Objective To investigate the mechanism of abdominal massage for treating chronic fatigue syndrome(CFS).Methods Thirty clean-grade female Sprague-Dawley rats were randomly divided into the normal control,model control,and abdominal massage groups(n=10 rats per group).The CFS rat model was established through cold water swimming combined with the chronic restraint method in the model control and abdominal massage groups.The rats in the abdominal massage group were treated with the core techniques of Jingu zang-fu massage,namely layer press"Guanyuan"(CV4)for 8 min and Tuanmo"Zhongwan"(CV12)for 12 min as the primary intervention techniques,once a day for 14 consecutive days.The rats in the two control groups did not receive intervention;however,they were bound to the experimental bench when the experimental group was massaged.After the intervention,the indexes of the main organs of the hypothalamic-pituitary-adrenal(HPA)axis and hippocampal cell apoptosis in each group were measured.The morphology of hippocampal cells in each group was observed using Nissl staining of hippocampal tissue and transmission electron microscopy of hippocampal neurons.Results The index of each organ in the model control group was upregulated(P<0.01)compared to that of the normal control group.In contrast,the index of each organ in the abdominal massage group was downregulated(P<0.01)compared with that of the model control group.Compared to the normal control group,the index of each organ in the abdominal massage group was upregulated;however,the difference was not significant.Compared to the normal control group,the cell nuclei in the model control group were significantly consolidated,the nuclear membrane structure was ruptured,and the margins were irregular.Most of the cell morphology in the abdominal massage group was normal compared with that of the model control group,and a small number of nuclear membrane structures were unclear.Compared to the normal control group,the hippocampal neuronal cell in the other two groups was significantly damaged,and the hippocampal neuronal cell in the abdominal massage group was in good condition compared to the model control group.The degree of neuronal apoptosis in the model control group was significantly higher than that in the normal control group(P<0.01).The degree of neuronal apoptosis in the abdominal massage group decreased compared to that of the model control group(P<0.01),which was slightly higher than that in the normal control group but not significant.Conclusion Cold water swimming combined with chronic restraint can simulate CFS in rats,and abdominal massage can reduce the organ index of the hypothalamus,pituitary gland,and adrenal gland,increase hippocampal cell activity,reduce hippocampal tissue damage,inhibit hippocampal cell apoptosis,and maintain the normal physiological function of hippocampal neurons.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective:To develop an online interactive cytopathological training program, and to evaluate it for improving the cytopathological diagnostic ability of endoscopists in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreas.Methods:A total of 5 500 cytopathological images were collected from 194 patients with pancreatic solid mass who underwent EUS-FNA in Nanjing Drum Tower Hospital from August 2018 to August 2019. The cell type in each cytopathological picture was labeled by senior cellular pathologists, which was used to build a learning and testing platform for online interactive cytopathological training. Five endoscopists without cytopathological background were invited to participate in this training. Sensitivity, specificity, positive predictive value and negative predictive value of endoscopists in differential diagnosis of cancer and non-cancer before and after training were compared to evaluate the effect of the online interactive cytopathological training program on improving the ability of endoscopists in diagnosis of cytopathology.Results:A cytopathological training platform for endoscopists to learn and take online test was successfully built. Before training, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis of cancer and non-cancer for endoscopists were 0.55 (95% CI: 0.53-0.58), 0.32 (95% CI: 0.30-0.35), 0.43 (95% CI: 0.41-0.45), 0.44 (95% CI: 0.41-0.47) and 0.43 (95% CI: 0.42-0.45), respectively. After training, the above indicators were 0.96 (95% CI: 0.95-0.97), 0.70 (95% CI: 0.68-0.73), 0.74 (95% CI: 0.72-0.76), 0.95 (95% CI: 0.94-0.96) and 0.81 (95% CI: 0.80-0.83), respectively, which were significantly improved compared with those before ( P<0.001). Conclusion:The online interactive cytopathological training program can improve the understanding and diagnostic ability of endoscopists in pancreatic cytopathology, help to implement rapid on-site evaluation in the process of EUS-FNA, and improve the diagnostic efficiency of EUS-FNA.

Objective:To understand the sleep quality and mental health status of nurses in public health emergencies, and analyze the correlation between them.Methods:A total of 128 first-line nursing staff participating in public health emergencies on February 22-23, 2020 in Tianjin Beichen Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital were investigated by the general data questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist 90 (SCL-90).Results:70.3%(90/128) of nursing staff had poor sleep quality, and the total score of PSQI was (9.71±4.01) points, which was statistically significant compared with the domestic norm ( t value was 16.479, P<0.01). The total score of SCL-90 was 1.59±0.52, which was statistically significant compared with the domestic norm ratio ( t value was 4.505, P<0.01). One-way ANOVA showed that the nursing staff's age had a significant impact on sleep quality, and the difference was statistically significant ( F value was 4.092, P<0.05). Pearson correlation analysis showed that the Pittsburgh sleep quality scale index scores and symptom self-assessment scale and somatization, force, sensitive interpersonal relationship, depression, anxiety, hostile, terrorist, paranoia, and psychosis were positively correlated( r values were 0.292-0.444, P< 0.01). Conclusions:The sleep quality and mental health status of nurses in public health emergencies are poor, and the sleep quality is correlated with mental health status.

Mogrosides, the main sweet components isolated from Siraitia grosvenorii, are a family of cucurbitane-type tetracyclic triterpenoid saponins. Given that the high sweetness, low calorie and excellent taste, mogrosides have become the important resource for the development of natural non-nutritive sweeteners. As reported, 11α-hydroxyl group in the structural skeleton of mogrosides was closely related to sweetness and taste, but it had not been confirmed experimentally. In this work, we used mogroside IIIE as a model compound, which was 300 times sweeter than 5% sucrose and tasted better, and modified its 11α-hydroxyl group through glycosyltransferase to elucidate the relations between structure and sweetness of mogroside compounds. The glycosyltransferase HXSW-GT-2 was obtained to regio-selectively glycosylate the 11α-hydroxyl group of mogroside IIIE through the screening of glycosyltransferase library. And then, the soluble expression of HXSW-GT-02 in Escherichia coli was efficiently achieved by optimizing the induction conditions. Subsequently, the yield of glycosylated mogroside IIIE(MG-IIIE-Glu)was increased to > 85% through optimizing reaction pH, temperature, UDP-G dosage and biocatalyst loading. The product MG-IIIE-Glu was bio-prepared at a 0. 5 L scale and the final purity was 97. 8%. A “mouth feel” test showed that MG-IIIE-Glu had no sweetness and displayed obvious bitterness through the comparison with mogroside IIIE and 5% sucrose. In conclusion, the function of the 11α-hydroxyl group of mogrosides in sweetness and taste was preliminarily elucidated which would be beneficial for the structural modification and development of mogroside sweeteners.

Objective To determine the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for gastrointestinal lesions with inconclusive endoscopic biopsies. Methods A retrospective analysis was performed in 65 patients who were found to have gastrointestinal lesions with inconclusive endoscopic biopsies and underwent EUS-FNA in Drum Tower Hospital. Diagnostic value of EUS-FNA was determined by comparing with surgical histopathology and follow-up results. Results This study included 41 males ( 63％) and 24 females ( 37％) with median age of 60 years. The most common lesion was diffuse infiltrative lesions ( 37, 56. 9％) , followed by submucosal protrusion types ( 17, 26. 2％) . Fifty-four cases ( 83. 1％) were malignant lesions, and 11 cases ( 16. 9％) were benign. The overall sensitivity, specificity, and accuracy of EUS-FNA for gastrointestinal lesions with inconclusive biopsies were 76. 8％ ( 95％CI: 65. 7％-87. 8％) , 100. 0％ ( 95％CI: 66. 4％-100. 0％) , and 80. 0％( 95％CI: 70. 3％-89. 7％) , respectively. Sub-group analysis showed the sensitivity, specificity, and accuracy of EUS-FNA for diffuse infiltrative lesions were 70. 6％ ( 95％CI: 55. 3％-85. 9％, 100. 0％( 95％CI:29. 2％-100. 0％) , and 73. 0％ ( 95％CI: 58. 7％-87. 3％) , respectively. For submucosal protrusions, the sensitivity, specificity, and accuracy of EUS-FNA were 68. 8％ ( 95％CI: 46. 0％ -91. 5％) , 100. 0％ ( 95％CI: 2. 5％-100. 0％) , and 70. 6％ ( 95％CI: 44. 0％-89. 7％) , respectively. Conclusion EUS-FNA has moderate diagnostic value for endoscopic biopsy-inconclusive gastrointestinal lesions. It can be an alternative option when standard methods, such as endoscopic mucosal forceps biopsy, fail to provide a definitive diagnosis.

Finite element method (FEM) was used to investigate the biomechanical properties of three types of surgical fixations of U-shaped sacral fractures. Based on a previously established and validated complete lumbar-pelvic model, three models of surgical fixations of U-shaped sacral fractures were established: ① S1S2 passed through screw (S1S2), ② L4-L5 pedicle screw + screw for wing of ilium (L4L5 + IS), and ③ L4-L5 pedicle screw + S1 passed through screw + screw for wing of ilium (L4L5 + S1 + IS). A 400 N force acting vertically downward, along with torque of 7.5 N·m in different directions (anterior flexion, posterior extension, axial rotation, and axial lateral bending), was exerted on the upper surface of L4. Comparisons were made on differences in separation of the fracture gap and maximum stress in sitting and standing positions among three fixation methods. This study showed that: for values of separation of the fracture gap produced by different operation groups in different positions, L4L5 + S1 + IS was far less than L4L5 + IS and S1S2. For internal fixators, the maximum stress value produced was: L4L5 + IS > L4L5 + S1 + IS > S1S2. For the intervertebral disc, the maximum stress value produced by S1S2 is much larger than that of L4L5 + S1 + IS and L4L5 + IS. In a comprehensive consideration, L4L5 + S1 + IS could be prioritized for fixation of U-shaped sacral fractures. The objective of this research is to compare the biomechanical differences of three different internal fixation methods for U-shaped sacral fractures, for the reference of clinical operation.
Biomechanical Phenomena ; Finite Element Analysis ; Fracture Fixation ; methods ; Humans ; Lumbar Vertebrae ; Pedicle Screws ; Sacrum ; injuries ; Spinal Fractures ; surgery ; Spinal Fusion

Objective To study the operation method of modified Lichtenstein herniorrhaphy in patients with femoral hernia.Methods The clinical data of 37 femoral hernia patients having underwent the modified Lichtenstein herniorrhaphy from January 2010 to January 2017 were retrospectively analyzed. Results The average operation time was 50 min, and average hospitalization day was 5.6 d. During the follow-up period,the postoperative pain and foreign body sensation were mild,no recurrence of femoral hernia was found,and no complications such as postoperative infection,testicular atrophy and painful ejaculation occurred. Conclusions Modified Lichtenstein herniorrhaphy for femoral hernia is effective.

Objective To evaluate the safety and feasibility of step-by-step balloon dilatation combined with contineous biliary drainage in treating benign biliary-enteric anastomosis stricture.Methods The clinical data and imaging materials of 49 patients with benign biliary-enteric anastomosis stricture,who were admitted to authors' hospital during the period from January 2008 to March 2014 to receive treatment,were retrospectively analyzed.Before treatment,the diagnosis of benign biliary-enteric anastomosis stricture was confirmed in all patients by color Doppler ultrasound,MRI and/or contrast-enhanced CT scan,endoscopic or DSA-guided anastomosis biopsy.Among the 49 patients,23 patients (study group) were treated with percutaneous transhepatic step-by-step balloon dilatation (the diameter of used balloon was 8 mm initially,then 10 mm balloon was used in the second month,and 12 mm balloon was used in the third month) together with contineous biliary drainage (lasting for 6 months);26 patients (control group) were treated with single percutaneous transhepatic balloon dilatation (balloon diameter of 6 mm or 8 mm) plus biliary drainage (lasting for 6 months).The improvement of clinical symptoms,the incidence of postoperative complications,and the anastomotic patency rate were compared between the two groups.Results Technical success was obtained in all patients.No procedure-related complications,such as biliary tract hemorrhage and perforation,occurred.One week after the treatment,the difference in bilirubin level between the two groups was not statistically significant (P＞0.05).Although the difference in 3-month anastomotic patency rate between the two groups was not statistically significant,the 6-month,12-month and 24-month anastomotic patency rates of the study group were significantly higher than those of the control group (P＜0.05).Three patients in the study group developed recurrent jaundice at 11.2,14.3 and 17.6 months after treatment respectively;MRI and contrast-enhanced CT scan confirmed the diagnosis of anastomotic stricture recurrence,and balloon dilatation together with drainage tube placement had to be carried out again.In the control group,16 patients developed recurrent jaundice within 3.1-17.1 months after balloon dilatation management,among them one patient died of disseminated intravascular coagulation and the remaining 15 patients received balloon dilatation together with drainage tube placement again.Conclusion For benign biliary-enteric anastomosis strictures,step-by-step balloon dilatation combined with persistent biliary drainage is a safe and effective minimally-invasive treatment.