Objective To investigate the effect of total paeony glycoside(TPG)on cerebral ischemia-reperfusion injury(CI/RI)of rats.Methods The rats were randomly divided into sham surgery(sham)group,CI/RI model group(simple CI/RI group),positive control group(nimodipine group,5 mg/kg),low-dose TPG group(TPG-L group,27 mg/kg),a high-dose TPG group(TPG-H group,54 mg/kg)and a high-dose TPG+NOD-like receptor thermal protein domain associated protein 3(NLRP3)activator diethyl dithiocarbamate(DDC)group(TPG-H+DDC group,54 mg/kg TPG and 30 mg/kg DDC),with 18 rats in each,administered once a day for 7 consecutive days.After the administration,the neurological deficit score of the rats was evaluated.Nissl staining microscopy was applied to observe neuronal activity in brain tissue.2,3,5-triphenyltetrazolium chloride(TTC)staining microscopy was applied to detect the area of cerebral infarction in rats.The level of interleukin-1β and IL-18 in brain tissue was measured by ELISA method.Western blot was applied to detect the expression of purinergic receptor P2X ligand-gated ion channel 7(P2X7R)/NLRP3 signaling pathway related proteins and pyroptosis related proteins such as apoptosis associated speck like protein containing a CARD(ASC)and cysteine protease 1(caspase-1)proteins in brain tissue.Results Compared with the sham group,the neurological deficit score,infarct area,level of IL-1β and IL-18 in brain tissue and protein expression of P2X7R,NLRP3,ASC,and caspase-1 in brain tissue of rats in the simple CI/RI group were significantly increased(P<0.05),while the proportion of Nissl body positive cells in brain tissue was significantly reduced(P<0.05).The change in corresponding indicators of rats in the nimodipine group,TPG-L group,and TPG-H group was opposite to those in the simple CI/RI group(P<0.05).NLRP3 acti-vator DDC antagonized the inhibitory effect of TPG on cell pyroptosis in CI/RI rats.Conclusions TPG may inhibit brain injury in CI/RI rats by down-regulating the P2X7R/NLRP3 pathway.

BACKGROUND:Increasing evidence has indicated that early reinforcement of correct posture is particularly important for improving abnormal gait in stroke patients.Wearable exoskeleton-assisted training can improve patients'walking function in a short period of time,and can also assist the coordinated movement of muscles around the pelvis,hip,knee,and ankle joints,control the walking trajectory of the lower limbs,and improve walking ability in patients with stroke.OBJECTIVE:To explore the improvement of abnormal gait in stroke patients by a wearable exoskeleton with posture feedback,and to explore the rehabilitation mechanism.METHODS:A total of 52 patients in the recovery period of stroke admitted to the Affiliated Hospital of Jining Medical College from January 2023 to January 2024 were included in this study and randomly divided into an experimental group(n=26)and a control group(n=26)using a random number table method.Based on conventional rehabilitation training,the patients in the experimental group participated in training using a wearable exoskeleton with posture feedback(15 minutes per day,6 times per week),while those in the control group were given conventional gait therapy(15 minutes per day,6 times per week).Training in each group lasted for 4 weeks.Before and after training,the lower limb motor function scores,gait parameters(step length,step speed,step width)and gait symmetry were compared between the two groups,and the brain functional connectivity values of the prefrontal motor area,the primary motor cortex and the sensorimotor area were detected using portable near-infrared spectroscopy.RESULTS AND CONCLUSION:After training,lower limb motor function scores,gait parameters and gait symmetry were significantly improved in the two groups(P＜0.05).Meanwhile,the experimental group was superior to the control group in terms of gait parameters and gait symmetry(P＜0.05).Brain functional connectivity values of the right sensorimotor area-left prefrontal motor area and right sensorimotor area-right prefrontal motor area were significantly increased in the two groups after training(P＜0.05).The functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex in the experimental group were increased after training(P＜0.05).Compared with the control group,the functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex were increased in the experimental group after training(P＜0.05).To conclude,based on conventional rehabilitation training,a wearable exoskeleton with posture feedback can not only effectively improve the abnormal gait of stroke patients,but also activate the functional sensorimotor areas of the brain associated with abnormal gait.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

OBJECTIVE To construct a prevention and control index system suitable for stomatology outpatient de-partment of general hospital,so as to provide a theoretical basis for risk assessment of stomatology outpatient de-partment,and to provide an evidence-based basis for precise prevention and control.METHODS Based on the methods of literature research,literature quality evaluation and brainstorming,a draft index of the prevention and control of the general hospital's oral outpatient department was constructed,and the index system for the preven-tion and control in the stomatology outpatient department of a general hospital was finally established through re-search group discussion,content analysis and expert consultation.The three-level indicators in the index system were incorporated into the risk points of risk assessment,the failure mode and effects analysis were applied to con-duct the risk assessment,and the intervention measures and rectification cycles were formulated and implemented in clinical practice for the risk points with risk priority number(RPN)greater than 125.Based on the established index system and risk points with RPN＞125,the hospital infection prevention and control checklist for stoma-tology outpatient was developed and regularly checked in the clinic.After the rectification was completed,the risk points were evaluated again,and the RPN values were compared before and after the risk control.RESULTS The recovery rate of expert consultation questionnaire was 100.00％,and the average expert authority coefficient was 0.84.The consistency ratio(CR)for the first-level indicators was 0.0499,and the consistency ratio(CR)of the second-level indicators was 0.0000-0.0790,which was less than 0.1,and the consistency was acceptable.Final-ly,a hospital infection prevention and control index system was established,comprising 5 first-level indicators,7 second-level indicators and 23 third-level indicators.The improved key control risk points were evaluated again,and the RPN values before and after comparing the risk control were reduced and＜125,indicating that the im-provement measures were effective.CONCLUSION The evaluation system of prevention and control for the stoma-tology outpatient department of a general hospital established in this study is reliable,scientific and practical,and the improvement measures of risk assessment before and after the control of risk points are effective,which pro-vides evidence-based basis for risk assessment and precise prevention and control in the stomatology outpatient de-partment of general hospitals.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

OBJECTIVE To construct a prevention and control index system suitable for stomatology outpatient de-partment of general hospital,so as to provide a theoretical basis for risk assessment of stomatology outpatient de-partment,and to provide an evidence-based basis for precise prevention and control.METHODS Based on the methods of literature research,literature quality evaluation and brainstorming,a draft index of the prevention and control of the general hospital's oral outpatient department was constructed,and the index system for the preven-tion and control in the stomatology outpatient department of a general hospital was finally established through re-search group discussion,content analysis and expert consultation.The three-level indicators in the index system were incorporated into the risk points of risk assessment,the failure mode and effects analysis were applied to con-duct the risk assessment,and the intervention measures and rectification cycles were formulated and implemented in clinical practice for the risk points with risk priority number(RPN)greater than 125.Based on the established index system and risk points with RPN＞125,the hospital infection prevention and control checklist for stoma-tology outpatient was developed and regularly checked in the clinic.After the rectification was completed,the risk points were evaluated again,and the RPN values were compared before and after the risk control.RESULTS The recovery rate of expert consultation questionnaire was 100.00％,and the average expert authority coefficient was 0.84.The consistency ratio(CR)for the first-level indicators was 0.0499,and the consistency ratio(CR)of the second-level indicators was 0.0000-0.0790,which was less than 0.1,and the consistency was acceptable.Final-ly,a hospital infection prevention and control index system was established,comprising 5 first-level indicators,7 second-level indicators and 23 third-level indicators.The improved key control risk points were evaluated again,and the RPN values before and after comparing the risk control were reduced and＜125,indicating that the im-provement measures were effective.CONCLUSION The evaluation system of prevention and control for the stoma-tology outpatient department of a general hospital established in this study is reliable,scientific and practical,and the improvement measures of risk assessment before and after the control of risk points are effective,which pro-vides evidence-based basis for risk assessment and precise prevention and control in the stomatology outpatient de-partment of general hospitals.

BACKGROUND:Increasing evidence has indicated that early reinforcement of correct posture is particularly important for improving abnormal gait in stroke patients.Wearable exoskeleton-assisted training can improve patients'walking function in a short period of time,and can also assist the coordinated movement of muscles around the pelvis,hip,knee,and ankle joints,control the walking trajectory of the lower limbs,and improve walking ability in patients with stroke.OBJECTIVE:To explore the improvement of abnormal gait in stroke patients by a wearable exoskeleton with posture feedback,and to explore the rehabilitation mechanism.METHODS:A total of 52 patients in the recovery period of stroke admitted to the Affiliated Hospital of Jining Medical College from January 2023 to January 2024 were included in this study and randomly divided into an experimental group(n=26)and a control group(n=26)using a random number table method.Based on conventional rehabilitation training,the patients in the experimental group participated in training using a wearable exoskeleton with posture feedback(15 minutes per day,6 times per week),while those in the control group were given conventional gait therapy(15 minutes per day,6 times per week).Training in each group lasted for 4 weeks.Before and after training,the lower limb motor function scores,gait parameters(step length,step speed,step width)and gait symmetry were compared between the two groups,and the brain functional connectivity values of the prefrontal motor area,the primary motor cortex and the sensorimotor area were detected using portable near-infrared spectroscopy.RESULTS AND CONCLUSION:After training,lower limb motor function scores,gait parameters and gait symmetry were significantly improved in the two groups(P＜0.05).Meanwhile,the experimental group was superior to the control group in terms of gait parameters and gait symmetry(P＜0.05).Brain functional connectivity values of the right sensorimotor area-left prefrontal motor area and right sensorimotor area-right prefrontal motor area were significantly increased in the two groups after training(P＜0.05).The functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex in the experimental group were increased after training(P＜0.05).Compared with the control group,the functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex were increased in the experimental group after training(P＜0.05).To conclude,based on conventional rehabilitation training,a wearable exoskeleton with posture feedback can not only effectively improve the abnormal gait of stroke patients,but also activate the functional sensorimotor areas of the brain associated with abnormal gait.

Objective:To explore any effect of repeated transcranial magnetic stimulation (rTMS) on the upper limb motor function and cerebral cortex activation of stroke survivors.Methods:Sixty stroke survivors were randomly divided into an intervention group and a control group, each of 30. In addition to routine rehabilitation training (including drug therapy, comprehensive hemiplegic limb training and physical factor therapy), the intervention group received 15 minutes of rTMS daily, five days a week for 4 weeks while the control group was given false rTMS. Upper limb motor function was evaluated before and after the treatment using the Fugl Meyer upper limb motor function rating scale (FMA-UE). Functional near-infrared spectroscopy was used to detect and compare the activation (β values) of the prefrontal cortex, the motor cortex and the primary somatosensory cortex in the 2 groups. The correlation between the FMA-UE scores and the β values was quantified.Results:①There was no significant difference in the average FMA-UE scores between the two groups before the treatment. Afterward, though both groups′ average scores had increased significantly, there was significantly greater improvement in the treatment group. ②There was also no significant difference in average β value between the two groups before the experiment, but afterward the average βs of channels 27 and 13 in the intervention group were significantly higher than in the control group. Moreover, in patients with lesion in the left brain, the β-values of CH27 and CH13 were also significantly higher than the control group ( P<0.05). ③The FMA-UE scores of the intervention group were moderately correlated with the CH27 and CH13 β values, but those of the control group were only weakly correlated with the β values of CH27. Conclusion:Transcranial magnetic stimulation activates a lesioned left brain region, improving upper limb motor function. The improvement is correlated with the activation of the left prefrontal cortex and the left primary somatosensory cortex.

Objective:To prepare rabbit polyclonal antibodies against respiratory syncytial virus (RSV) N protein and use them as the detection antibodies to establish a N-ELISA-based method for rapid detection of neutralizing antibodies.Methods:A plasmid of pET30a-N for the expression of RSV N protein was constructed. After purification, the protein was immunized into New Zealand rabbits to prepare polyclonal antibodies, which were used as the detection antibodies. Positive serum samples were diluted and used to neutralize RSV (100 TCID 50/well). Hep-2 cells were inoculated and cultured, and then the cells were fixed with 80% acetone. ELISA was performed to detect RSV N protein in infected cells. When the absorbance value of a well was below the cut-off value, it was regarded as the positive well in the neutralization test. The highest dilution of a positive well serum was the neutralizing antibody titer. After optimizting the antibody dilution, detection time, cell density and the duration of neutralization, the method for neutralizing antibody detection was established based on N-ELISA. The established method was verified by analyzing the influences of different cell generations and edge effects, and calculating the accuracy, repeatability and precision. The correlation between the established method and microneutralization method was analyzed by detecting human RSV IgG-positive serum. Results:The plasmid pET30a-N was successfully constructed, and the expressed N protein showed high purity and good specificity. After the third immunization, the antibody titer in rabbit serum was 1∶51 200, and the antibodies could specifically bind to RSV. The prepared rabbit anti-RSV N polyclonal antibodies had a titer of 1∶51 200, and showed good specificity. The neutralizing antibodies could be detected on day 4 with the established method, and the duration of neutralization was shortened to 30 min. Cell generations and the position of wells in the 96-well plate (edge well and non-edge well) had no significant effect on the method, and the repeatability, precision and accuracy of the method were good. In the detection of 64 RSV IgG-positive human serum samples by the established method and microneutralization method, the correlation coefficient was 0.929 6, indicating a good positive correlation between the two methods.Conclusions:A N-ELISA-based method for rapid neutralizing antibody detection is successfully established, which can be used to evaluate the serum antibody level after RSV vaccination.

Objective Studies on the expression and location of zinc finger protein A20 (A20) and connective tissue growth factor (CTGF) in liver tissues of patients with chronic hepatitis B were conducted, and the relationship between them and liver fibrosis was determined by FibroScan. Methods Studies on A20 and CTGF in liver tissues of 160 patients with chronic hepatitis B were conducted in accordance with the stage of pathological fibrosis and inflammation of the liver, and quantitative immunohistochemistry test was conducted, and statistical analysis was conducted by FibroScan. Results The expressions of A20 and CTGF in liver tissues increased with the aggravation of liver pathological fibrosis and inflammation, and there were significant differences between each stage and the control group (P<0.05), and there were significant differences between adjacent groups (P<0.05). Studies have shown that FibroScan increases along with pathological fibrosis and inflammation in the liver. There are significant differences between the stage and the control group (P<0.05), and no significant differences between the adjacent groups (P>0.05). There was positive correlation between liver A20 and CTGF, r=0.796 (P<0.05). Conclusions In patients with chronic hepatitis B, A20, CTGF and FibroScan are positively correlated with the degree of liver fibrosis, and A20 and CTGF are also positively correlated with the degree of liver inflammation, which can be used as indicators to evaluate the degree of liver inflammation and fibrosis, and further guide the anti-inflammatory and anti-fibrosis treatment of patients.