22-0.53), unmarried (a OR=0.47, 95% CI: 0.24-0.93), first marriage (a OR=0.38, 95% CI: 0.22-0.67), remarriage (a OR=0.36, 95% CI: 0.20-0.67) and cohabiting (a OR=0.47, 95% CI: 0.23-0.97), and knew they had HIV infection before this pregnancy (a OR=0.53, 95% CI: 0.40-0.70) was lower. Han nationality (a OR=1.52, 95% CI: 1.09-2.13), primary school (a OR=2.06, 95% CI: 1.10-3.89) and junior middle school (a OR=1.81, 95% CI: 1.03-3.17) educational level, non-use of antiviral drugs (a OR=6.21, 95% CI: 4.32-8.93) and delivery in township (street) level midwifery institutions (a OR=5.72, 95% CI: 1.61-20.27) had higher rates of loss to follow-up among infants born to HIV-infected pregnant women. Conclusions:HIV-exposed children still have a specific rate of loss to follow-up in China in 2019. In order to further reduce the rate of loss to follow-up, it is of great significance to improve the detection rate of HIV before pregnancy and the rate of antiviral drugs used in pregnant women with HIV infection, which is of great significance for the effective implementation of comprehensive intervention measures of prevention of mother-to-child transmission of HIV.

Objective:To explore the distribution and hematological characteristics of rare thalassemia-associated mutations in Chenzhou region of Hunan Province with an aim to provide a basis for genetic counseling and effective prevention.Methods:A total of 37 370 individuals enrolled from January 2015 to December 2021 were screened by routine blood test and hemoglobin electrophoresis. The genotypes were determined with high-throughput sequencing.Results:A total of 8 455 thalassemia mutations (including 185 rare ones) were detected, which had involved 27 mutational types. Rare type α-Thalassemia --THAI and CD31 (AGG>AAG) have the typical microcytic hypochromic hematological features, whilst SEA-HPFH, CD14 (CTG>-TG), CD37 (TGG>TAG), -90(C>T), Codon 15 (G>A), IVS-Ⅰ-128 (T>G), CD86 (GCC>GC-) and Chinese Gγ+ (Aγδβ)0 had typical microcytic hypochromic and β-thalassemia-associated hematological features of elevated HbA2 or HbF. In addition, the -50(G>A)heterozygotes of β-thalassemia had normal or slightly decreased MCV and MCH without an increase in HbA2.Conclusion:Various forms of thalassemia-associated mutations have been identified in the Chenzhou region of Hunan Province. Above finding has facilitated development of preventive and control strategies for thalassemia as well as birth health programs.

Objective:To explore the drug resistance of pathogens in puerperal infection of pregnant women with diabetes mellitus (GDM), and analyze the influence of puerperal infection on the expression of toll like receptor 4 (TLR4) inflammatory pathway in peripheral blood monocytes.Methods:A retrospective selection was conducted on 120 GDM postpartum women who underwent regular prenatal check ups and delivery at the 903th Hospital of the PLA (People′s Liberation Army) Joint Logistic Support Force from January 2020 to October 2022. The postpartum infection status, pathogenic characteristics of the infected pathogens, and drug resistance of the mothers were analyzed; According to the postpartum infection situation, the parturients were divided into an infected group and an uninfected group. Logistic regression analysis was used to analyze the relevant factors affecting postpartum infection, and the TLR4 protein and mRNA expression levels of peripheral blood mononuclear cells in the two groups were compared.Results:Among 120 GDM pregnant women, 21 cases (17.50%) developed post infection, including 8 cases (38.10%) of incision infection, 6 cases (28.57%) of uterine cavity infection, 4 cases (19.05%) of urinary system infection, and 3 cases (14.28%) of blood infection; A total of 43 pathogenic bacteria were detected, including 26 Gram negative bacteria (60.46%), 14 Gram positive bacteria (32.56%), and 3 fungi (6.98%). Among the main Gram negative bacteria, escherichia coli had the highest resistance rate to ceftazidime and tetracycline, and had not developed resistance to meropenem; Pseudomonas aeruginosa had the highest resistance rate to ceftazidime and gentamicin. Among the main Gram positive bacteria, staphylococcus aureus had the highest resistance rate to penicillin G and ceftazidime, and had not developed resistance to vancomycin; Enterococcus faecalis had the highest resistance rate to clindamycin. The results of multivariate logistic regression analysis showed that postpartum hemorrhage, premature rupture of membranes, and poor control of prenatal blood sugar were independent risk factors for postpartum infection in GDM mothers (all P<0.05). The expression rate of TLR4 protein, relative expression level of TLR4 mRNA, and levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1, and IL-10 in the infected group were significantly higher than those in the non infected group (all P<0.05). Conclusions:The distribution and drug resistance of pathogenic bacteria in postpartum infections of GDM mothers have certain characteristics. Postpartum hemorrhage, premature rupture of membranes, and poor control of prenatal blood sugar are independent risk factors affecting postpartum infections in GDM mothers; The TLR4 inflammatory pathway in peripheral blood mononuclear cells may be involved in the occurrence and development of postpartum infection in GDM mothers.

Thyroid carcinoma is closely related to environmental factors. Gene mutations and molecular biological changes of gland tissue caused by environmental changes are important factors inducing thyroid carcinoma. Although the molecular mechanism of thyroid carcinoma has not been fully elucidated,increasingly specific genetic changes and molecular markers for thyroid carcinoma have been discovered with the development of molecular biology techniques. This article reviews the recent progresses on the etiology,specific molecular markers,diagnosis and targeted therapies of thyroid carcinoma,so as to provide theoretical support for the clinical diagnosis and treatment of thyroid carcinoma.

Objective:To design a programmed evaluation process,and to explore its application effect in the management of medical equipment in emergency department.Methods:The information management platform was constructed based on IntelliJ IDEA and Java language with browser and server(B/S)architecture,a programmed evaluation process was designed to manage medical equipment in the emergency department.From 2021 to 2022,27 medical devices in use in the emergency department of Beijing Friendship Hospital,Capital Medical University were selected,the programmed evaluation process and the post-evaluation process were adopted respectively for management according to the different equipment management methods.A total of 800 equipment operation logs sampled were analyzed under the two management methods.The timeliness of equipment management,management effect and satisfaction scores of related management personnel were compared between the two management methods.Results:The average time consumption of equipment warning timeliness,timeliness of maintenance personnel's arrival and timeliness of proposed treatment methods in the programmed evaluation process management were(0.92±0.21)min,(5.43±1.08)min and(15.63±2.27)min,respectively,which were lower than those in post-evaluation process management method,the difference was statistically significant(t=13.810,16.893,16.554,P＜0.05).The failure rate of 400 logs sampled by the programmed evaluation process management method was 2.75%(11/400),which was lower than that of the post-evaluation process management method,the regular maintenance completion rate was 99.75%(399/400),which was higher than that of the post-evaluation process management method,the difference was statistically significant(x2=18.841,10.778,P＜0.05).The equipment maintenance time and equipment maintenance cost of the programmed evaluation process management were(9.32±1.18)days and CNY(201,600±50,500),respectively,which were lower than those of the post-evaluation process management method,and the difference was statistically significant(t=12.663,37.213,P＜0.05).The satisfaction scores of maintenance engineers,medical staff and patients in equipment use management for the programmed evaluation process management were(97.25±2.44),(98.63±4.57)and(97.16±3.09),respectively,which were higher than the post-evaluation process management method,and the differences were statistically significant(t=21.284,8.206,5.933,P＜0.05).Conclusion:The application of programmed evaluation process to the equipment management of emergency department of the hospital can effectively improve and make up for the loopholes and deficiencies in the conventional equipment management,improve the effect of equipment management,reduce the frequency of equipment failure,and ensure the safe and stable operation of equipment.

Objective:To investigate Helicobacter pylori (Hp) infection status, strain typing, and their correlations with gastric mucosal lesions in chronic gastritis. Methods:A retrospective analysis was conducted on the medical records of 11 500 patients with chronic gastritis who received treatment at Xi'an International Medical Center Hospital, People's Hospital of Wuhai, and People's Hospital of Tongchuan from January to July 2022. Hp test results, strain typing, and the basic characteristics and gastric mucosal lesions of Hp-infected patients were determined. Pearson correlation analysis was performed to assess the correlation between strain types and gastric mucosal lesions. Logistic regression analysis was performed to identify factors influencing Hp infection in patients with chronic gastritis.Results:A total of 7 549 cases of Hp infection were identified (65.65%). Patients with more than three family members, farmers and workers, those who frequently drank raw water, consumed pickled foods, did not drink tea, were aged 50 years or older, or had a disease duration of 2 years or more had a higher Hp-positive rate compared with those with fewer than three family members, government officials, those who infrequently drank raw water, did not consume pickled foods, drank tea, were younger than 50 years, or had a disease duration of less than 2 years (all P < 0.05). The majority of infected patients harbored the highly virulent type I Hp strains (55.65%). The numbers of cases of non-epithelial neoplasia, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, and gastric infiltrating carcinoma were significantly different among different strain types (χ2 = 40.33, 7.65, 11.39, 54.89, all P < 0.05). Conclusion:A higher number of family members, being a farmer or a worker, frequently drinking raw water, and consuming pickled foods are associated with an increased rate of Hp infection, while drinking tea is linked to a reduced infection rate. Patients with chronic gastritis are often infected with highly virulent type I Hp strain. There is a positive correlation between non-epithelial neoplasia and strain type. Age ≥ 50 years and disease duration ≥ 2 years are independent factors influencing Hp infection in chronic gastritis.

Objective:To retrieve and summarize the best evidence for nursing of hematopoietic stem cell reinfusion in children.Methods:Clinical decisions, guidelines, recommended practices, evidence summaries, systematic reviews, and expert consensuses on nursing of hematopoietic stem cell reinfusion in children were searched in Chinese and English databases as well as related websites such as British Medical Journal (BMJ) Best Practice, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, UpToDate, CINAHL, Embase, PubMed, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to March 2023. Two researchers independently conducted literature quality evaluation, identified the included literature, extracted evidence item by item, and translated, organized and summarized the evidence.Results:A total of nine articles were included, including two clinical decisions, two expert consensuses, four guidelines, and one evidence summary. 24 pieces of evidence were summarized from six aspects, consisting of child preparation, stem cell preparation, item preparation, nursing during reinfusion, nursing after reinfusion, and evaluation and education.Conclusions:The best evidence for nursing of hematopoietic stem cell reinfusion in children involves a wide range of aspects. Managers, clinical medical and nursing staff should apply evidence based on specific medical situations in order to safely and reasonably perform hematopoietic stem cell reinfusion.

Objective:To summarize the best evidence of medication adherence interventions for patients with multiple chronic conditions.Methods:According to the "6S" evidence model, literature on medication adherence in patients with multiple chronic conditions was retrieved from BMJ Best Clinical Practice, UpToDate, Medlive, National Institute for Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang data and so on. The search period was from establishing the database to August 30, 2023.Results:A total of 16 articles were included, including three guidelines, four expert consensus, seven systematic reviews, and two meta-analyses. Twenty-seven pieces of evidence were summarized from six aspects of compliance assessment, educational intervention, behavioral intervention, optimized treatment program, technical reminder intervention, and social-psychological-emotional intervention.Conclusions:The best evidence of medication adherence interventions for patients with multiple chronic conditions summarized provides a reference for medical and nursing staff to develop medication adherence interventions.