Objective To explore the risk factors for bleeding at the puncture site after femoral artery puncture intervention.Methods A computerized retrieval of observation studies,including cross-sectional studies,case-control studies,and cohort studies,about the risk factors for bleeding at the puncture site after femoral artery puncture intervention from the databases of China National Knowledge Infrastructure(CNKI),Wanfang,VIP,China Biomedical Literature Service(CBM),PubMed,Medline,The Cochrane Library,EMbase and Web of Science was conducted.The retrieval time period was from the establishment of the database to December 31,2022.Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included studies,and RevMan5.3 software was used to make meta-analysis of the literature data.Results A total of 8 articles with a total sample size of 35 250 patients were included in this analysis.There were 1 410 patients in the postoperative bleeding group and 33 840 patients in the non-bleeding group.The results of the meta-analysis showed that the aged(OR=2.71,95％ CI=2.17-3.38),female(OR=4.26,95％ CI=1.08-16.89),hypertension(OR=2.48,95％CI=1.69-3.63),obesity(OR=2.33,95％ CI=1.59-3.42),use of thrombolytic agents,anticoagulants or platelet antagonists(OR=2.95,95％ CI=2.24-3.89),manual compression(OR=6.78,95％ CI=1.34-34.43)were the risk factors for the bleeding at the puncture site after femoral artery puncture intervention.Conclusion The aged,female,hypertension,obesity,use of thrombolytic agents,anticoagulants or platelet antagonists,and manual compression are the risk factors for the bleeding at the puncture site after femoral artery puncture intervention.(J Intervent Radiol,2024,33:314-320)

ObjectiveTo study the effects of Wendantang on the expression of receptor tyrosine kinase receptors B （TrkB） and cyclic adenosine monophosphate response element binding protein （CREB） in the hippocampus of rats with schizophrenia （SCZ）. MethodFifty-four rats were randomly divided into a normal group， a model group， high （40 g·kg^-1）， medium （20 g·kg^-1）， low-dose （10 g·kg^-1） Wendantang groups， and a clozapine （0.02 g·kg^-1） group， with 9 rats in each group. All groups of rats were given corresponding drugs by gavage for 21 d. The normal and model groups were given equal volume of normal saline. Except the normal group， the other 5 groups were given 0.6 mg·kg^-1 dizocilpine maleate （MK-801） at 2 hours after the last administration for intraperitoneal injection to induce the rat model of SCZ. The level of spontaneous activity of rats was observed by open field experiment. Histomorphological changes in the hippocampal CA1 area was observed by hematoxylin-eosin （HE） staining. The protein expression levels of TrKB， phosphorylated-TrKB （p-TrKB）， CREB， and phosphorylated-CREB （p-CREB） were detected by Western blot. The protein expression levels of TrKB and CREB in the hippocampal CA1 area were observed by immunohistochemistry. The mRNA expression levels of TrKB and CREB in the hippocampus were detected by real-time quantitative polymerase chain reaction （Real-time PCR）. ResultAs compared with the normal group， the level of spontaneous activity in the model group was significantly increased （P<0.01）. The arrangement of neuronal cells in the hippocampus CA1 area was loose and disorganized， and some neurons were denatured in the model group. The protein expression levels of TrKB， p-TrKB， CREB， and p-CREB in the hippocampus， the protein expression levels of TrKB and CREB in the hippocampal CA1 area， and the mRNA expression of TrKB and CREB in the hippocampus were significantly decreased （P<0.05， P<0.01）. As compared with the model group， the level of spontaneous activity in all Wendantang groups were significantly decreased （P<0.01）. The neuronal cells in the hippocampal CA1 area of rats in all Wendantang groups were relatively neatly and closely arranged， the morphology of cell body was more regular， and neurons degeneration was rarely observed. The protein expression level of TrKB in the hippocampus was significantly higher in the medium and low-dose Wendantang groups （P<0.05）. The protein expression levels of p-TrKB， CREB， and p-CREB in the hippocampus were significantly higher in all Wendantang groups （P<0.05）. The protein expression of TrKB in the hippocampal CA1 area was significantly increased in all Wendantang groups （P<0.05， P<0.01）. The protein expression of CREB in the hippocampal CA1 area was significantly increased in the medium and low-dose Wendantang groups （P<0.01）. The mRNA expression of TrKB in the hippocampus was significantly increased in the high and low-dose Wendantang groups （P<0.05， P<0.01）. The mRNA expression of CREB was significantly increased in the medium and low-dose Wendantang groups （P<0.05， P<0.01）. ConclusionWendantang can prevent the occurrence and development of SCZ and cognitive impairment by decreasing the level of spontaneous activity， improving the pathological damage of hippocampal neurons， and increasing the expression levels of TrKB， p-TrKB， CREB， and p-CREB.

ObjectiveTo study the metabolism of chemical components from Citri Reticulatae Pericarpium（CRP）in different parts of rats by sequential metabolism and ultra performance liquid chromatography-high resolution mass spectrometry（UPLC-HRMS）. MethodSD male rats were employed as experimental subjects， and blood samples of intestinal metabolism and hepatic metabolism were prepared after administration of CRP ethanol extract by in situ intestinal perfusion， and comprehensive metabolic samples were collected after intragastric administration. UPLC-HRMS was used to analyze the samples with acetonitrile（A）-0.1% formic acid aqueous solution（B）as the mobile phase for gradient elution（0-10 min， 10%-30%A； 10-30 min， 30%-95%A； 30-31 min， 95%-10%A； 31-35 min， 10%A）at a flow rate of 0.35 mL·min^-1， using a heated electrospray ionization with positive and negative ion mode scanning in the range of m/z 100-1 500. Under these conditions， the differences in the profiles of CRP ethanol extract， blank plasma and drug-containing plasma under different treatment groups were compared， and the chemical components of each sample were analyzed and identified based on the retention time， accurate relative molecular mass， primary and secondary ion fragments， and the information of reference substances. ResultA total of 44 chemical components were identified in the CRP ethanol extract， including flavone-O-glycosides， flavone-C-glycosides and polymethoxyflavonoids， etc. The results of sequential metabolism showed that 22 chemical components in CRP were detected in the intestinal metabolic sample， 18 chemical components were detected in the hepatic metabolic sample， and 9 identical chemical components（narirutin， hesperidin， meranzin， 5，7，8，3ʹ，4ʹ，5ʹ-hexamethoxy-flavone， isosinensetin， sinensetin， 3，5，6，7，8，3ʹ，4ʹ-heptamethoxyflavone， nobiletin and tangeretin）could be detected in all three metabolic samples， with a total of 22 compounds entering the blood in prototype form. ConclusionThe identified 21 components with well-defined structures entering the blood as prototypes may be potential active components of CRP， and differences in the components at different metabolic parts can provide an experimental basis for elucidating the in vivo biotransformation process of the metabolic components of CRP.

Objective: To analyze the trends and influencing factors of endurance performance of 19-22 years old college students in Hunan Province from 1985 to 2019, so as to provide objective and scientific basis for sports and health work in colleges and universities. Methods: A retrospective analysis was conducted on the data of 14 490 college students aged 19-22 in Hunan Province from 8 consecutive National Student Physical Fitness and Health Surveys conducted from 1985 to 2019. The analysis indexes were 1 000 m running for boys and 800 m running for girls. Results: From 1985 to 2019, the endurance running time of 19-22 years old Han college students in Hunan Province showed an obvious trend of decline. The 1 000 m running time of urban and rural male students increased by 41.9 and 45.4 s on average, and the 800 m running time of urban and rural female students increased by 29.5 and 30.6 s on average, respectively. Multiple linear regression analysis showed that age ( β =0.17), urban students (rural students as reference; β =0.44), GDP ( β =0.94) and urbanization level ( β = 0.44 ) were positively correlated with the average endurance running time of males. Urban students ( β =0.92), GDP ( β = 1.38 ) and Engel coefficient ( β =0.93) were positively correlated with the average endurance running time of females. BMI ( β =-0.47) was negatively correlated with the females mean time of endurance running ( P ＜0.05). Conclusion The endurance performance of Han college students in Hunan Province showed a declining trend from 1985 to 2019,which is associated with age, urban and rural distribution, regional GDP, Engel s coefficient, urbanization level and BMI. Effective measures should be taken to improve the physical quality of college students.

Objective:To systematically evaluate the disease experience of patients with gestational hypertension, provide targeted care support for patients with gestational hypertension and promote their physical and mental health.Methods:This study is a Meta-synthesis. Qualitative studies on the experience of hypertensive patients during pregnancy were searched through PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, VIP and China Biology Medicine disc. The retrieval time limit was from the establishment of the databases to May 8, 2022. The quality of the studies were evaluated using the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center, and the results were integrated by the pooled integration method.Results:A total of 13 studies were included, 55 complete research results were extracted, 9 new categories were summarized and 3 integrated results were synthesized. Integration result 1 was the physical, psychological and behavioral changes that occurred in patients with gestational hypertension after diagnosis of the disease. Integration result 2 was that patients with gestational hypertension had coping deficits and hoped to receive support from multiple sources. Integration result 3 was the current and future challenges for patients with gestational hypertension.Conclusions:Gestational hypertension will bring many impacts to the patients, which needs support from many aspects. There are many challenges for disease management in the future. Medical staff should fully understand the experience of patients with gestational hypertension, give guidance and support to the most authentic feelings and experiences of the patients and encourage them to actively deal with the disease. At the same time, an effective and comprehensive support system should be built to help them better manage the disease.

Objective:To systematically integrate qualitative research on the decision-making experience of fertility preservation in cancer patients of childbearing age, so as to provide evidence-based basis for improving patients' fertility preservation decision-making ability and formulating targeted intervention plans.Methods:Qualitative research on the decision-making experience of fertility preservation in cancer patients of childbearing age was systematically searched on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI) , Wanfang Database, VIP and China Biology Medicine disc. The search period was from database establishment to December 2, 2022. The quality of literature was evaluated using the quality evaluation criteria for qualitative research of the Australia Joanna Briggs Institute Evidence-Based Health Care Center. The results were integrated using the Meta-synthesis method.Results:A total of 11 articles were included, 28 results were extracted, summarized into 6 categories, and formed 3 integrated results. The integration results included the challenges and opportunities faced by fertility preservation decision-making, fertility preservation decision-making was influenced by individual, family and social factors, and lack of sufficient decision-making support.Conclusions:Cancer patients of childbearing age lack decision-making support for fertility preservation and face decision-making difficulties. Medical and nursing staff should comprehensively evaluate the fertility needs of cancer patients of childbearing age, pay attention to their cognition and experience, provide professional fertility counseling, and help patients make high-quality decision-making.

ObjectiveBased on sequential metabolism and ultra-high performance liquid chromatography-high resolution mass spectrometry （UPLC-HRMS）， to identify the prototype components and metabolites of Tongfengding capsules in rat plasma. MethodAn ACQUITY UPLC BEH Shield RP18 column （2.1 mm×100 mm， 1.7 µm） was used for gradient elution with 0.1% formic acid aqueous solution （A）-acetonitrile （B） as the mobile phase （0-1 min， 5%B； 1-2.4 min， 5%-10%B； 2.4-13.5 min， 10%-32%B； 13.5-18.5 min， 32%-90%B； 18.5-19 min， 90%-5%B； 19-21 min， 5%B） at a flow rate of 0.3 mL·min^-1， injection volume of 2 μL and column temperature at 35 ℃. The heated electrospray ionization （HESI） was applied under positive and negative ion modes， and the scanning range was m/z 100-1 500. By comparing the differences between the administered plasma and the blank plasma， the prototype components and metabolites in intestinal metabolism sample and liver metabolism sample prepared by intestinal perfusion with parallel blood collection， and comprehensive metabolism sample prepared by intragastric administration method were identified. ResultA total of 76， 53， 74 chemical components were detected in the intestinal metabolism sample， the liver metabolism sample and the comprehensive metabolism sample. A total of 100 components were identified from these different plasma samples， including 64 prototype components （34 alkaloids， 12 terpenoids， 9 organic acids， 6 flavonoids and 3 other components） and 36 metabolites. The main metabolic reactions involved in the formation of metabolites were glucuronidation， deglucosylation， dehydrogenation and hydroxylation. ConclusionThe chemical components of Tongfengding capsules can undergo a series of metabolic reactions in the intestine and liver， and a large number of metabolites are generated， among which alkaloids may be the leading component group for efficacy， which can lay the foundation for systematic elucidating the material basis of Tongfengding capsules in vivo.

Currently, there is still no effective curative treatment for the development of late-stage liver fibrosis. Here, we have illustrated that TB001, a dual glucagon-like peptide-1 receptor/glucagon receptor (GLP-1R/GCGR) agonist with higher affinity towards GCGR, could retard the progression of liver fibrosis in various rodent models, with remarkable potency, selectivity, extended half-life and low toxicity. Four types of liver fibrosis animal models which were induced by CCl₄, α-naphthyl-isothiocyanate (ANIT), bile duct ligation (BDL) and Schistosoma japonicum were used in our study. We found that TB001 treatment dose-dependently significantly attenuated liver injury and collagen accumulation in these animal models. In addition to decreased levels of extracellular matrix (ECM) accumulation during hepatic injury, activation of hepatic stellate cells was also inhibited via suppression of TGF-β expression as well as downstream Smad signaling pathways particularly in CCl₄-and S. japonicum-induced liver fibrosis. Moreover, TB001 attenuated liver fibrosis through blocking downstream activation of pro-inflammatory nuclear factor kappa B/NF-kappa-B inhibitor alpha (NFκB/IKBα) pathways as well as c-Jun N-terminal kinase (JNK)-dependent induction of hepatocyte apoptosis. Furthermore, GLP-1R and/or GCGR knock-down results represented GCGR played an important role in ameliorating CCl₄-induced hepatic fibrosis. Therefore, TB001 can be used as a promising therapeutic candidate for the treatment of multiple causes of hepatic fibrosis demonstrated by our extensive pre-clinical evaluation of TB001.

Objective:To summarize the nursing experience of enteral nutritionin a patient with severe pneumonia who received extracorporeal membrane oxygenation combined with prone ventilation.Methods:A patient with severe pneumonia who underwent extracorporeal membrane oxygenation combined with prone ventilation from Xiangya Hospital of Central South University on November 8, 2020 was given individualized nutrition support program. The patient′s condition was evaluated, individual nutrition support plan was formulated, early nutrition was implemented, appropriate feeding route was selected, tolerance was evaluated during the implementation process, and enteral nutrition-related complications were nursing.Results:After careful treatment and nursing, the patient′s condition was improved and was transferred out of ICU for continued treatment.Conclusions:For this kind of patients with severe pneumonia who underwent extracorporeal membrane oxygenation combined with prone ventilation to choose the pyloric feeding to reduce aspiration. Early nourishing nutrition to protect the intestinal mucosa; ultrasonic monitoring of antral motility index was used to guide the implementation of enteral nutrition. Regular evaluation of feeding tolerance during nutrition implementation, the strategy and implementation of enteral nutrition were adjusted according to the intra-abdominal pressure combined with feeding tolerance, and the prevention and nursing of enteral nutrition complications were carried out at the same time.

Objective : To explore the effect of sericin on podocyte epithelial-mesenchymal transition induced by high glucose． Methods : Conditional immortalized mouse podocytes were used as the research object to construct podocyte injury model by high glucose stimulation．The podocytes were divided into normal (NG) group ，hyperton- ic control (MG) group ，high glucose injury ( HG) group ，low ，medium and high dose sericin ( LS ，MS ，HS) group．CCK-8 method was used to determine the viability of podocytes in each group ; the morphological structure of podocytes in each group was observed by ordinary optical inverted microscope．The migration ability was detected by Transwell and cell scratch test．Western blot was used to detect the expression levels of EMT-related mesenchy- mal phenotype factors Snai1，α-SMA，FSP-1，MMP-9 and epithelial phenotype factors Nephrin，E-cadherin，and WT-1 in podocytes of each group. Results : Compared with NG group，HG group showed lower podocyte activity (P＜0. 01) ，worse podocyte status and enhanced podocyte migration ability，up-regulated Snai1，α-SMA，FSP-1 and MMP-9 protein expressions (P ＜0. 01) ，and down-regulated Nephrin，E-cadherin and WT-1 protein expres- sions (P＜0. 01) ．Compared with HG group，the viability of podocytes in sericin group increased (P＜0. 05) ，the state of podocytes was improved ，the migration ability of podocytes was weakened ，the expression of Snai1 ，α - SMA，FSP-1 and MMP-9 was down-regulated (P＜0. 05) ，and the expression of Nephrin，E-cadherin and WT-1 was up-regulated (P ＜0. 05 ) ． Conclusion Sericin can alleviate podocyte epithelial-mesenchymal transition in- duced by high glucose.