Objective:To evaluate the effect of dexmedetomidine on the viability of dopaminergic neurons in the ventral tegmental area (VTA) of morphine-addicted mice.Methods:Experiment Ⅰ Thirty SPF healthy adult male C57BL/6 mice, aged 8 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) using the random number table method: normal saline group (NS group), dexmedetomidine 50 μg/kg group (DEX50 group), and dexmedetomidine 100 μg/kg group (DEX100 group). A morphine addiction model was established by intraperitoneal injection of increasing doses of morphine (10, 20, 30, 40, 50 and 50 mg/kg) for 6 consecutive days in mice. After the successful establishment of the model, dexmedetomidine 50 and 100 μg/kg were intraperitoneally injected for 14 consecutive days in group DEX50 and group DEX100 respectively, while normal saline was given instead in group C. The conditioned place preference (CPP) experiment was conducted every other day. Experiment Ⅱ Thirty SPF healthy adult male C57BL/6 mice, aged 8 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) by the random number table method: control group (C group), morphine group (Mor group) and dexmedetomidine 50 μg/kg group (DEX50 group). Normal saline was intraperitoneally injected for 10 consecutive days in group C. Morphine with increasing doses was intraperitoneally injected for 6 days, and then normal saline was intraperitoneally injected for 4 consecutive days in group Mor. Morphine with increasing doses was intraperitoneally injected for 6 days, and then dexmedetomidine 50 μg/kg was intraperitoneally injected for 4 consecutive days in group DEX50. The mice were anesthetized at 90 min after the last intraperitoneal injection, brain tissues were harvested, and the corresponding brain slices of the VTA were selected for c-Fos immunofluorescence staining. Experiment Ⅲ Ten dopamine transporter-Cre recombinase mice were divided into 2 groups ( n=5 each) by the random number table method: morphine group (Mor group) and morphine+ dexmedetomidine 50 μg/kg group (Mor+ DEX group). Stereotaxic viral injection was performed in the brain. rAAV-EF1α-DIO-GCaMP6s was injected into the VTA and an optical fiber was implanted. Three weeks later, a morphine addiction model was established based on Experiment Ⅰ for the CPP experiment, morphine was intraperitoneally injected in group Mor, and morphine and dexmedetomidine were intraperitoneally injected in group Mor+ DEX. The viral fluorescence signals were recorded at 5 min before and 20 min after the drug administration in the three groups. Results:Experiment Ⅰ There was no statistically significant difference in the CPP scores after developing the morphine addiction model among the three groups ( P>0.05). Compared with group NS, the CPP scores were significantly decreased at 4-14 days of the continuous administration in group DEX50 and group DEX100 ( P<0.05). Experiment Ⅱ Compared with group C, the number of c-Fos positive cells in the VTA was significantly increased in group Mor ( P<0.05). Compared with group Mor, the number of c-Fos positive cells in the VTA was significantly decreased in group DEX ( P<0.05). Experiment Ⅲ Compared with that before administration, the calcium signals of dopaminergic neurons in the VTA were significantly enhanced in group Mor ( P<0.05), and no statistically significant difference was found in the calcium signals of dopaminergic neurons in the VTA in group Mor+ DEX ( P>0.05). Compared with group Mor, no statistically significant difference was found in the calcium signals of dopaminergic neurons in the VTA before drug administration ( P>0.05), and the calcium signals of dopaminergic neurons in the VTA were significantly weakened after administration in group Mor+ DEX ( P<0.05). Conclusions:The mechanism by which dexmedetomidine promotes the extinction of morphine addiction is related to the inhibition of the viability of dopaminergic neurons in the VTA of mice.

Stent migration is one of the common complications following transcatheter valve implantation. This study aims to design a "drum-shaped" balloon-expandable aortic valve stent to address this issue and conduct a mechanical analysis. The implantation process of the stent was evaluated using a method that combines numerical simulation and in vitro experiments. Furthermore, the fatigue process of the stent under pulsatile cyclic loading was simulated, and its fatigue performance was assessed using a Goodman diagram. The process of the stent migrating toward the left ventricular side was simulated, and the force-displacement curve of the stent was extracted to evaluate its anti- migration performance. The results showed that all five stent models could be crimped into a 14F sheath and enabled uniform expansion of the native valve leaflets. The stress in each stent was below the ultimate stress, so no fatigue fracture occurred. As the cell height ratio decreased, the contact area fraction between the stent and the aortic root gradually decreased. However, the mean contact force and the maximum anti-migration force first decreased and then increased. Specifically, model S5 had the smallest contact area fraction but the largest mean contact force and maximum anti-migration force, reaching approximately 0.16 MPa and 10.73 N, respectively. The designed stent achieves a "drum-shaped" change after expansion and has good anti-migration performance.
Stents ; Prosthesis Design ; Heart Valve Prosthesis ; Humans ; Aortic Valve/surgery* ; Stress, Mechanical ; Transcatheter Aortic Valve Replacement/instrumentation*

Objective:To elucidate the epidemiological characteristics and temporal trends of out-of-hospital cardiac arrest (OHCA) in Shenzhen.Methods:Retrospective data on OHCA cases managed by emergency medical services (EMS) and admitted to network hospitals in Shenzhen from January 1, 2011 to December 31, 2022, were collected following the Utstein template. Demographic characteristics, event information, treatment, and resuscitation outcomes were included. Descriptive statistics, Joinpoint time trend analysis and a multivariate logistic regression were employed to identify factors influencing the return of spontaneous circulation (ROSC) after prehospital resuscitation.Results:A total of 46 053 EMS-accessed OHCA were included, of which 16 330 (35.46%) received EMS resuscitation. The crude incidence of EMS-accessed OHCA increased significantly from 15.51 per 100 000 in 2011 to 44.73 per 100 000 in 2022, with a significant overall upward trend (AAPC=11.83%, 95% CI: 8.33%-15.44%, P<0.001). Among EMS-treated OHCA, the bystander cardiopulmonary resuscitation (CPR) rate rose from 5.11% to 20.90% (AAPC=13.68%, 95% CI: 9.11%-18.44%, P<0.001), while prehospital ROSC rates increased from 2.33% to 8.62% (AAPC=17.53%, 95% CI: 13.01%-22.23%, P<0.001), both showing significant upward trends. Among EMS-treated OHCA patients, those with events occurring in public places (a OR=1.28, 95% CI: 1.06-1.55, P=0.006), presumed cardiovascular etiology (a OR=1.95, 95% CI: 1.65-2.32, P<0.001), initial shockable rhythm on monitoring (a OR=2.56, 95% CI: 1.08-3.15, P<0.001), bystander CPR (a OR=1.43, 95% CI: 1.16-1.76, P<0.001), airway opening (a OR=2.39, 95% CI: 1.70-3.46, P<0.001), and defibrillation (a OR=1.29, 95% CI: 1.06-1.57, P=0.010) had higher ROSC rates. Conversely, males (a OR=0.67, 95% CI: 0.55-0.81, P<0.001), the older (a OR=0.99, 95% CI: 0.98-0.99, P<0.001), and longer symptom onset to call 120 time of [10, 20) min (a OR=0.52, 95% CI: 0.39-0.70, P<0.001), [20, 30) min (a OR=0.33, 95% CI: 0.24-0.47, P<0.001), and ≥ 30 min (a OR=0.35, 95% CI: 0.25-0.49, P<0.001) were associated with lower prehospital resuscitation success rates. Conclusions:The incidence of OHCA in Shenzhen exhibited a significant upward trend from 2011 to 2022. Public location of arrest and early recognition-intervention were critical determinants of outcomes. Enhancing prehospital ROSC requires targeted improvements in the prehospital survival chain, including widespread public CPR training and optimized EMS accessibility.

Objective:To evaluate the effect of dexmedetomidine on the viability of dopaminergic neurons in the ventral tegmental area (VTA) of morphine-addicted mice.Methods:Experiment Ⅰ Thirty SPF healthy adult male C57BL/6 mice, aged 8 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) using the random number table method: normal saline group (NS group), dexmedetomidine 50 μg/kg group (DEX50 group), and dexmedetomidine 100 μg/kg group (DEX100 group). A morphine addiction model was established by intraperitoneal injection of increasing doses of morphine (10, 20, 30, 40, 50 and 50 mg/kg) for 6 consecutive days in mice. After the successful establishment of the model, dexmedetomidine 50 and 100 μg/kg were intraperitoneally injected for 14 consecutive days in group DEX50 and group DEX100 respectively, while normal saline was given instead in group C. The conditioned place preference (CPP) experiment was conducted every other day. Experiment Ⅱ Thirty SPF healthy adult male C57BL/6 mice, aged 8 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) by the random number table method: control group (C group), morphine group (Mor group) and dexmedetomidine 50 μg/kg group (DEX50 group). Normal saline was intraperitoneally injected for 10 consecutive days in group C. Morphine with increasing doses was intraperitoneally injected for 6 days, and then normal saline was intraperitoneally injected for 4 consecutive days in group Mor. Morphine with increasing doses was intraperitoneally injected for 6 days, and then dexmedetomidine 50 μg/kg was intraperitoneally injected for 4 consecutive days in group DEX50. The mice were anesthetized at 90 min after the last intraperitoneal injection, brain tissues were harvested, and the corresponding brain slices of the VTA were selected for c-Fos immunofluorescence staining. Experiment Ⅲ Ten dopamine transporter-Cre recombinase mice were divided into 2 groups ( n=5 each) by the random number table method: morphine group (Mor group) and morphine+ dexmedetomidine 50 μg/kg group (Mor+ DEX group). Stereotaxic viral injection was performed in the brain. rAAV-EF1α-DIO-GCaMP6s was injected into the VTA and an optical fiber was implanted. Three weeks later, a morphine addiction model was established based on Experiment Ⅰ for the CPP experiment, morphine was intraperitoneally injected in group Mor, and morphine and dexmedetomidine were intraperitoneally injected in group Mor+ DEX. The viral fluorescence signals were recorded at 5 min before and 20 min after the drug administration in the three groups. Results:Experiment Ⅰ There was no statistically significant difference in the CPP scores after developing the morphine addiction model among the three groups ( P>0.05). Compared with group NS, the CPP scores were significantly decreased at 4-14 days of the continuous administration in group DEX50 and group DEX100 ( P<0.05). Experiment Ⅱ Compared with group C, the number of c-Fos positive cells in the VTA was significantly increased in group Mor ( P<0.05). Compared with group Mor, the number of c-Fos positive cells in the VTA was significantly decreased in group DEX ( P<0.05). Experiment Ⅲ Compared with that before administration, the calcium signals of dopaminergic neurons in the VTA were significantly enhanced in group Mor ( P<0.05), and no statistically significant difference was found in the calcium signals of dopaminergic neurons in the VTA in group Mor+ DEX ( P>0.05). Compared with group Mor, no statistically significant difference was found in the calcium signals of dopaminergic neurons in the VTA before drug administration ( P>0.05), and the calcium signals of dopaminergic neurons in the VTA were significantly weakened after administration in group Mor+ DEX ( P<0.05). Conclusions:The mechanism by which dexmedetomidine promotes the extinction of morphine addiction is related to the inhibition of the viability of dopaminergic neurons in the VTA of mice.

Objective:To investigate the levels of chemokine 2 (CCL2), chemokine (C-X-C motif) ligand 1 (CXCL1), chemokine (C-X3-C motif) ligand 1 (CX3CL1), and chemokine (C-X-C motif) ligand 10 (CXCL10) in the cerebrospinal fluid of patients with acute and chronic herpes zoster (HZ), and their correlation with the severity of neuropathic pain.Methods:A total of 60 patients with acute herpes zoster and postherpetic neuralgia (PHN) treated at the First Affiliated Hospital of Zhengzhou University from November 2022 to November 2023 were selected for a case-control study. These patients were divided into a HZ group ( n = 25) and a PHN group ( n = 35). The pressure pain threshold in the affected area was measured on the day of admission for all patients. The Visual Analogue Scale scores were evaluated in both groups. After lumbar puncture, 2 mL of cerebrospinal fluid was collected, and the levels of related chemokines in the cerebrospinal fluid were detected using the enzyme-linked immunosorbent assay. Results:In the HZ group, the levels of chemokines CXCL1 and CXCL10 were (24.84 ± 6.97) ng/L and (107.46 ± 28.29) μg/L, respectively, while in the PHN group, they were (20.51 ± 3.16) ng/L and (132.98 ± 30.92) μg/L. The differences in the levels of chemokines CXCL1 and CXCL10 between the two groups were statistically significant ( t = 2.91, -3.26, both P < 0.05). There were no statistically significant differences in the levels of chemokines CCL2 and CX3CL1 between the two groups ( t = 1.62, -0.23, both P > 0.05). The levels of CCL2, CXCL1, CX3CL1, and CXCL10 in both groups were negatively correlated with the pressure pain threshold (HZ group: r = -0.84, -0.78, -0.93, -0.86; PHN group: r = -0.71, -0.78, -0.94, -0.76, all P < 0.01). Conclusion:Higher levels of chemokines in the cerebrospinal fluid of patients with acute and chronic HZ are associated with more pronounced neuropathic pain. The neuro-immune inflammation involving chemokines may be correlated with the severity of neuropathic pain in acute and chronic HZ.

Objective To investigate whether curdione inhibits the formation of deep vein thrombosis(DVT)in rats through thrombolytic effects.Methods Twenty-five rats were randomly divided into five groups,the normal control group,the sham operation group,the model group,the low dose group of curdione(60 mg/kg)and the high dose group of curdione(120 mg/kg),with five rats in each group.Using the inferior vena cava ligation model,blood was taken from the pulmonary aorta in a sodium citrate anticoagulant tube one week after drug administration.The coagulation and fibrinolytic indexes Fibrin Degradation Products,(FDP),D-dimer(D-D),plasminogen activator inhibitor(PAI)-1 and plasminogen(PLG)were detected in each group;the thrombus weight/weight-length ratio was detected;and the formation of venous thrombus in the lower limbs of rats was detected by hematoxylin-eosin(HE)staining nuclear factor;NF-κB protein expression in inferior vena cava tissues was dectected by Western Blot assay.Results There was no significant difference in plasma FDP levels among groups of rats(P＞0.05);compared with the model group,the plasma FDP and D-D levels of rats in each dosing group were increased,the plasma PAI-1 and PLG levels were elevated,and the fibrinolytic effect was better in the group with high dose of curdione administration than in the group with low dose of curdione administration(P＜0.05);compared with the model group,the thrombus weight/weight-length ratio,the thrombus mass and NF-κB protein expression in the curdione dosing group were decreased.Conclusion Curdione can inhibit the formation of DVT in rats by influencing the fibrinolytic regulators.

Objective:To evaluate the role of lactate-induced mitochondrial division of spinal cord neurons in diabetic neuropathic pain (DNP) in mice.Methods:Thirty-six SPF-grade healthy adult male C57BL/6 mice, aged 2 months, weighing 20-25 g, were divided into 3 groups ( n=12 each) using a random number table method: control group (CON group), DNP group, and DNP+ sodium oxalate group (OXA group). The diabetic model was established by intraperitoneal injection of streptozotocin 130 mg/kg. After the diabetic model was successfully established, sodium oxalate 750 mg/kg was intraperitoneally injected once a day for 4 consecutive weeks to inhibit lactate production in OXA group, while the equal volume of normal saline was given instead at the same time in C group and DNP group. The mechanical paw withdrawal threshold (MWT) of the left hindpaw was measured before developing the model and at 1, 2, 3 and 4 weeks after developing the model. After completing the last behavioral testing, the spinal cord tissue of the lumbar segment (L 4-6) was taken for determination of the levels of lactate in serum and spinal cord tissues (by the colorimetric method), expression of the mitochondrial membrane potential, reactive oxygen species (ROS) content (using JC-1 or DHE probes), expression of mitochondrial dynamin-related protein 1 (Drp1) and mitochondrial protein mitofusin 2 (Mfn2) (by Western blot), and co-expression of Drp1 and neuronal neuronal marker neuronal nuclear protein (NeuN) (by immunofluorescence double labeling) and for examination of the structure and the number of mitochondria (with a transmission electron microscope). Results:Compared with C group, the MWT was significantly decreased after developing the model, the levels of lactate in serum and spinal cord tissues and ROS content in the spinal cord were increased, the mitochondrial membrane potential was decreased, the Drp1 expression was up-regulated, the Mfn2 expression was down-regulated, the number of mitochondria was increased, the area was reduced ( P<0.05), and the co-expression of Drp 1 and NeuN was increased in DNP group and OXA group. Compared with DNP group, the MWT was significantly increased after developing the model, the levels of lactate in serum and spinal cord tissues and ROS content in the spinal cord were decreased, the mitochondrial membrane potential was increased, the Drp1 expression was down-regulated, the Mfn2 expression was up-regulated, the number of mitochondria was decreased, the area was increased ( P<0.05), and the co-expression of Drp 1 and NeuN was decreased in OXA group. Conclusions:Lactate-induced excessive mitochondrial division of spinal cord neurons can lead to mitochondrial dysfunction, which may be involved in the maintenance mechanism of DNP in mice.

Traditional Chinese medicine dispensing granules（TCMDGs）is the new type of decoction pieces with the development of modernization of TCM， which has received mixed opinions since its practical application. In 2021， the national departments issued Announcement on Ending the Pilot Work of TCMDGs， marking the end of the 28-year pilot work of TCMDGs， and eligible TCM enterprises can produce TCMDGs after filing. However， this does not mean that the preparation process， quality standard and efficacy research of TCMDGs have been developed and matured， on the contrary， there are still some problems that need to be solved and gradually improved. For example， in the production process， there are problems such as unclear， unified and non-standardized preparation parameters. In terms of quality control， there are some problems such as lack of producing area regulation， variety selection and processing specification. In terms of consistency evaluation with traditional decoction， there are problems such as unclear relationship between the chemical constituents and pharmacological effects of the two. Therefore， in view of some prominent problems of TCMDGs at present， this paper takes the published literature as the main data source and combines the specific requirements of the code or technical standards such as the 2020 edition of Chinese Pharmacopoeia， Publicity of the Unified Standard on the Varieties of TCMDGs， Quality Control and Standard Formulation Technical Requirements of TCMDGs. The production process of TCMDGs， the origin and variety of raw materials， the processing of decoction pieces， the quality control standard and the consistency evaluation of formula granules and traditional decoction were sorted out and visualized by literature mining， data analysis and list comparison. Based on the analysis results， the following suggestions were made. In terms of preparation process， the completeness and standardization of process parameters should be strengthened. In terms of quality evaluation， attention should be paid to the relationship between the authenticity， variety， processing and quality of medicinal materials. In the consistency evaluation of formula granules and traditional decoction， the deep difference and mechanism between TCMDGs and traditional decoction were discussed by combining structural Chinese medicine， quality marker（Q-Marker） theory and physicochemical characterization， so as to provide reference for the application and development of TCMDGs.

Objective: To explore character strengths of college students who sought counseling, and its relationship with mental health. Methods: A total of 180 college students who sought counseling were investigated by using the short version of Character Strengths Questionnaire and the Symptom Checklist 90 (SCL-90) during March 2020 to October 2021. Results: The top five character strengths of college students who sought counseling were appreciation, authenticity, gratitude, humor, love of learning ( 8.39± 1.64, 7.82±1.74, 7.73±1.57, 7.29±1.81, 7.17±1.88); The bottom five character strengths were kindness, bravery, persistence, zest, leadership (5.59±1.75, 5.81±1.30, 5.86±1.72, 5.98±1.59, 6.06±1.60). Linear regression analysis found love, social intelligence and insight showed associations with different dimensions of mental health, with correlation coefficient of each regression equation between -0.12 and 0.16, and the coefficient of determination between 0.05 and 0.19 ( P <0.01). Love had a negativeassociation with all factors of SCL- 90 ( β=-0.314--0.159, P <0.05), which could explain 3.3%-12.5% of the variation of each factor. Social intelligence had a negative association with obsessive compulsive, interpersonal sensitivity and anxiety ( β=-0.200--0.150, P <0.05), which can explain 1.6%-3.2% of the variation. Insight had a positive association with somatization, hostility and paranoia ( β=0.168-0.279, P <0.05), which can explain 2.3%-3.8% of the variation. Conclusion The lack and excess of character strengths is associated with mental health problems. Therefore, it would be more effective to help counseling cases build an appropriate and balanced character in the context of a strengths based approach.

Objective:To explore the effect of regional nerve block anesthesia for elderly patients with traumatic tibia and fibula fractures.Methods:Ninety-three elderly patients with tibia and fibula fractures undergone surgical treatment were randomly divided into an observation group and a control group, with 47 and 46 patients, respectively, in each group.The control group received general anesthesia and the observation group received a regional nerve block.Results:There was no difference in operative time between the two groups[(42.2±5.4)min and(43.3±5.7)min, t=0.953, P=0.343].The time to recovery of consciousness[(11.2±2.6)min and(14.5±2.8)min, t=5.714, P<0.001]and the volume of intraoperative infusion[(415.6±27.5)ml/L and(686.6±36.3)ml/L, t=40.626, P<0.001]were lower and patients' blood pressure and respiratory rate were also lower at skin incision, fracture fixation, end of surgery and 30 min after surgery in the observation group than in the control group.The levels of Glu, IL-6 and COR were higher than those in the control group(all P<0.05).The incidence of complications was 2.13% in the observation group and 15.22% in the control group( χ2=5.07, P<0.05). Conclusions:Elderly patients with traumatic tibia and fibula fractures receive beneficial anesthetic effects with the regional nerve block technique, with stable hemodynamics, mild stress response and minor adverse reactions.