Objective:Using bioinformatics methods to study the immune infiltration mechanism of lupus nephritis(LN)and to explore potential target Chinese medicines,which can provide new directions for clinical treatment of LN.Methods:Gene expres-sion profile microarray dataset of LN was downloaded from GEO database,differential expressed genes(DEGs)were screened using R software,and GO and KEGG enrichment analysis were performed on these DEGs.Protein interaction network analysis of DEGs was performed by applying STRING database,key genes were screened by using Cytoscape,core gene expression was validated by Nephro-seq database,and the infiltration and correlation of 22 kinds of immune cells in LN were calculated by CIBERSORT deconvolution algorithm.Finally,herbal prediction of significantly enriched immune-related biological processes and key target genes were performed by Coremine Medical database.Results:A total of 367 LN-related DEGs were obtained,of which 253 were up-regulated and 114 were down-regulated.GO was mainly enriched in response to viruses,defense response to viruses,regulation of viral life cycle,regulation of viral processes,etc;KEGG was mainly enriched in S.aureus infection,COVID-19,influenza A,complement and coagulation cascade,pertussis,etc.Ten key genes were screened:IFIT3,OAS2,MX1,OAS1,RSAD2,XAF1,ISG15,IFIT1,ITGAM and PTPRC.Immune infiltration by CIBERSORT deconvolution algorithm showed that monocytes and initial B cells were highly expressed in LN,while memory B cells,naive CD4+T cells,follicular helper T cells and resting natural killer cells were lowly expressed in LN.Immune cell correlation analysis showed a positive correlation between initial B cells and plasma cells,a positive correlation between resting natural killer cells and resting dendritic cells,a negative correlation between monocytes and regulatory T cells,and a negative correlation between resting CD4+memory T cells and monocytes.Coremine Medical predicted that Salvia miltiorrhiza,Panax notogin-seng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony were found to be most closely related to immunity in LN.Conclusion:The development and progression of LN are results of the combined involvement of multiple genes and pathways.Mono-cytes,memory B cells,initial CD4+T cells and initial B cells are most closely associated with LN.The predicted Salvia miltiorrhiza,Panax notoginseng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony may be used as target herbs for the poten-tial treatment of LN.

Background and aims:Promoting gastrointestinal function recovery is one of the key aspects of enhanced recovery after surgery(ERAS)for colorectal cancer(CRC).Many ancient Chinese medical texts suggest that acupuncture at four acupoints—Zusanli,Shangjuxu,Sanyinjiao,and Neiguan—helps promote gastrointestinal peristalsis.However,there is currently no systematic study on multi-point acupuncture to promote postoperative gastrointestinal function recovery in CRC patients.Therefore,this study was conducted to evaluate the clinical efficacy of multi-point acupuncture in promoting gastrointestinal function recovery in CRC patients through a prospective study to provide new options for implementing ERAS in CRC patients in clinical practice. Methods:Using a prospective,randomized,controlled design,a total of 100 eligible patients who underwent laparoscopic CRC radical surgery at the Department of Gastrointestinal Surgery,Third Xiangya Hospital of Central South University,between January 2021 and February 2022,were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups underwent the same ERAS protocols and radical surgery during the perioperative period.The observation group received acupuncture treatment from the day of surgery to the third postoperative day,once per day,while the control group did not receive acupuncture.Primary outcomes included the time to bowel sound recovery,time to first flatus,and time to first defecation.Secondary outcomes included abdominal pain scores,incidence of bloating,nausea,vomiting,white blood cell count,neutrophil percentage,C-reactive protein,hemoglobin,serum albumin,blood potassium levels,postoperative hospital stay,and incidence of postoperative complications. Results:A total of 96 patients completed the study,with 48 in each group.There were no statistically significant differences in baseline characteristics such as age,gender,or surgery time between the two groups(all P＞0.05).Compared with the control group,the observation group had a significantly shorter time for bowel sound recovery,first flatus,first defecation,and postoperative hospital stay(all P＜0.05).Additionally,the observation group showed reduced abdominal pain scores on postoperative day(POD)2 and 3,a lower incidence of bloating on POD 1 and 2,and a reduced incidence of nausea and vomiting on POD 3(all P＜0.05).There were no statistically significant differences in the remaining comparisons between the two groups(all P＞0.05). Conclusion:Multi-point acupuncture treatment can promote the recovery of gastrointestinal function in patients undergoing minimally invasive CRC surgery without increasing postoperative complications,and it is recommended for integration into routine ERAS protocols.

Objective:As the cesarean section rate increases year by year,the treatment of previous cesarean scar defects(PCSD)poses a significant challenge.This study aims to evaluate the clinical value of preoperative magnetic resonance imaging(MRI)technology and analyze relevant influencing factors for patients with abnormal uterine bleeding(AUB)associated with cesarean scar defects who underwent laparoscopic surgery.Methods:A retrospective cohort analysis was performed on women who underwent laparoscopic surgery for PCSD-related AUB at the Department of Gynecology,the Third Xiangya Hospital of Central South University from 2018 to 2022.A total of 57 patients who underwent laparoscopic surgery for the treatment of AUB associated with PCSD were divided into 2 groups based on their postoperative clinical cure status:The clinically-cured group(n=28,49.1%)and the non-clinically-cured group(n=29,50.9%).After a postoperative follow-up period of 3 months for all participants,logistic regression analysis was conducted to explore the correlation between the clinical cure rate of AUB associated with cesarean scar defects treated by laparoscopic surgery and various factors.These factors included patient age,clinical symptoms,obstetric history,history of cesarean section,basic clinical information,preoperative MRI parameters,and postoperative menstrual conditions.Results:There were no significant differences in many aspects,including the patient's age at the time of previous cesarean section,number of pregnancy,time since the previous cesarean section,the uterus position assessed by preoperative T2 signal MRI,defect length,defect width,residual muscle layer thickness,adjacent uterine muscle layer thickness,and distance from the defect to the external cervical os between the 2 groups(all P>0.05).However,the time of onset of AUB symptoms(P=0.036,OR=1.019,95%CI 1.002 to 1.038)and the depth of the defect on the preoperative MRI(P=0.010,OR=5.793,95%CI 1.635 to 25.210)were identified as risk factors affecting the clinical cure rate.Conclusion:The time of onset of AUB symptoms and the depth of the defect on preoperative MRI are risk factors that influence the clinical cure rate of laparoscopic surgery for the treatment of AUB associated with PCSD,which could be helpful for evaluating the prognosis of disease.

Objective Using bioinformatics methods to study the immune infiltration mechanism of Primary Sj?gren's syndrome(pSS)and to explore potential target Chinese medicines,which can provide new directions for the clinical treatment of pSS.Methods Gene expression profile microarray dataset of pSS was downloaded from the GEO database,differential genes were screened using R software,and gene ontology(GO)and gene pathway enrichment(KEGG)enrichment analysis was performed on these differential genes.Protein interaction network analysis of differential genes was performed by applying the STRING database,key genes were screened by using Cytoscape,and ELISA for the verification of key genes expression.Immune infiltration and correlation of immune cells in pSS were calculated by CIBERSORT inverse convolution method in 22.Finally,the herbal prediction of key target genes was performed by using the Coremine Medical database.Results A total of 232 differential genes were obtained,of which 207 were up-regulated and 25 were down-regulated.GO was mainly enriched in:leukocyte mediated immunity,lymphocyte mediated immunity,leukocyte cell-cell adhesion,etc;KEGG was mainly enriched in Hematopoietic cell lineage,Primary immunodeficiency,Intestinal immune network for IgA production,Phagosome,Leishmaniasis.Ten key genes were screened:PTPRC,CD19,LCP2,CCR5 and CD69 etc.The hub genes expression in the pSS is the same as that of GSE40611.Immune infiltration showed that memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve were highly expressed in the pSS.Immune cell correlation analysis showed a positive correlation between initial Monocytes and T cells regulatory(Tregs),a positive correlation between Macrophages M1 and B cell na?ve,and a negative correlation between Plasma cells and T cells CD4 memory activated.COREMINE Medical predicted that Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,and Strychni may treat pSS.Conclusion The development and progression of pSS are the results of the combined involvement of multiple genes and pathways.Memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve may promote the development of pSS.The predicted Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,Strychni may be used as target herbs for the potential treatment of pSS.

Objective:To explore the effects of feedback teaching based on dynamic cases on teaching quality of practice nurses in the department of neurosurgery.Methods:A total of 69 practice nurses from the Department of Neurosurgery in the First Affiliated Hospital of Nanjing Medical University were enrolled as the research subjects between January 2019 and August 2020, of which 33 practice nurses between January and October 2019 were selected as the control group and the other 36 practice nurses between November 2019 and August 2020 were selected as the observation group. The control group used routine teaching, while the observation group adopted feedback teaching based on dynamic cases. The assessment scores, practice effect, nursing job satisfaction, and the incidence of nursing errors after teaching were compared between the two groups. SPSS 24.0 was used for Chi-square test and t-test. Results:After teaching, the scores of each assessment (teaching rounds, health education, specialist nursing operations, morning questions, basic operations, and theoretical assessment) in the observation group were significantly higher than those in the control group, and the scores of disease change recognition ability, independent work ability, communication ability and teamwork ability were significantly higher than those in the control group ( P<0.05). After 1 week, 2 weeks, 3 weeks and 4 weeks of teaching, the teaching satisfaction in the observation group was significantly higher than that in the control group ( P<0.05). The total incidence of nursing errors in the observation group 2.78%(1/36) was significantly lower than that in the control group 27.27(9/33)( P<0.05). Conclusion:Feedback teaching based on dynamic cases can effectively improve the teaching quality of practice nurses in the department of neurosurgery, improve nursing job satisfaction, and reduce the risk of nursing errors.

Objective:To compare the early efficacy of proximal femoral bionic nail (PFBN) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 45 elderly patients with intertrochanteric fracture treated at First Affiliated Hospital of Henan Polytechnic University from March 2020 to December 2021, including 13 males and 32 females; aged 70-96 years [(78.6±7.3)years]. According to the AO classification, there were 10 patients with type 31-A1, 16 type 31-A2 and 19 type 31-A3. There were 20 patients treated with PFBN (PFBN group) and 25 with PFNA (PFNA group). The operation time, intraoperaive blood loss, bone healing time, and time to full weight-bearing were compared between the two groups. The tip-apex distance, distance from tail of lag screw to lateral side of intramedllary nail, proximal femoral length and femur neck-shaft angle were compared between the two groups at day 1 postoperatively and at the last follow-up, and their amount of changes between the two time points were also measured. Harris hip score was evaluated at 3, 6 months postoperatively and at the last follow-up. Complications were observed as well.Results:All patients were followed up for 6-21 months [(14.7±3.6)months]. There were no significant differences in operation time, intraoperative blood loss and bone healing time between the two groups (all P>0.05). The time to full weight-bearing was significantly earlier in PFBN group [(7.9±1.2)weeks] than that in PFNA group [(9.1±0.9)weeks] ( P<0.05). At day 1 postoperatively and at last follow-up, the tip-apex distance was (23.4±1.7)mm and (23.3±1.6)mm in PFBN group ( P>0.05), and was (24.5±2.1)mm and (24.3±2.3)mm in PFNA group ( P>0.05); the distance from tail of lag screw to lateral side of intramedllary nail was (8.1±1.1)mm and (11.8±0.9)mm in PFBN group ( P<0.01), and was (7.7±1.0)mm and (12.6±1.6)mm in PFNA group ( P<0.01); the proximal femoral length was (91.3±1.6)mm and (88.5±2.6)mm in PFBN group ( P<0.01), and was (91.4±2.0)mm and (87.6±2.0)mm in PFNA group ( P<0.01); the femur neck-shaft angle was (127.2±2.9)°and (125.7±3.0)° in PFBN group ( P>0.05), and was (128.5±3.0)° and (127.2±3.2)° in PFNA group ( P>0.05). There were no significant differences in the above indicators between the two groups at day 1 postoperatively and at the last follow-up (all P>0.05). The amount of changes in the tip-apex distance and femur neck-shaft angle were (-0.2±0.1)mm and (-1.6±0.7)° in PFBN group, similar with (-0.2±0.2)mm and (-1.5±1.0)° in PFNA group (all P>0.05). However, the amount of changes in the distance from tail of lag screw to lateral side of intramedllary nail and proximal femoral length were (3.6±1.4)mm and (2.7±1.2)mm in PFBN group, significantly lower than (5.2±1.1)mm and (4.0±1.1)mm in PFNA group (all P<0.01). There were no significant differences in Harris hip score between the two groups at 3, 6 months postoperatively or at the last follow-up (all P>0.05). PFBN group had 1 patient with fracture displacement, 2 with compression screw backup and 2 with thigh pain. PFNA group had 1 patient with fracture displacement and 4 with thigh pain. Conclusion:For elderly patients with intertrochanteric fracture, PFBN provides not only earlier full weight-bearing, but also stronger stability of fracture fixation than PFNA.

More and more evidences point to the involvement of neural cell senescence in the pathogenesis of neurodegenerative diseases. However, previous studies mostly focus on neuronal senescence. In recent years, transcriptomics and epigenetic studies have found that gene expression patterns of senescence astrocyte have changed significantly, suggesting that they play an important role in neurodegenerative diseases. This review focuses on astrocyte senescence and its effect on neurodegenerative diseases in order to provide new direction for the mechanism research of astrocyte senescence and neurodegenerative diseases and new target for drug therapy in the future.

To systematically analyze the status of the standardization of basic public health services, the project of basic public health service equalization and the first round of national pilot projects of the standardization of basic public services are carried out to provide support for the promotion of the standardization and equalization of basic public health services. The information about above-mentioned three aspects related to national basic public health services were collected, and a systematic comparison of standardization of basic public health services with the 14 specifications in the National Basic Public Health Service Specification ( the 3 th Edition ) and the 51 pilot projects in the Notice of Carrying Out the Pilot Work of National Basic Public Service Standardization was conducted. The current public health standards are basically in line with the requirement of the resident health record management service specifications. However, the public health standards related to public health projects in other 13 service specifications and national basic public health service standardization pilot projects are incomplete or absent. The current public health standards cannot fully meet the requirements of the implementation of national basic public health services. In the process of promoting the equalization of basic public health service, it is urgent to develop targeted public health standards in related fields.

Objective: To evaluate the role of hippocampal CD200 receptor 1 (CD200R1) in perioperative neurocognitive disorders (PND) in mice. Methods: Sixty clean-grade male C57BL/6 mice, aged 9-10 months, weighing 32-38 g, were used in the study.The experiment was performed in two parts.Experiment Ⅰ Thirty-six mice were divided into 2 groups (n=18 each) using a random number table method: control group (group C) and PND group.Group C only received isoflurane anesthesia.Partial left lobectomy of the liver was performed under isoflurane anesthesia in group PND.Contextual fear conditioning test was performed at 1, 3 and 7 days after surgery, and the freezing time was recorded.The mice were then sacrificed, and the hippocampus was isolated for determination of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) contents (by enzyme-linked immunosorbent assay) and CD200 and CD200R1 expression (by Western blot). Experiment Ⅱ Twenty-four mice were divided into 2 groups (n=12 each) using a random number table method: CD200-Fc group and IgG1-Fc group.Recombinant proteins CD200-Fc and human IgG1-Fc were injected into the lateral cerebral ventricle in CD200-Fc group and IgG1-Fc group, respectively.Partial left lobectomy of the liver was performed after the end of injection.Contextual fear conditioning test was performed at 1 and 3 days after surgery, and the freezing time was recorded. Results: Experiment Ⅰ Compared with group C, the freezing time in the contextual fear conditioning test was significantly shortened, and the contents of IL-1β were increased at 1 and 3 days after surgery, the contents of TNF-α were increased at 3 and 7 days after surgery, and the expression of CD200 and CD200R1 was up-regulated at 1 day after surgery in group PND (P<0.05). Experiment Ⅱ Compared with IgG1-Fc group, the freezing time in the contextual fear conditioning test was significantly prolonged at 1 day after surgery in CD200-Fc group (P<0.05). Conclusion Up-regulated expression of hippocampal CD200R1 is the endogenous protective mechanism of PND in mice.

Objective To evaluate the role of hippocampal CD200 receptor 1(CD200R1)in peri-operative neurocognitive disorders(PND)in mice.Methods Sixty clean-grade male C57BL/6 mice,aged 9-10 months,weighing 32-38 g,were used in the study.The experiment was performed in two parts.Ex-periment Ⅰ Thirty-six mice were divided into 2 groups(n＝18 each)using a random number table meth-od: control group(group C)and PND group.Group C only received isoflurane anesthesia.Partial left lo-bectomy of the liver was performed under isoflurane anesthesia in group PND.Contextual fear conditioning test was performed at 1,3 and 7 days after surgery,and the freezing time was recorded.The mice were then sacrificed,and the hippocampus was isolated for determination of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)contents(by enzyme-linked immunosorbent assay)and CD200 and CD200R1 expression(by Western blot).ExperimentⅡ Twenty-four mice were divided into 2 groups(n＝12 each)using a random number table method: CD200-Fc group and IgG1-Fc group.Recombinant proteins CD200-Fc and human IgG1-Fc were injected into the lateral cerebral ventricle in CD200-Fc group and IgG1-Fc group,respectively.Partial left lobectomy of the liver was performed after the end of injection.Contextual fear conditioning test was performed at 1 and 3 days after surgery,and the freezing time was recorded.Re-sults Experiment Ⅰ Compared with group C,the freezing time in the contextual fear conditioning test was significantly shortened,and the contents of IL-1β were increased at 1 and 3 days after surgery,the contents of TNF-α were increased at 3 and 7 days after surgery,and the expression of CD200 and CD200R1 was up-regulated at 1 day after surgery in group PND(P＜0.05).ExperimentⅡ Compared with IgG1-Fc group,the freezing time in the contextual fear conditioning test was significantly prolonged at 1 day after surgery in CD200-Fc group(P＜0.05).Conclusion Up-regulated expression of hippocampal CD200R1 is the endogenous protective mechanism of PND in mice.