Objective To systematic evaluate the impact of applying the clinical nursing pathway(CNP)on epidural anesthetic analgesia natural delivery.Methods The randomized controlled trial(RCT)and quasi-experimental researches on the application of CNP in epidural anesthetic analgesia natural delivery were retrieved from PubMed,Cochrane Library,Embase,Web of Science,China Knowledge Network database,Wanfang database,VIP and the Chinese Biomedical Literature Database.The retrieval time limit was from January 1,2014,to July 31,2024 with no language limitation.The meta analysis on the included studies was performed by applying RevMan5.4.1.Results A total of 5 RCTs and 2 quasi-experimental studies were in-cluded,involving 979 parturients with deliveries.The meta analysis showed that compared with the conven-tional nursing,CNP could shorten the duration of the first stage of labor(MD=—1.06,95％CI:—1.95——0.17,P=0.02)and the duration of the second stage of labor(MD=—0.12,95％CI:—0.21——0.03,P=0.006);decreased the rate of perineal lateral incision(RR=0.73,95％CI:0.65-0.83,P＜0.001)and inci-dence rate of postpartum urinary retention(RR=0.35,95％CI:0.20-0.63,P＜0.001);and shortened the time to lactation initiation(SMD=—1.52,95％CI:—2.38——0.66,P＜0.001).There was no influence on reducing postpartum 24 h hemorrhage amount(SMD=—0.51,95％CI:—1.23-0.21,P=0.16).The study subjects were divided into the primipara women subgroup and unclassified parturients subgroup.Compared with the conventional nursing group,compared with the conventional nursing,CNP had no impact on the dura-tion of the first stage of labor(MD=—0.32,95％CI:—0.61-0.98,P=0.63)and the duration of the second stage of labor(MD=—0.11,95％CI:—0.25-0.04,P=0.15)in the primipara women subgroup.CNP could reduce the postpartum 24 h hemorrhage volume in the unclassified parturients subgroup(SMD=—1.47,95％CI:—1.72——1.21,P＜0.001).Conclusion Application of CNP in parturients labor analgesia could reduce the perineal lateral incision rate and incidence rate of postpartum urinary retention and shorten the time to lac-tation initiation.Due to the heterogeneity among studies,the impact of CNP on the labor duration and the bleeding amount within postpartum 24 h still requires more high-quality studies to be conducted in the future for verification.

Objective To investigate the therapeutic mechanism of Pterocarya hupehensis Skan total flavonoids(PHSTF)for rheumatoid arthritis(RA).Methods Twenty-five male SD rats were randomly divided into normal control group,RA model group,PHSTF treatment(45 and 90 mg/kg)groups,and Tripterygium glycosides(TPG)tablet(10 mg/kg)group(n=5).Except for those in the normal control group,all the rats were subjected to collagen-induced arthritis(CIA)modeling using a secondary immunization method,after which PHSTF and TPG were administered via gavage once daily for 4 weeks.After the treatments,serum levels of TNF-α and IL-1β were measured using ELISA,and ankle joint pathologies were assessed with HE staining;the expression of citrullinated histone H3(Cit-H3),a neutrophil extracellular trap(NET)marker,in the ankle joints was evaluated with immunohistochemistry.In primary cultures of rat peripheral blood neutrophils stimulated with phorbol ester(PMA),the effects of PHSTF(100 and 200 μg/mL)on the expressions of Cit-H3,peptidylarginine deiminase 4(PADI4),neutrophil elastase(NE),and myeloperoxidase(MPO)were examined with Western blotting;immunofluorescence assay was used to observe Cit-H3 expression and NET formation in the cells.Results In the CIA rat models,PHSTF significantly alleviated ankle swelling,decreased serum levels of TNF-α and IL-1β,improved histopathological changes in the ankle joints,and reduced Cit-H3 expression in both the serum and ankle joint cartilage.In the isolated rat neutrophils,PHSTF showed no significant effect on cell viability but strongly inhibited PMA-induced NET release.Conclusion PHSTF can alleviate RA by inhibiting the formation of NETs.

Objective To investigate the therapeutic mechanism of Pterocarya hupehensis Skan total flavonoids(PHSTF)for rheumatoid arthritis(RA).Methods Twenty-five male SD rats were randomly divided into normal control group,RA model group,PHSTF treatment(45 and 90 mg/kg)groups,and Tripterygium glycosides(TPG)tablet(10 mg/kg)group(n=5).Except for those in the normal control group,all the rats were subjected to collagen-induced arthritis(CIA)modeling using a secondary immunization method,after which PHSTF and TPG were administered via gavage once daily for 4 weeks.After the treatments,serum levels of TNF-α and IL-1β were measured using ELISA,and ankle joint pathologies were assessed with HE staining;the expression of citrullinated histone H3(Cit-H3),a neutrophil extracellular trap(NET)marker,in the ankle joints was evaluated with immunohistochemistry.In primary cultures of rat peripheral blood neutrophils stimulated with phorbol ester(PMA),the effects of PHSTF(100 and 200 μg/mL)on the expressions of Cit-H3,peptidylarginine deiminase 4(PADI4),neutrophil elastase(NE),and myeloperoxidase(MPO)were examined with Western blotting;immunofluorescence assay was used to observe Cit-H3 expression and NET formation in the cells.Results In the CIA rat models,PHSTF significantly alleviated ankle swelling,decreased serum levels of TNF-α and IL-1β,improved histopathological changes in the ankle joints,and reduced Cit-H3 expression in both the serum and ankle joint cartilage.In the isolated rat neutrophils,PHSTF showed no significant effect on cell viability but strongly inhibited PMA-induced NET release.Conclusion PHSTF can alleviate RA by inhibiting the formation of NETs.

To clarify the genetic diversity and structure of the nucleus population of F1-generation Litopenaeus vannamei, this study utilized 15 pairs of highly polymorphic microsatellite primers to analyze the simple sequence repeat (SSR) markers and genetic diversity in 15 full-sib families of L. vannamei. A total of 112 alleles (N_a) and 60.453 effective alleles (N_e) were identified among the selected 15 SSR loci, with the average polymorphic information content (PIC) of 0.648. The average N_e, observed heterozygosity (H_o), and expected heterozygosity (H_e) in the 15 F1 families varied from 1.925 to 2.626, 0.425 to 0.783, and 0.403 to 0.572, respectively. The 15 full-sib families were primarily clustered into three categories in the phylogenetic analysis, with the genetic distance between families ranging from 0.252 to 0.574. Additionally, the genetic differentiation coefficient (F_st) among the families varied from 0.112 to 0.278, indicating substantial genetic differentiation. Overall, this study suggested that the genetic diversity of the 15 full-sib families was moderate, providing valuable genetic insights for the subsequent breeding initiatives aimed at enhancing the tolerance of L. vannamei to high levels of soybean meal.
Penaeidae/classification* ; Microsatellite Repeats/genetics* ; Animals ; Genetic Variation ; Polymorphism, Genetic ; Phylogeny ; Alleles ; Genetic Markers

【Objective】 To investigate the prevalence and risk factors of primary nocturnal enuresis (PNE) in adolescents, and to explore its psychological effects. 【Methods】 During Sep.2020 and Dec.2020, an epidemiological survey was conducted among 6 408 junior and senior high school students in a region of Henan Province by stratified and cluster random sampling. The survey included general information questionnaire, urinary frequency, urgency, incontinence, recurrent urinary tract infection (RUTI), Enuresis Questionnaire, Self-esteem Scale (SES) and the Pittsburgh Sleep Quality Index (PSQI). 【Results】 A total of 7, 000 questionnaires were distributed and 6 408 (91.54%) were valid. The survey showed that the total prevalence of PNE among adolescents was 2.98%. The prevalence was 4.67% in those aged 12 years and 1.37% in those aged 18 years. The results of Logistic regression analysis showed that male (OR=1.677, P<0.05), overweight (OR=1.842, P<0.05), urgency (OR=1.676, P<0.05), frequency (OR=1.919, P<0.05), incontinence (OR=3.493, P<0.001), RUTI (OR=2.535, P<0.001) and family history (OR=3.005, P<0.001) were related to the risk of PNE. The SES score of PNE patients was lower than that of non-PNE group (z=-3.097, P<0.05), and the PSQI was higher (z=-5.456, P<0.05). 【Conclusion】 The prevalence of PNE is high in adolescents and decreases gradually with age. Male, overweight, frequency, urgency, incontinence, RUTI and family history are risk factors. PNE has a negative impact on self-esteem and sleep quality in adolescents.

【Objective】 To investigate the current situation and related factors of emotional and behavioral problems in children with diurnal urinary incontinence (DUI), in order to provide reference for clinical treatment and psychological intervention. 【Methods】 During Sep.2019 and Mar.2020, a survey was conducted in six primary schools in a county of Henan Province using the method of cluster sampling. The survey included general data and current DUI and urination-related problems, Strengths and Difficulties Scale (SDQ), and Pittsburgh Sleep Quality Index (PSQI). 【Results】 Of the 4 500 questionnaires distributed, 4 120 were collected, and 3 912 were qualified for statistical analysis. The overall prevalence of DUI was 3.6%. The detection rate of abnormal emotion and behavior in the DUI group was 48.2%, which was significantly higher than that in the non-DUI group (12.6%) (P<0.05). The scores of emotional symptoms, conduct problems, hyperactivity, peer communication problems and SDQ were significantly higher in the DUI group than in the control group (P<0.05). The results of multivariate analysis showed that gender, academic achievement, DUI times, caregivers, caregivers’ education level, family education style and sleep disorder were influencing factors of emotional and behavioral problems in DUI children (P<0.05). The total score of SDQ was positively correlated with the total score of PSQI (P<0.05). 【Conclusion】 The detection rate of emotional and behavioral abnormalities is high in DUI children, which is related to gender, academic achievement, DUI times, caregivers, education level of caregivers, family education style and sleep disorders.

Familial primary nocturnal enuresis (FPNE) is common in clinical practice and has shown an obvious familial aggregation that is associated with genetic factors.It has been found that chromosomes 4, 8, 12, 13 and 22 are related to the inheritance of enuresis. PRDM13 and EDNRB genes are related to the pathogenesis of enuresis, but the specific functions remain unclear.FPNE accounts for a high proportion in patients with refractory enuresis.Compared with other types of primary enuresis, FPNE is not difficult to be diagnosed, as long as the related family members have enuresis, it can be diagnosed as FPNE.Due to treatment difficulties, FPNE easily lasts into adulthood, serving as a type of intractable enuresis.Therefore, early diagnosis and active intervention should be made for children with FPNE.In this review, the epidemiology, pathogenesis, diagnosis and treatment of FPNE were summarized, aiming to provide references for improving the clinical diagnosis and treatment of FPNE.

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.

Objective To explore the utility of CT for the evaluation of abdominal aortic calcification(AAC)in chronic kidney disease(CKD).Methods Laboratory examination indexes and abdominal plain CT imaging of 132 CKD stage 3-5 patients were analyzed retrospectively.The ACC score was evaluated according to quantitative method,the risk factors related to AAC were analyzed.Results In correlation analyses,AAC score was positively correlated with creatinine(Cr)level,CO2 combining power(P＜0.05),and negatively corrected with albumin(ALB).Logistic regression analysis showed that Cr level were risk factors for AAC,and ALB were protective factors.Conclusion Based on abdominal plain CT images,Cr level,CO2 combining power and ALB level are related to AAC.Quantitative method based on CT has a high application value in evaluating AAC.

Anorectal malformation (ARM) accounts for the first place of digestive tract malformations in children, with the incidence of 1/5 000-1/1 500 in newborns.ARM is typically manifested as anal stenosis or anal atresia with or without fistulas and persistent cloaca.Genitourinary malformation is the most common malformation associated with ARM, with the incidence ranging 26%-55%.There were 35%-50% of ARM children develop spinal cord peripheral abnormalities or neurogenic lower urinary tract dysfunction, which usually causes voiding dysfunction associated with ARM.Urodynamic study is the best method to analyze the changes of lower urinary tract function, which can provide an objective classification for bladder and urethral function and guide the formulation of precision treatment plan and therapeutic efficacy during the follow-up period.This study aims to review the cause of voiding dysfunction asso-ciated with ARM and its urodynamic changes.