Astrocytes in the spinal dorsal horn (SDH) exhibit diverse reactive phenotypes under neuropathic conditions, yet the mechanisms driving this diversity and its implications in chronic pain remain unclear. Here, we report that spared nerve injury (SNI) induces marked upregulation of both complement component 3 (C3⁺, A1-like) and S100 calcium-binding protein A10 (S100A10⁺, A2-like) astrocyte subpopulations in the SDH, with elevated microglial cytokines including interleukin-1α, tumor necrosis factor-α, and complement component 1q. Transcriptomic, immunohistochemical, and Western blot analyses reveal co-activation of multiple reactive astrocyte states over a unidirectional shift toward an A1-like phenotype. Fibroblast growth factor 8 (FGF8), a neuroprotective factor via FGFR3, mitigated microglia-induced C3⁺ astrocyte reactivity in vitro and suppressed spinal C3 expression and mechanical allodynia following intrathecal administration in SNI mice. These findings reveal a microglia-astrocyte signaling axis that promotes A1 reactivity and position FGF8 as a promising therapeutic candidate for neuropathic pain by modulating astrocyte heterogeneity.
Animals ; Astrocytes/drug effects* ; Neuralgia/pathology* ; Receptor, Fibroblast Growth Factor, Type 3/metabolism* ; Signal Transduction/physiology* ; Male ; Mice ; Microglia/drug effects* ; Fibroblast Growth Factor 8/pharmacology* ; Mice, Inbred C57BL ; Hyperalgesia/drug therapy* ; Spinal Cord/drug effects* ; Complement C3/metabolism* ; Spinal Cord Dorsal Horn/metabolism*

ObjectiveTo investigate the safety and feasibility of intra-biliary drainage tube placement after laparoscopic common bile duct exploration in elderly patients with choledocholithiasis， and to provide more options for surgical procedures in the clinical management of elderly patients with choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 52 elderly patients with choledocholithiasis who were admitted to Department of Hepatobiliary Surgery， Affiliated Dalian Friendship Hospital of Dalian Medical University， from November 2021 to October 2024. According to the biliary drainage method after surgery， the patients were divided into internal drainage group with 24 patients and T-tube drainage group with 28 patients， and there were 19 patients in each group after propensity score matching. The two groups were compared in terms of perioperative parameters and postoperative complications. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the T-tube drainage group， the internal drainage group had a significantly shorter length of postoperative hospital stay and a significantly lower volume of postoperative bile loss （Z=-2.845 and -5.633， both P<0.05）， while there were no significant differences between the two groups in time of operation， intraoperative blood loss， and drainage tube indwelling time （all P>0.05）. There were no significant differences between the two groups in postoperative bile leak， stone recurrence， biliary stricture， and drainage tube-related complications， and the internal drainage group had a significantly lower total complication rate than the T-tube drainage group ［1 （5.3%） vs 7 （36.8%）， P<0.05］. ConclusionFor elderly patients with choledocholithiasis， intra-biliary drainage tube placement after laparoscopic common bile duct exploration can shorten the length of postoperative hospital stay， reduce bile loss， and lower the incidence rate of postoperative complications， thereby helping to accelerate postoperative recovery.

Objective To investigate the clinical efficacy of infrared thermal imaging technology-assisted CT-guided spinal dorsal root ganglion pulse radiofrequency(DRG-PRF)combined with ozone therapy in treating patients with acute herpes zoster.Methods A total of 128 patients with acute herpes zoster,who were admitted to Hengshui Municipal People's hospital between March 2021 and March 2024 to receive treatment,were enrolled in this study.Using SPSS,the patients were simply and randomly divided into the control group(n=64,receiving conventional DRG-PRF combined with ozone therapy)and the study group(n=64,receiving infrared thermal imaging technology-assisted CT-guided DRG-PRF combined with ozone therapy).The patients were followed up for 3 months.The pain numerical score(NRS),Pittsburgh Sleep Quality Index(PSQI),36-item health survey Summary Form(SF-36)score,skin temperature difference(ΔT),and adverse reactions were compared between the two groups.Results Compared with the control group,in the study group the postoperative one-day,3-day,5-day,7-day,and one-month NRS scores were lower(P＜0.05);the postoperative one-month,2-month and 3-month PSQI scores and the ΔT were lower,and the postoperative one-month,2-month and 3-month SF-36 scores were higher(P＜0.05).No statistically significant difference in the incidence of adverse reactions existed between the two groups(P＞0.05).Conclusion In treating patients with acute herpes zoster,infrared thermal imaging technology-assisted CT-guided DRG-PRF combined with ozone therapy can significantly relieve pain,improve quality of sleep and life of patients,reduce the skin temperature difference on the affected side,besides,this technique carries certain clinical safety.

Objective:This study based on comprehensive bioinformatics technology aimed to investigate the pathogenesis of ferroptosis in IgA nephropathy(IgAN)from an immunological perspective,and to identify the key genes and functional pathways.Methods:Differentially expressed ferroptosis-related genes(DE-FRGs)were identified from GSE93798 and analyzed by Kyoto Ency-clopedia of Genes and Genomes(KEGG)and Gene Ontology(GO).STRING and Cytoscape were used to construct a protein-protein interaction(PPI)network.Degree and MCODE algorithm were run.Combining LASSO regression,SVM-RFE and PLS-DA machine learning to construct the optimal feature selection hub gene.Cibersort and ssGESA algorithms were used to assess the immune infiltra-tion,as well as to explore the relationship between hub genes and immune infiltration.Single cell RNA sequence(scRNA-seq)data was used to analyze the location of hub genes in IgAN cell populations.Gene Set Enrichment Analysis(GSEA)was performed on hub genes.The HPA database was used to obtain the position of the specific protein of the hub genes,and the DsigDB database was used to predict the target drug.The GSE37460,GSE116626 and GSE73953 were treated as validation sets and diagnostic effectiveness evalua-tion.Collecting IgAN and healthy kidney tissue for immunohistochemical testing of hub genes expression.Results:This study identi-fied 94 DE-FRGs and 3 hub genes(JJUN,EGR1 and DDR2).KEGG and GO analysis indicated that the DE-FRGs were mainly con-centrated in pathways of ferroptosis,reactive oxygen species,responsing to oxidative stress and metal particles,mitochondrion,and transcriptional regulatory complex.GESA analysis involved in amino acid and fatty acid metabolism.The analysis of immune cell infil-tration in IgAN revealed an increased ratio of naive B cells,mast cells,and CD4+T cells.Differential analysis of immune function re-vealed that mechanisms such as chemokine receptor signaling pathways,human leukocyte antigen signaling pathways,and inflamma-tion promotion were more active in IgAN.Furthermore,the correlation was observed between immune infiltration and hub genes.ScRNA-seq analysis demonstrated that hub genes were localized in monocytes,macrophages,poximal convoluted tubule cells,princi-pal cells,and smooth muscle cells.Validations set analysis suggested that JUN and SIRT1 had a diagnostic value.The HPA database analysis showed that JUN was mainly located in the nucleus,while EGR1 was located in the membrane and cytoplasm.The 2 278 po-tential drugs for the treatment of IgAN were predicted.Finally,the results of immunohistochemistry and bioinformatics analysis were consistent.Conclusion:Ferroptosis may be associated with immune cell infiltration and immune related function during the occur-rence and development of IgAN.

Objective:To analyze the clinical characteristics of warfarin-related nephropathy (WRN).Methods:Medical records of patients with WRN admitted to Linyi People′s Hospital Affiliated to Shandong Second Medical University from January 1, 2020 to December 31, 2024 were collected. The patients′ basic information (gender, age), warfarin medication details (indications, dosage, frequency, etc.), comorbidities, concomitant medication usage, international normalized ratio (INR) and serum creatinine (Scr) test results before and after the occurrence of WRN, as well as the clinical manifestations, interventions, and outcomes of WRN were extracted. The causal relationship between warfarin and renal dysfunction was evaluated according to the Adverse Drug Reaction Reporting and Monitoring Manual. The clinical data of patients were descriptively and statistically analyzed. Results:A total of 11 patients were entered in the analysis, including 7 males and 4 females; the age ranged from 49 to 85 years, with a median age of 70 years, and 9 cases were older than 60 years. The causality evaluation showed that 3 patients were definite and 8 patients were probable. All the 11 patients had at least one comorbidity, including 6 cases of heart failure, 6 cases of hypoproteinemia, 4 cases of chronic kidney disease, 3 cases of hypertension, 3 cases of pulmonary infection, and 1 case of diabetes. Seven patients were treated with warfarin combined with broad-spectrum antibiotics, 6 combined with diuretics, and 3 combined with renin angiotensin system blockers. The time from the highest INR to the highest Scr level was 0-6 days, with a median time of 2 days, and it was ≤2 days in 9 patients. Six patients had bleeding manifestations such as microscopic hematuria, melena, epistaxis, hematochezia, and skin ecchymosis. Among the 11 patients, 10 stopped warfarin immediately and 1 reduced dosage. All patients received different doses of vitamin K 1 according to the INR level. Among the 6 patients of bleeding, 4 received symptomatic treatments such as omeprazole, tranexamic acid, somatostatin, thrombin powder and octreotide, and 2 patients received hemodialysis due to high Scr level. One patient with severe anemia received blood transfusion. After 1-5 days of treatments (with a median time of 2 days), the INR in all patients decreased to <3.00, of which 5 patients continued to take warfarin, 1 changed warfarin to rivaroxaban, and 5 did not continue anticoagulation therapy. After 2 to 14 days of treatments, Scr in 8 patients recovered to the reference value range, and Scr in 3 patients was still at a high level, of which 1 patient died of unexplained cardiac arrest. Conclusions:WRN is a common adverse reaction of warfarin, with or without bleeding. After the occurrence of WRN, the drug should be stopped as soon as possible and symptomatic treatment should be given. The prognosis is generally good, but it may also lead to chronic kidney disease.

Objective:To analyze the clinical characteristics of warfarin-related nephropathy (WRN).Methods:Medical records of patients with WRN admitted to Linyi People′s Hospital Affiliated to Shandong Second Medical University from January 1, 2020 to December 31, 2024 were collected. The patients′ basic information (gender, age), warfarin medication details (indications, dosage, frequency, etc.), comorbidities, concomitant medication usage, international normalized ratio (INR) and serum creatinine (Scr) test results before and after the occurrence of WRN, as well as the clinical manifestations, interventions, and outcomes of WRN were extracted. The causal relationship between warfarin and renal dysfunction was evaluated according to the Adverse Drug Reaction Reporting and Monitoring Manual. The clinical data of patients were descriptively and statistically analyzed. Results:A total of 11 patients were entered in the analysis, including 7 males and 4 females; the age ranged from 49 to 85 years, with a median age of 70 years, and 9 cases were older than 60 years. The causality evaluation showed that 3 patients were definite and 8 patients were probable. All the 11 patients had at least one comorbidity, including 6 cases of heart failure, 6 cases of hypoproteinemia, 4 cases of chronic kidney disease, 3 cases of hypertension, 3 cases of pulmonary infection, and 1 case of diabetes. Seven patients were treated with warfarin combined with broad-spectrum antibiotics, 6 combined with diuretics, and 3 combined with renin angiotensin system blockers. The time from the highest INR to the highest Scr level was 0-6 days, with a median time of 2 days, and it was ≤2 days in 9 patients. Six patients had bleeding manifestations such as microscopic hematuria, melena, epistaxis, hematochezia, and skin ecchymosis. Among the 11 patients, 10 stopped warfarin immediately and 1 reduced dosage. All patients received different doses of vitamin K 1 according to the INR level. Among the 6 patients of bleeding, 4 received symptomatic treatments such as omeprazole, tranexamic acid, somatostatin, thrombin powder and octreotide, and 2 patients received hemodialysis due to high Scr level. One patient with severe anemia received blood transfusion. After 1-5 days of treatments (with a median time of 2 days), the INR in all patients decreased to <3.00, of which 5 patients continued to take warfarin, 1 changed warfarin to rivaroxaban, and 5 did not continue anticoagulation therapy. After 2 to 14 days of treatments, Scr in 8 patients recovered to the reference value range, and Scr in 3 patients was still at a high level, of which 1 patient died of unexplained cardiac arrest. Conclusions:WRN is a common adverse reaction of warfarin, with or without bleeding. After the occurrence of WRN, the drug should be stopped as soon as possible and symptomatic treatment should be given. The prognosis is generally good, but it may also lead to chronic kidney disease.

Objective:This study based on comprehensive bioinformatics technology aimed to investigate the pathogenesis of ferroptosis in IgA nephropathy(IgAN)from an immunological perspective,and to identify the key genes and functional pathways.Methods:Differentially expressed ferroptosis-related genes(DE-FRGs)were identified from GSE93798 and analyzed by Kyoto Ency-clopedia of Genes and Genomes(KEGG)and Gene Ontology(GO).STRING and Cytoscape were used to construct a protein-protein interaction(PPI)network.Degree and MCODE algorithm were run.Combining LASSO regression,SVM-RFE and PLS-DA machine learning to construct the optimal feature selection hub gene.Cibersort and ssGESA algorithms were used to assess the immune infiltra-tion,as well as to explore the relationship between hub genes and immune infiltration.Single cell RNA sequence(scRNA-seq)data was used to analyze the location of hub genes in IgAN cell populations.Gene Set Enrichment Analysis(GSEA)was performed on hub genes.The HPA database was used to obtain the position of the specific protein of the hub genes,and the DsigDB database was used to predict the target drug.The GSE37460,GSE116626 and GSE73953 were treated as validation sets and diagnostic effectiveness evalua-tion.Collecting IgAN and healthy kidney tissue for immunohistochemical testing of hub genes expression.Results:This study identi-fied 94 DE-FRGs and 3 hub genes(JJUN,EGR1 and DDR2).KEGG and GO analysis indicated that the DE-FRGs were mainly con-centrated in pathways of ferroptosis,reactive oxygen species,responsing to oxidative stress and metal particles,mitochondrion,and transcriptional regulatory complex.GESA analysis involved in amino acid and fatty acid metabolism.The analysis of immune cell infil-tration in IgAN revealed an increased ratio of naive B cells,mast cells,and CD4+T cells.Differential analysis of immune function re-vealed that mechanisms such as chemokine receptor signaling pathways,human leukocyte antigen signaling pathways,and inflamma-tion promotion were more active in IgAN.Furthermore,the correlation was observed between immune infiltration and hub genes.ScRNA-seq analysis demonstrated that hub genes were localized in monocytes,macrophages,poximal convoluted tubule cells,princi-pal cells,and smooth muscle cells.Validations set analysis suggested that JUN and SIRT1 had a diagnostic value.The HPA database analysis showed that JUN was mainly located in the nucleus,while EGR1 was located in the membrane and cytoplasm.The 2 278 po-tential drugs for the treatment of IgAN were predicted.Finally,the results of immunohistochemistry and bioinformatics analysis were consistent.Conclusion:Ferroptosis may be associated with immune cell infiltration and immune related function during the occur-rence and development of IgAN.

Objective: To translate the Maternal Blue Scale (MBS) into Chinese, and evaluate the reliability and validity. Methods: The MBS was translated back-translated, culturally adapted and pre-tested according to the Brislin translation model to develop the Chinese version of MBS. Postpartum women from obstetrics centers in three tertiary general hospitals in Shandong Province were selected using convenience sampling method to assess the reliability and validity of the Chinese version of MBS. Content validity was evaluated based on expert ratings. Criterion-related validity was evaluated using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) as the criterion. Structural validity was evaluated using exploratory and confirmatory factor analyses. Reliability was assessed by calculating Cronbach's α and split-half reliability. Receiver operating characteristic (ROC) curve was plotted to evaluate predictive validity. Results: Totally 500 questionnaires were allocated, and 479 valid ones were recovered, with an effective recovery rate of 95.80%. The Chinese version of MBS consisted of 32 items across 6 dimensions: mother-infant communication, infant feeding, role adaptation, maternal responsibilities, family acceptance and social support. The item-level content validity index ranged from 0.900 to 1.000, and the scale-level content validity index/average was 0.990. The correlation coefficient between the Chinese version of MBS scores and the Chinese version of EPDS scores was 0.675 (P<0.05). Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 74.581%. Confirmatory factor analysis indicated good model fit, with a root mean square error of approximation of 0.014, a goodness of fit index of 0.896, a comparative fit index of 0.996, an incremental fit index of 0.996, a normed fit index of 0.913, and a Tucker-Lewis index of 0.995. The overall Cronbach's α was 0.924, and the split-half reliability was 0.765. The Cronbach's α of each dimension ranged from 0.809 to 0.956, and the split-half reliability ranged from 0.807 to 0.966. The area under the ROC curve was 0.909 (95%CI: 0.880-0.937). At the optimal cutoff score of 75.5, the Youden index reached its maximum of 0.698, with a sensitivity of 0.874 and a specificity of 0.824. Conclusion The Chinese version of MBS has good reliability and validity, and it is suitable to evaluate maternal blue among Chinese postpartum women.

Objective To explore the current status of posttraumatic growth (PTG) among nurses at psychiatric department and analyze its latent profiles and population characteristics. Methods A total of 357 nurses from psychiatric departments of five tertiary Grade A hospitals were selected as the research subjects using the convenience sampling method. The PTG and professional quality of life were studied using the Posttraumatic Growth Inventory and the Chinese version of the Compassion Fatigue Scale. Results The PTG score of the nurses was (56.6±23.2). The scores of compassion satisfaction, burnout, and secondary traumatic stress among nurses were (32.6±7.2), (26.9±5.9), and (26.0±5.4), respectively. The result of potential profile analysis showed that the nurses could be divided into three latent profiles based on PTG levels: low PTG group (34.4%), moderate PTG group (44.0%), and high PTG group (21.6%). The results of multinomial logistic regression analysis showed that the nurses who slept 7-8 hours per day were at higher risk of being in the high PTG group compared with those who slept more than eight hours per day (P<0.05). Psychiatric nurses who took regular exercise were at higher risk of being in the high PTG group compared with those who took irregular exercise (P<0.05). The nurses who had high job satisfaction scores were at higher risk of being in the high PTG group compared with those who had low job satisfaction scores (P<0.01). The nurses with higher compassion satisfaction scores increased the risk of being in the high PTG group compared with those with lower compassion satisfaction scores (P<0.01). The nurses with higher burnout scores increased the risk of being in the low PTG group compared with those with lower burnout scores (P<0.01). Conclusion The PTG characteristics of the nurses exhibit heterogeneity and can be categorized into three distinct profiles. Sleep duration, regular exercise, job satisfaction, compassion satisfaction, and burnout are influencing factors for the PTG latent profiles of nurses working at psychiatric department.