ObjectiveThis study aimed to explore the correlation between the quality of life （QOL） and different traditional Chinese medicine （TCM） syndromes in patients with myasthenia gravis （MG）， identifying potential influencing factors to provide new insights for clinical interventions and improving the QOL of patients with MG. MethodsA questionnaire survey was conducted on 93 adults with MG who visited the Department of Neurology at the Affiliated Hospital of Changchun University of Chinese Medicine from March 2023 to January 2024. Statistical analysis was performed on the clinical data collected using SPSS 24.0 software. ResultsAmong the 93 patients with MG， the average score for myasthenia gravis quality of life-15 （MGQOL-15） was 17.65±6.27， and that for the 36-item short form health survey （SF-36） was （106.13±11.83） scores. The QOL was rated as good for 16 patients and moderate for 77 patients. There were no statistically significant differences in the scores of MGQOL-15， SF-36， and their individual scales by gender or education level. Age showed statistically significant differences in MGQOL-15 and the role physical （RP） scale （P<0.05）， and occupational type showed significant differences in the vitality （VT） scale （P<0.01）. The Myasthenia Gravis Foundation of America （MGFA） classification had statistical significance on the total SF-36 score （P<0.01）， VT scale （P<0.01）， role emotional （RE） scale （P<0.05）， social functioning （SF） scale （P<0.05）， and physical functioning （PF） scale （P<0.01）. Among patients with different TCM syndromes， there were significant differences in MGQOL-15 scores （F=4.919， P<0.01）. Moreover， significant differences were observed in SF-36 scores （P<0.01）， VT scale （P<0.01）， RE scale （P<0.05）， mental health （MH） scale （P<0.01）， and SF scale （P<0.05）. ConclusionFactors affecting the QOL of patients with MG include age， occupational type， and clinical classification of MG. Specifically， a greater impact on the QOL of older patients is observed， while physical laborers have a poorer QOL compared to non-physical laborers. Patients classified as MGFA type Ⅱ and higher have a poorer QOL. Additionally， there is a potential correlation between the QOL and TCM syndromes， with patients presenting with spleen and kidney Qi deficiency having a lower QOL than those with spleen and stomach Qi deficiency or Qi and Yin deficiency， which is particularly evident in the VT， RE， MH， and SF scales.

Central nervous system （CNS） is a sophisticated system subject to complex regulation， which dominates the high-level neural activities of the human body. Due to its complex physiological structure and refined regulatory mechanism covering a variety of diseases， CNS is the place where many chronic， refractory and rare diseases occur. Nerve cell is the basic unit of CNS， and its dysfunction and death is the root cause of CNS diseases. Ferroptosis is a new form of programmed cell death proposed in recent years， and has been proved to be closely related to the production and development of multiple CNS diseases. Traditional Chinese medicine （TCM）， including Chinese herbs， acupuncture and moxibustion， and massage， has shown unique advantages in the treatment of CNS diseases for a long time. A large number of studies have demonstrated that TCM participates in the regulation of CNS diseases via regulating ferroptosis and shows a good research prospect. This paper summarized the characteristics of ferroptosis and discussed the association between ferroptosis and CNS diseases in pathological mechanism. We also reviewed the regulation of various CNS diseases by different TCM interventions through ferroptosis， providing references for TCM to participate in the treatment of CNS diseases properly in the future.

Stroke is one of the most common cerebrovascular diseases， including hemorrhagic stroke and ischemic stroke. From a modern medical perspective， stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation. From the traditional Chinese medicine （TCM） perspective， the pathogenesis of this disease is mainly due to the disorder of Qi and blood， which ascend to the brain， causing either blood extravasation or blockage of brain collaterals. Stasis is a pathological factor that runs throughout the entire course of stroke， and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time. Hirudo， as a traditional insect drug， has shown good effects in promoting blood circulation and resolving stasis. Modern pharmacological research has confirmed that Hirudo contains anticoagulant components， which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke. Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation， anti-thrombosis， and protection of vascular endothelium. As a result， they have been widely used in the treatment of stroke. This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations， aiming to provide references for the involvement of Hirudo in stroke treatment.

Stroke is a common cerebrovascular disease， characterized by high incidence， mortality and disability rate. Neuronal cells， the basic unit of the central nervous system， can be injured to varying degrees when stroke occurs. Neuronal cell injury after stroke is also the key cause leading to neurological dysfunction， affecting the prognosis and quality of life of patients. Therefore， reducing the neuronal cell injury and delaying the process of cell death are effective to decrease the nerve function injury in stroke patients and improve their prognosis， thus lowering the death and disability rate of stroke. Ferroptosis is a new form of cell death that has been widely concerned in recent years. Several studies have confirmed that there is ferroptosis in neuronal cells after stroke. Since ferroptosis is an adjustable form， its intervention can help regulate the injury and death of neuronal cells. Studies have shown that inhibiting ferroptosis plays a role in protecting neuronal cells. Traditional Chinese medicine （TCM）， with the multi-channel and multi-target treatment advantages， has been widely used in the whole stroke and has achieved good clinical efficacy. It might be a new direction taking TCM regulation of ferroptosis as the entry point for stroke treatment in the future. This review revealed the mechanism of ferroptosis， discussed the research status of TCM in intervening in neuronal cell ferroptosis， and provided reference for further improving the efficacy of TCM in stroke.

Genomic epidemiology, based on whole-genome sequencing technology and bioinformatics analysis, can make up for the shortcomings of traditional molecular typing methods and provide a novel insight for the genetic evolution and transmission of pathogenic fungi. The combination of genetic information and epidemiological methods of pathogenic fungi can predict fungi transmission routes and risks, and provide a theoretical basis for the development of public health strategies for fungi infection prevention and control. This paper summarizes the development of molecular epidemiology and genomic epidemiology, as well as the application of genomic epidemiology methods in the analyses of genetic relationship, origin, evolution, drug resistance, virulence, and genome-wide association of pathogenic fungi, and discusses the development of pathogenic fungi genomic epidemiology.

Objective To investigate the intervention value of intensive care team in neonatal respiratory distress syndrome.Methods 110 cases of neonatal respiratory distress syndrome were selected,by using a random number table method they were randomly divided into the observation group and the control group,55 cases in each group.The control group was treated with routine care model,the observation group dedicated care team for critically ill children.The incidence of complications,mechanical ventilation time,cost of hospitalization,duration of hospitalization were compared after the care of children.Results The incidence rates of infection,abdominal bloating and intraventricular hemorrhage in the observation group (3.64%,1.82%,0.00%) were significantly lower than those in the control group(20.00%,16.36%,5.45%),the incidence of infection,abdominal distension between the two groups had statistically significant differences (χ2=4.852,P=0.027;χ2=7.040,P=0.008).The mechanical ventilation time,hospitalization time in the observation group [(11.23±2.17)d,(23.45±5.45)d]were significantly shorter than those in the control group[(16.78±4.52)d,(26.78±6.47)d],there were statistically significant differences between the two groups(t=8.209,P=0.000;t=2.919,P=0.004).The hospitalization costs of the observation group[(20 462.78±214.45) yuan] was significantly lower than the control group [(24 975.45±312.45)yuan],there was significant difference between the two groups(t=88.311,P=0.000).The total effective rate of the observation group was 98.18%,which was higher than 87.27% of the control group,there was statistically significant difference between the two groups(χ2=4.852,P=0.027).Conclusion Full implementation of critical care nursing team intervention on neonatal respiratory distress syndrome,can effectively reduce the incidence of children with complications,mortality,shorter hospital stays,reduce hospitalization costs,the effect is significant and should be introduced.

Objective To understand the pathogenic characteristics of intra-abdominal infection after appendecto-my in patients with appendicitis.Methods Clinical data of patients undergoing appendectomy in a hospital from January 2013 to December 2015 were analyzed retrospectively,pathogenic characteristics,treatment,and prognosis of patients with intra-abdominal infection were analyzed.Results A total of 431 patients undergoing appendectomy were investigated,38 (8.82%)developed intra-abdominal infection.36 strains of pathogenic bacteria were isolated, 34 (94.44%)of which were gram-negative bacteria,mainly Escherichiacoli(n=29,80.55%);2 (5.56%)strains were gram-positive bacteria,1 of which was Staphylococcusaureus,and the other was Enterococcusavium.The re-sistance rates of 29 strains of Escherichia coli to commonly used antimicrobial agents (amoxicillin,piperacillin,ti-carcillin,cefuroxime,ceftazidime,and cefalotin)were 72.41%-93.10%,none of strains were found to be resistant to piperacillin/tazobactam,meropenem,imipenem,and amikacin.Conclusion Escherichiacoli is the most common pathogen causing intra-abdominal infection after appendectomy and it has high resistance rates to most commonly used antimicrobial agents,piperacillin/tazobactam,amikacin,and carbapenems are recommended for treating intra-abdominal infection after appendectomy.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Objective To explore the effects of cotransplantation with osteoblasts on hematopoietic reconstitution in mice after bone marrow transplantation (BMT). Methods The typical model of syngeneic BMT was established. 18 Balb/c mice were used to prepare the bone marrow nuclear cells and osteoblasts for BMT. The 42 Balb/c mice were randomly divided into 3 group:normal group (6 mice, without any treatment), the single BMT group ( 18 mice, given 2 × 106 bone marrow nuclear cells/each mouse) and the cotransplantation group of HSC with osteoblaats (18 mice,given 2 × 106 bone marrow nuclear cells and osteoblasts/each mouse). The following factors were measured on day 7, 14, 21 after BMT: peripheral blood cells, bone marrow mononuclear cells (BMMNC), the percentage of CD34+ cells in BMMNC (assayed by flow cytometry), the hematopoietic tissue changes (detected by HPIAS-1000 image analysis system) and micro vascular density (MVD) of bone marrow tissue (with immunohistochemistry). Results The levels of periphral WBC, RBC, PLT, BMMNC in the contransplantation group were higher than those in the single BMT group (P＜0. 01 or P＜0. 05). In the contransplantation group, the percentage of CD34+ cells in BMMNC, the hematopoietic tissue area and the MVD of bone marrow were also higher than the single BMT group on the 7th, 14th, 21st day after BMT(P＜0.01 or P＜0.05). Conclusion Cotransplantation with osteoblasts could significantly promote hematopoietic reconstruction in mice after BMT. Cotransplantation may represent a promising means of achieving higher engraftment rate after BMT.

Recent studies indicate that immune-associated aplastic anemia(AA)resembles such autoimmune diseases as insulin-dependent diabetes and chronic autoimmune thyroiditis that belong to organ-specific autoimmune diseases.Many independent investigation groups have successfully isolated the pathopoiesis-associated T cell clone causing hematopoiesis failure with a CD4 phenotype from peripheral blood and bone marrow(BM)in AA patients.In the current study,BM CD4+ T cells were isolated from AA patients and healthy controls with immunomagnetic beads sorting,and proliferation capability,apoptosis features and the impacts of their secreted cytokines on hematopoiesis stem/progenitor cells were compared between them.By 3H-TdR method,CD4+ T cells in AA group presented more enhanced proliferative activity.The stimulation index in control group and AA group was 1.47±0.24,and 2.51±0.34 respectively(P<0.01).After BM CD4+ T cells were induced by high concentration of CD3 monoclonal antibody for 18h,evident apoptosis cells could be seen under the electron microscope in both control group and AA group.Flow cytometry revealed that apoptosis rates in the early and late stages of AA group were significantly higher than in control group(P<0.01).Early-stage apoptosis rate in control and AA groups was(6.85±1.48)% and(16.98±4.40)%,and late-stage apoptosis rate in control group and AA group was(2.654±1.57)% and(7.74±0.83)%,respectively(P<0.01).The CFU-GM count in AA group and control group was(74.50±9.50)/104 cells and(124.25±19.80)/104 cells respectively under an inverted microscope(P<0.01),and the expression levels of CyclinD3 mRNA and protein in cord blood CD34+ cells were both down-regulated induced by BM CD4+ T cell culture supernatant in AA patients.These results indicate that BM CD4+ T cells of AA patients are likely in an abnormally proliferative,and activated state which can correlate intimately with AA hematopoiesis damage.BM CD4+ T cells in AA patients can secret some soluble cytokines that can inhibit proliferation of hematopoietic stem cells by suppressing the expression of Cyclin D3,resulting in hematopoiesis failure.