Objective To explore the protective effect of polydatin and its mechanism on secondary liver injury in silicosis rats based on network pharmacology and animal experiments. Methods i) Network pharmacology study. Based on multiple databases, the targets of polydatin effect related to silicosis and liver injury were collected, and the common targets of polydatin-silicosis-liver injury were screened to construct a protein-protein interaction network. Enrichment analyses were performed to identify core targets involved in the effects of polydatin on silicosis-associated secondary liver injury. The mechanism of action of polydatin in relieving silicosis and silicosis-associated secondary liver injury was investigated, in which polydatin served as molecular docking ligand. ii) Animal experimental validation. Specific pathogen free male SD rats were randomly divided into three groups, with 10 rats per group. Rats in the model and intervention groups received 1 mL of a silica suspension at a mass concentration of 50 g/L for modeling using a one-time non-tracheal exposure method. Then rats in the intervention group were injected intraperitoneally with polydatin solution at 30 mg/kg body weight, once daily starting from the first day after silica exposure, whereas rats in the control group received no treatment. Lung and liver histopathology of rats, which were randomly sacrificed on days 28 and 56 post-exposure in both groups, were examined. Biomarkers of liver injury and hepatic oxidative stress were measured, and hepatic expression of nuclear factor erythroid 2-related factor 2 (NRF2) related proteins was detected by Western blotting. Results i) Network pharmacology study results. A total of 137 polydatin-related targets, 14 812 silicosis-related targets, and 3 038 liver injury-related targets were identified, among which 69 were common targets and 28 were key targets. Gene Ontology analysis indicated that the key targets were involved in 1 883 pathways. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis identified 137 pathways related to the targets. Molecular docking showed good binding affinities between polydatin and B-cell lymphoma 2 (BCL2), interleukin 6 (IL-6), tumor necrosis factor (TNF), and NRF2. ii) Animal experimental validation results. Compared with the control group, rats in the model group showed increased collagen deposition in both lung and liver tissues, with hepatic degeneration, necrosis, and inflammatory cell infiltration on days 28 and 56 after silica exposure. The collagen in lung and liver tissues of rats on days 28 and 56 after silica exposure increased in the model group compared with the control group (all P<0.05). Meanwhile, serum alanine aminotransferase and aspartate aminotransferase activities, hepatic lactate dehydrogenase 5 activities and NADPH: quinone oxidoreductase 1 (NQO1) expression in liver tissue increased (all P<0.05), whereas hepatic superoxide dismutase activity and NRF2 expression were decreased (all P<0.05). The level of malondialdehyde and the relative expression of heme oxygenase-1 (HO-1) protein in liver tissue in rat of model group were higher than those in the control group (all P<0.05). These alterations were ameliorated in rats of the intervention group compared with the model group (all P<0.05). Conclusion Polydatin exerts protective effects against secondary liver injury in rats with silicosis. These effects may be mediated by regulation of core targets such as BCL2, IL6, TNF, and NRF2, modulation of inflammatory pathways including TNF and IL17 signaling, and activation of the NRF2/HO-1 pathway, thereby exerting synergistic anti-inflammatory, antioxidant, and antifibrotic effects via the "lung-liver axis".

[Objective]To explore the alleviating effect of Yunpi Yishen Tongdu Decoction on spinal lesion and immune inflammation of ankylosing spondylitis(AS)model mice,and to provide a scientific basis for its clinical application.[Methods]A total of 42 female BALB/c mice were randomly divided into blank group,model group,western medicine group,low,medium and high dose Yunpi Yishen Tongdu Decoction groups.Except for blank group,the remaining 5 groups were injected with proteoglycans in the abdominal cavity to construct AS model.After modeling,the mice in blank group and model group were given 0.9％sodium chloride solution,the mice in western medicine group were given 3.57 mg·mL-1 celecoxib solution,and the mice in the low,medium,and high dose Yunpi Yishen Tongdu Decoction were given 0.9,1.8 and 3.6 mg·mL-1 of Yunpi Yishen Tongdu Decoction for 4 weeks,respectively.After gavage,the behavioral changes,serum inflammation cytokines,spinal lesions,and expression of receptor activator of nuclear factor-κB ligand(RANKL),receptor activator of nuclear factor-κB(RANK),and osteoclastogenesis inhibitory factor(OPG)in the spine were measured.[Results]Compared with blank group,model group had significantly increased total time in tail immobility,serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)level,spinal pathological score,RANKL and RANK expression(P＜0.01,P＜0.05),while the vertebral bone mineral density and OPG expression of the spine were significantly decreased(P＜0.01).After treatment with the Yunpi Yishen Tongdu Decoction,the latency time in tail immobility in AS mice was significantly reduced,along with decreased serum levels of IL-6 and TNF-α and a notable reduction in spinal pathological scores(P＜0.01,P＜0.05).Additionally,the treatment downregulated RANKL and RANK expression,upregulated OPG expression(P＜0.01,P＜0.05).[Conclusion]Yunpi Yishen Tongdu Decoction alleviates the bone destruction of AS by affecting the RANKL/RANK/OPG pathway.

Objective:To investigate the application effect of teaching rounds with problem-based learning (PBL) and clinical teaching unit (CTU) in standardized residency training for anesthesiology.Methods:A total of 40 resident trainees in Department of Anesthesiology, The First Affiliated Hospital of Soochow University, were randomly divided into research group and control group, with 20 trainees in each group. In the first stage (1-4 months), the trainees in the research group received PBL-CTU teaching rounds, and those in the control group received conventional teaching rounds; in the second stage (5-8 months), both groups received the PBL-CTU teaching rounds. The two groups were compared in terms of general information, assessment results of theoretical knowledge and skill operation in the first and second stages, and questionnaire survey of the degree of satisfaction with teaching. SPSS 24.0 was used for statistical analysis; the t-test was used for continuous data, and the chi-square test was used for categorical data. Results:There were no significant differences between the two groups in terms of age, sex, educational level, residency grade, and comprehensive ability assessment before the study. After the first stage of training, compared with the control group, the research group had significantly better theoretical assessment score [(85.30±3.39) vs. (81.15±4.66), P=0.003], skill assessment score [(83.95±4.37) vs. (79.70±6.20), P=0.017], and effective communication ability (95.00% vs. 65.00%, P=0.048) and team collaboration ability (100.00% vs. 65.00%, P=0.013) in questionnaire survey of the degree of satisfaction with teaching. After the second stage of training, both groups had significant increases in theoretical assessment score [the research group: (89.30±4.12) vs. (85.30±3.39), P=0.002; the control group: (88.90±3.49) vs. (81.15±4.66), P<0.001] and skill assessment score [the research group: (88.40±4.84) vs. (83.95±4.37), P=0.004; the control group: (86.20±4.98) vs. (79.70±6.20), P=0.001], and the questionnaire survey showed that a relatively high degree of satisfaction (95.00%-100.00%) was achieved for teaching effect, while there were no significant differences in each indicator between the two groups. Conclusions:Compared with conventional teaching rounds, PBL-CTU teaching rounds significantly improve the levels of theoretical knowledge and clinical operation ability and enhance the quality of teaching rounds. All residents have achieved satisfactory learning outcomes and progress after the two stages of teaching activities.

[Objective]To explore the alleviating effect of Yunpi Yishen Tongdu Decoction on spinal lesion and immune inflammation of ankylosing spondylitis(AS)model mice,and to provide a scientific basis for its clinical application.[Methods]A total of 42 female BALB/c mice were randomly divided into blank group,model group,western medicine group,low,medium and high dose Yunpi Yishen Tongdu Decoction groups.Except for blank group,the remaining 5 groups were injected with proteoglycans in the abdominal cavity to construct AS model.After modeling,the mice in blank group and model group were given 0.9％sodium chloride solution,the mice in western medicine group were given 3.57 mg·mL-1 celecoxib solution,and the mice in the low,medium,and high dose Yunpi Yishen Tongdu Decoction were given 0.9,1.8 and 3.6 mg·mL-1 of Yunpi Yishen Tongdu Decoction for 4 weeks,respectively.After gavage,the behavioral changes,serum inflammation cytokines,spinal lesions,and expression of receptor activator of nuclear factor-κB ligand(RANKL),receptor activator of nuclear factor-κB(RANK),and osteoclastogenesis inhibitory factor(OPG)in the spine were measured.[Results]Compared with blank group,model group had significantly increased total time in tail immobility,serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)level,spinal pathological score,RANKL and RANK expression(P＜0.01,P＜0.05),while the vertebral bone mineral density and OPG expression of the spine were significantly decreased(P＜0.01).After treatment with the Yunpi Yishen Tongdu Decoction,the latency time in tail immobility in AS mice was significantly reduced,along with decreased serum levels of IL-6 and TNF-α and a notable reduction in spinal pathological scores(P＜0.01,P＜0.05).Additionally,the treatment downregulated RANKL and RANK expression,upregulated OPG expression(P＜0.01,P＜0.05).[Conclusion]Yunpi Yishen Tongdu Decoction alleviates the bone destruction of AS by affecting the RANKL/RANK/OPG pathway.

Objective To analyze the modeling and evaluation method for vascular restenosis animal models in the last 10 years,to provide a reference for improving animal models of vascular restenosis.Methods Literature related to vascular restenosis was retrieved from mainstream Chinese and English databases from 2013 to 2023.Data on experimental animal strains,modeling method,modeling cycles,and detection method were extracted from the included literature,and a database was established using Excel for summary analysis.Results Among the 122 identified articles,the main experimental animals were rats,rabbits,and pigs,and most animals were male.The most common modeling method was balloon injury,and the modeling cycle was mainly within 4～8 weeks.The main detection indexes were histopathology,accounting for 37.18％,including routine hematoxylin-eosin,Masson,and Elastica van Gieson(EVG)staining.Conclusions The translatability of porcine vascular restenosis models is currently more in line with expectations,but their cost is high and they are unpopular,and rats and rabbits thus remain the main animal models.Balloon injury is the main mode of modeling.Different animal models and modeling method for vascular restenosis have advantages and disadvantages,and the model should be selected according to the experimental purpose.Animal models of vascular restenosis still have some limitations,however,and better animal models are required in the future.

Objective To analyze the modeling and evaluation method for vascular restenosis animal models in the last 10 years,to provide a reference for improving animal models of vascular restenosis.Methods Literature related to vascular restenosis was retrieved from mainstream Chinese and English databases from 2013 to 2023.Data on experimental animal strains,modeling method,modeling cycles,and detection method were extracted from the included literature,and a database was established using Excel for summary analysis.Results Among the 122 identified articles,the main experimental animals were rats,rabbits,and pigs,and most animals were male.The most common modeling method was balloon injury,and the modeling cycle was mainly within 4～8 weeks.The main detection indexes were histopathology,accounting for 37.18％,including routine hematoxylin-eosin,Masson,and Elastica van Gieson(EVG)staining.Conclusions The translatability of porcine vascular restenosis models is currently more in line with expectations,but their cost is high and they are unpopular,and rats and rabbits thus remain the main animal models.Balloon injury is the main mode of modeling.Different animal models and modeling method for vascular restenosis have advantages and disadvantages,and the model should be selected according to the experimental purpose.Animal models of vascular restenosis still have some limitations,however,and better animal models are required in the future.

Objective:To investigate the application effect of teaching rounds with problem-based learning (PBL) and clinical teaching unit (CTU) in standardized residency training for anesthesiology.Methods:A total of 40 resident trainees in Department of Anesthesiology, The First Affiliated Hospital of Soochow University, were randomly divided into research group and control group, with 20 trainees in each group. In the first stage (1-4 months), the trainees in the research group received PBL-CTU teaching rounds, and those in the control group received conventional teaching rounds; in the second stage (5-8 months), both groups received the PBL-CTU teaching rounds. The two groups were compared in terms of general information, assessment results of theoretical knowledge and skill operation in the first and second stages, and questionnaire survey of the degree of satisfaction with teaching. SPSS 24.0 was used for statistical analysis; the t-test was used for continuous data, and the chi-square test was used for categorical data. Results:There were no significant differences between the two groups in terms of age, sex, educational level, residency grade, and comprehensive ability assessment before the study. After the first stage of training, compared with the control group, the research group had significantly better theoretical assessment score [(85.30±3.39) vs. (81.15±4.66), P=0.003], skill assessment score [(83.95±4.37) vs. (79.70±6.20), P=0.017], and effective communication ability (95.00% vs. 65.00%, P=0.048) and team collaboration ability (100.00% vs. 65.00%, P=0.013) in questionnaire survey of the degree of satisfaction with teaching. After the second stage of training, both groups had significant increases in theoretical assessment score [the research group: (89.30±4.12) vs. (85.30±3.39), P=0.002; the control group: (88.90±3.49) vs. (81.15±4.66), P<0.001] and skill assessment score [the research group: (88.40±4.84) vs. (83.95±4.37), P=0.004; the control group: (86.20±4.98) vs. (79.70±6.20), P=0.001], and the questionnaire survey showed that a relatively high degree of satisfaction (95.00%-100.00%) was achieved for teaching effect, while there were no significant differences in each indicator between the two groups. Conclusions:Compared with conventional teaching rounds, PBL-CTU teaching rounds significantly improve the levels of theoretical knowledge and clinical operation ability and enhance the quality of teaching rounds. All residents have achieved satisfactory learning outcomes and progress after the two stages of teaching activities.

ObjectiveTo explore the distribution of pharyngeal microbiota in coal miners exposed to dust. Methods Eight coal miners who had been engaged in occupational dust exposure for more than 20 years were selected as the dust-exposed group, and four coal miners who were not exposed to dust at work were selected as the control group using the judgment sampling method. Pharyngeal secretions of the coal miners were collected with throat swabs, and its pharyngeal microbiota was analyzed. The diversity, abundance and evenness of the microbiota were analyzed by gene sequencing using the 16sRNA gene high-throughput sequencing technology. Results A total of 254 operational taxonomic units of pharyngeal microbiota were detected in the coal miners in the control group, which was 210 more than that in the dust-exposed group. The Chao1 index, Shannon index, PD-tree index and Pielou index of pharyngeal microbiota in the dust-exposed group decreased compared with the control group (all P<0.01). The abundance of Bacteroidetes and Clostridum, at the phylum level, in the pharynx of coal miners in the dust-exposed group was higher than that in the control group (all P<0.05). The abundance of Prevotella, Neisseria, and Monas, at the genus level, in the pharynx of coal miners in the dust-exposed group was higher than that in the control group(all P<0.05), while the abundance of Lactobacillus decreased (P<0.05). The analysis results of the receiver operating characteristic curve showed that Lactobacillus, Fusobacterium and Rothia may play a role for pharyngeal microbiota imbalance prediction in dust-exposed workers, and the area under the curves were all 1.00±0.00. Conclusion The species diversity and evenness of pharyngeal microbiota in coal miners exposed to dust are decreased, which may be related to the continuous inhalation of coal dust that disrupts the microbial environment of the throat.

Background Multi-slice spiral computerized tomography (MSCT) can be used as an auxiliary diagnosis of chest radiography in diagnosis of pneumoconiosis, but there are few studies on the correlations between interstitial images and stage classification of coal workers' pneumoconiosis in the existing literature. Objective To present MSCT imaging manifestations and distribution characteristics of coal workers' pneumoconiosis and complications, evaluate correlations between coal workers' pneumoconiosis stages and pulmonary interstitial lesions, and provide a reliable imaging diagnosis basis for pneumoconiosis interstitial lesions. Methods From June 2022 to June 2023, a total of 1002 patients with coal workers' pneumoconiosis confirmed by the pneumoconiosis diagnostic and identification group in the Department of Occupational Diseases of the Emergency General Hospital were enrolled. MSCT was used to observe the abnormal imaging manifestations of the lungs of coal workers' pneumoconiosis patients and the diseases of pulmonary fibrosis related to their own diseases (thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, subpleural line, intralobular interstitial thickening, honeycomb, and subpleural interstitial thickening), the occurrence of coal workers' pneumoconiosis and complications (old tuberculosis, active tuberculosis, pneumonia, atelectasis, lung cancer, bronchiectasis), and the density, size, and location of pneumoconiosis nodules. Imaging data were analyzed and statistically processed. Results All 1002 patients were male, with an average age of (60.71±6.87) years and an average dust exposure time of (23.01±7.80) years. Among them, there were 470 patients with stage I, 422 patients with stage II, and 110 patients with stage III. There were significant differences in the distribution of thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, intralobular interstitial thickening, subpleural interstitial thickening, and honeycomb across different stages (P<0.05). Statistically significant differences in p, q, and r subsets of round nodules were found in patients with pneumoconiosis at different stages (P<0.05). Observed nodule types included solid nodules, pure ground-glass shadow nodules, and partial solid nodules. There were statistically significant differences in pulmonary tuberculosis and bronchiectasis among different stages of coal workers' pneumoconiosis (P<0.05). There were statistically significant differences in interstitial shadows and patches combined with interstitial shadows among different stages of pneumoconiosis complicated with pneumonia (P<0.05). Conclusion MSCT provides images of the progression of coal workers' pneumoconiosis and have a certain relationship with the stages of coal workers' pneumoconiosis, which is conducive to the formulation of reasonable treatment plans in the early clinical stage. Therefore, in the diagnosis and treatment of pneumoconiosis, a great attention should be paid to the imaging technology of chest computerized tomography, especially the use of MSCT examination.

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO₂/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO₂), maximum metabolic equivalent (METs), and maximum work (W_max). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO₂/kg, AT, EqCO₂, METs, or W_max between the two groups (P>0.05). At the end of the trail, the indicators like pVO₂/kg [(19.81±2.38) mL·(min·kg)⁻¹], AT [(14.48±2.33) mL·(min·kg)⁻¹], METs (5.64±0.69), and W_max [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)⁻¹, (11.70±1.94) mL·(min kg)⁻¹, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO₂ between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.