Objective To explore the factors affecting the prognosis of patients with symptomatic severe intracranial artery stenosis after interventional therapy,and to construct a nomogram prediction model accordingly.Methods The clinical data of 121 patients with symptomatic severe intracranial artery stenosis,who received interventional treatment at the First People's Hospital of Zhengzhou from June 1,2021 to October 31,2024,were retrospectively analyzed.The general data,characteristics of vascular lesions,treatment-related factors and prognosis of patients were collected.According to the modified Rankin scale(mRS)score,the patients were divided into good prognosis group(mRS score ≤2 points)and poor prognosis group(mRS score＞2 points).The clinical data were compared between the two groups.Multivariate logistic regression analysis was used to identify and determine independent factors affecting patient's outcomes,to construct a nomogram prediction model and to validate this model.Results Among the 121 patients,31(25.61％)had poor prognosis and 90(74.38％)had good prognosis.The postoperative 3-month mRS score was lower than preoperative mRS score value(P＞0.05).There were significant differences in hypertension history,stenosis site,stenosis degree,collateral circulation state,interventional therapeutic mode,cholesterol level,platelet count,lesion length and preoperative NIHSS score(P＜0.05)between the poor prognosis group and the good prognosis group.Multivariate analysis showed that hypertension history,stenosis degree,collateral circulation status,cholesterol level,platelet count,lesion's length and preoperative NIHSS score were the independent influencing factors for the prognosis of patients with symptomatic severe intracranial artery stenosis.The predicted AUC of the nomogram model was 0.931(95％ CI=0.873-0.989),and the calibration curve showed that the predicted value was in good agreement with the actual value.Conclusion Hypertension history,stenosis degree,collateral circulation status,cholesterol level,platelet count,lesion length and preoperative NIHSS score are the important influencing factors for the prognosis of patients with symptomatic severe intracranial artery stenosis.The nomogram prediction model constructed in this study shows a high accuracy in predicting the prognosis of patients,and it can provide important reference for clinical decision-making.

Objective:To explore the impact of various fixatives on the nuclear-cytoplasmic localization of Yes-associated protein (YAP) in human corneal epithelial cells under hyperosmotic stress condition.Methods:Immortalized human corneal epithelial cells were divided into control group and hypertonic group.After 1 day of normal culture, cells of the hypertonic group were exposed to hyperosmotic medium at 450 mOsM by adding sodium chloride for 1 hour.No special treatment was given to the control group.Both groups of cells were fixed with four different fixatives, including 4% paraformaldehyde (PFA), -20 ℃ precooled absolute ethanol, -20 ℃ precooled methanol-acetone 1∶1 mixture, and Zamboni fixative solution for 20 minutes.Subsequent to fixation, immunofluorescent staining procedures were performed to identify the intracellular localization of YAP in the two groups.Results:After fixation with 4% PFA, human corneal epithelial cells showed normal morphology with YAP mainly in the nucleus in both groups, and there was no significant difference in the mean nuclear YAP fluorescence intensity between the two groups ( t=1.803, P=0.121).After fixation with absolute ethanol, cells showed some degree of shrinkage and deformation, diffuse YAP fluorescence staining with YAP-positive signals mainly localized in the cytoplasm in both groups, and the mean nuclear YAP fluorescence intensity was slightly decreased in the hypertonic group compared with the control group, but the difference was not statistically significant ( t=0.803, P=0.453).After fixation with methanol-acetone 1∶1 mixture, cells were crenulated with YAP mainly in the cytoplasm, and the mean nuclear YAP fluorescence intensity in the hypertonic group was slightly decreased compared with the control group, but the difference was not statistically significant ( t=1.067, P=0.327).After fixation with Zamboni solution, the cell structure was complete and clearly outlined, and the YAP nucleoplasmic translocation phenomenon could be clearly observed in cells in different states.The mean nuclear YAP fluorescence intensity in the hypertonic group was 197.5±34.5, which was significantly higher than 62.2±10.0 in the control group ( t=7.530, P<0.001). Conclusions:In the immunofluorescence staining experiment, the nucleoplasmic localization of YAP in corneal epithelial cells is affected by different fixative treatments.Zamboni fixative is better than 4% PFA, absolute ethanol, and methanol-acetone 1∶1 mixture in observing nuclear translocation of YAP after hypertonic stimulation.

Objective To explore the effect of Sangxing Zhike Formula in rats with cough vari-ant asthma(CVA)and its possible mechanism based on the cyclic adenosine monophosphate(cAMP)/cystic fibrosis transmembrane conductance regulator(CFTR)pathway.Methods SD rats were randomly divided into control group,model group,dexamethasone group(0.5 mg/kg)and low-,medium-,high-dose Sangxing Zhike Formula groups(9.6,19.2 and 38.4 g/kg)using a ran-dom number table method,with 9 rats in each group.Except for the control group,CVA rat models were established in the other groups.Rats in each group were administered the drug by gavage once a day for 14 consecutive days.The general conditions of rats in each group were observed.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of interleukin-1β(IL-1β)and interleukin-18(IL-18)in rat serum.Hematoxylin-eosin(HE)staining and periodic acid-Schiff(PAS)staining were used to observe the pathological changes in rat lung and bronchial tissues,and the acid-base balance of airway surface liquid(ASL)was measured.Western blot and real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)were used to detect the expression levels of pro-tein kinase A(PKA),CFTR protein and their mRNA in lung tissues of rats.Results Compared with the control group,rats in the model group showed listlessness,dull fur,slow weight gain,a significantly expanded area of alveolar septal consolidation,and a large number of inflammatory cell infiltrations around the bronchi.Compared with the model group,rats in each intervention group had better general conditions and reduced inflammatory infiltrations in lung tissues and bronchial lu-mens.Compared with the control group,the serum levels of IL-1 β and IL-18 in the model group were increased,and the pH values of ASL in the model group,low-dose Sangxing Zhike Formula group,medium-dose Sangxing Zhike Formula group,and high-dose Sangxing Zhike Formula group were all decreased,with statistically significant differences(P＜0.05).Compared with the model group,the serum levels of IL-1β and IL-18 in each intervention group were decreased,and the pH values of ASL in the dexamethasone group,medium-dose Sangxing Zhike Formula group,and high-dose Sangxing Zhike Formula group were increased,with statistically significant differences(P＜0.05).Compared with the control group,the expressions of PKA protein and PKA mRNA in the model group,low-dose Sangxing Zhike Formula group,and medium-dose Sangxing Zhike Formula group were all decreased,and the expressions of CFTR protein and CFTR mRNA in the model group and each intervention group were all decreased,with statistically significant differences(P＜0.05).Compared with the model group,the expressions of PKA protein and PKA mRNA in the dexametha-sone group and high-dose Sangxing Zhike Formula group were increased,and the expressions of CFTR protein and CFTR mRNA in the high-dose Sangxing Zhike Formula group were increased,with statistically significant differences(P＜0.05).Conclusion Sangxing Zhike Formula can im-prove the general conditions of CVA rats,regulate the acid-base balance of ASL,reduce airway in-flammatory cell infiltration andairway remodeling,and decrease the levels of inflammatory factors IL-1β and IL-18.Its mechanism may be related to the cAMP/CFTR pathway.

Objective:To explore the impact of various fixatives on the nuclear-cytoplasmic localization of Yes-associated protein (YAP) in human corneal epithelial cells under hyperosmotic stress condition.Methods:Immortalized human corneal epithelial cells were divided into control group and hypertonic group.After 1 day of normal culture, cells of the hypertonic group were exposed to hyperosmotic medium at 450 mOsM by adding sodium chloride for 1 hour.No special treatment was given to the control group.Both groups of cells were fixed with four different fixatives, including 4% paraformaldehyde (PFA), -20 ℃ precooled absolute ethanol, -20 ℃ precooled methanol-acetone 1∶1 mixture, and Zamboni fixative solution for 20 minutes.Subsequent to fixation, immunofluorescent staining procedures were performed to identify the intracellular localization of YAP in the two groups.Results:After fixation with 4% PFA, human corneal epithelial cells showed normal morphology with YAP mainly in the nucleus in both groups, and there was no significant difference in the mean nuclear YAP fluorescence intensity between the two groups ( t=1.803, P=0.121).After fixation with absolute ethanol, cells showed some degree of shrinkage and deformation, diffuse YAP fluorescence staining with YAP-positive signals mainly localized in the cytoplasm in both groups, and the mean nuclear YAP fluorescence intensity was slightly decreased in the hypertonic group compared with the control group, but the difference was not statistically significant ( t=0.803, P=0.453).After fixation with methanol-acetone 1∶1 mixture, cells were crenulated with YAP mainly in the cytoplasm, and the mean nuclear YAP fluorescence intensity in the hypertonic group was slightly decreased compared with the control group, but the difference was not statistically significant ( t=1.067, P=0.327).After fixation with Zamboni solution, the cell structure was complete and clearly outlined, and the YAP nucleoplasmic translocation phenomenon could be clearly observed in cells in different states.The mean nuclear YAP fluorescence intensity in the hypertonic group was 197.5±34.5, which was significantly higher than 62.2±10.0 in the control group ( t=7.530, P<0.001). Conclusions:In the immunofluorescence staining experiment, the nucleoplasmic localization of YAP in corneal epithelial cells is affected by different fixative treatments.Zamboni fixative is better than 4% PFA, absolute ethanol, and methanol-acetone 1∶1 mixture in observing nuclear translocation of YAP after hypertonic stimulation.

Due to physiological and metabolic characteristics and disease characteristics being different from adults, such as the high incidence of infectious diseases, children are at a high-risk of acute kidney injury (AKI) related to anti-bacterial agents, and there were many challenges in prevention and treatment. The hot issues in the research of anti-bacterial agent-related AKI in children, including the study of nephrotoxicity mechanism of anti-bacterial agents, the exploration of early biomarkers, and the optimization of treatment strategies, are expounded in this article. In the future, it is recommended to strengthen researches on child specificity, deepen basic researches, optimize monitoring plans for pediatric treatment drugs, and establish a pediatric drug monitoring system, so as to provide references for rational clinical drug use of the anti-bacterial agents and further researches on AKI.

Nocturnal enuresis (NE) is a common pediatric disease with unclear pathogenesis.The prevailing hypothesis is that NE is caused by a discrepancy between nocturnal urine output and bladder capacity and sleep-wake disturbances.Monosymptomatic nocturnal enuresis (MNE) with nocturnal polyuria is a common subtype of NE, which can be effectively treated by Desmopressin.However, it is possible that some children may demonstrate an inability to respond favorably to this form of therapy and become resistant to it, which significantly impacts their physical and mental health and overall quality of life.In this article, recent advances in the pathogenesis and treatment of Desmopressin-resistant MNE with nocturnal polyuria in children were reviewed to provide a reference for its treatment.

Due to physiological and metabolic characteristics and disease characteristics being different from adults, such as the high incidence of infectious diseases, children are at a high-risk of acute kidney injury (AKI) related to anti-bacterial agents, and there were many challenges in prevention and treatment. The hot issues in the research of anti-bacterial agent-related AKI in children, including the study of nephrotoxicity mechanism of anti-bacterial agents, the exploration of early biomarkers, and the optimization of treatment strategies, are expounded in this article. In the future, it is recommended to strengthen researches on child specificity, deepen basic researches, optimize monitoring plans for pediatric treatment drugs, and establish a pediatric drug monitoring system, so as to provide references for rational clinical drug use of the anti-bacterial agents and further researches on AKI.

Nocturnal enuresis (NE) is a common pediatric disease with unclear pathogenesis.The prevailing hypothesis is that NE is caused by a discrepancy between nocturnal urine output and bladder capacity and sleep-wake disturbances.Monosymptomatic nocturnal enuresis (MNE) with nocturnal polyuria is a common subtype of NE, which can be effectively treated by Desmopressin.However, it is possible that some children may demonstrate an inability to respond favorably to this form of therapy and become resistant to it, which significantly impacts their physical and mental health and overall quality of life.In this article, recent advances in the pathogenesis and treatment of Desmopressin-resistant MNE with nocturnal polyuria in children were reviewed to provide a reference for its treatment.

Background Fatigue driving is an important cause of road traffic accidents in modern society, and the fatigue condition of heavy-duty commercial truck drivers has attracted widespread attention. Research on the fatigue status and influencing factors of heavy-duty commercial truck drivers in China is relatively rare at present. Objective To analyze the main characteristics of fatigue among heavy-duty commercial truck drivers and the impacts of factors such as working hours, insomnia, and occupational burnout on their fatigue status. Methods Using cluster sampling method, a cross-sectional study was conducted from July to August 2023, enrolling heavy-duty commercial truck drivers in long-distance freight logistics markets (stations) located in three administrative regions of W City, Xinjiang Uygur Autonomous Region. A self-designed questionnaire was used to collect demographic and occupational characteristics of heavy-duty commercial truck drivers, and the Chinese versions of Fatigue Scale-14 (FS-14), Athens Insomnia Scale (AIS), and Maslach Burnout Inventory General Survey (MBI-GS) were used to evaluate their fatigue, insomnia, and occupational burnout status, respectively. Mann-Whitney U test and Kruskal-Walls H test were used to compare intergroup differences, and Spearman correlation coefficient was used to analyze the correlation between variables. Hierarchical regression models were used to study the impacts of selected variables on fatigue status. Results This study obtained 311 valid questionnaires, with a valid recovery rate of 88.86% (311/350). The physical fatigue, mental fatigue, and total fatigue scores of the survey subjects in M (P₂₅, P₇₅) were 3.00 (2.00, 4.00), 2.00 (1.00, 3.00), and 5.00 (4.00, 6.00), respectively. The comparison results showed that, except for smoking, there were statistically significant differences in total fatigue scores between different groups of age, marital status, number of children, educational level, service length of freight transportation, average daily working time, and average monthly income (P<0.05). The difference in total fatigue score among the groups without sleep disorders, with suspected insomnia, and with insomnia was statistically significant (P<0.001). The difference in total fatigue score among the groups without occupational burnout, with moderate occupational burnout, and with severe occupational burnout was also statistically significant (P<0.001). Positive correlations were found between insomnia score and scores of physical fatigue (r_s=0.507), mental fatigue (r_s=0.547), and total fatigue (r_s=0.618) (P<0.001). Hierarchical regression models revealed that having more children, extended daily working hours, insomnia, and increased scores of decreased personal accomplishment were negative factors affecting the fatigue status of heavy-duty commercial truck drivers (P<0.05), and the final regression equation was: total fatigue score=7.579+0.581×number of children+0.916×average daily working time+0.434×score of AIS+0.754×score of reduced personal accomplishment. Conclusion The fatigue status of heavy-duty commercial truck drivers is not optimistic. An increase in the number of children, extended daily working hours, severe insomnia symptoms, and increased scores of decreased personal accomplishment associate with their worse fatigue status.

Objective:To investigate the efficacy and safety of Rituximab (RTX) in the treatment of children with frequently relapsing/steroid-dependent nephrotic syndrome (FRNS/SDNS) and to analyze the factors influencing the efficacy.Methods:Case series study.The clinical data of children with FRNS/SDNS who received B-cell-guided RTX (single dose: 375 mg/m 2, maximum dose: 500 mg, one additional dose when peripheral blood CD19 + B lymphocytes ≥0.01) in the First Affiliated Hospital of Zhengzhou University from September 2019 to March 2022 were retrospectively collected.The frequency of relapse and cumulative dose of glucocorticoids before and after RTX treatment were compared.The Kaplan-Meier method was used to analyze relapse-free survival rate and FRNS/SDNS-free survival rate after RTX treatment.The influencing factors of relapse were analyzed using the Cox proportional hazards regression model. Results:Totally 47 children were enrolled, including 35 males and 12 females; the age of first application of RTX was 10.2 (6.9, 13.0) years; 33 children had used one type of immunosuppressant before, and 14 children had used two or more types of immunosuppressant before; the dose of RTX treatment was 3.0 (2.0, 3.0). The frequency of relapse[0(0, 0.55) times/year vs.1.62 (1.09, 2.40) times/year] and cumulative dose of glucocorticoids[0.12 (0.05, 0.21) mg/(kg·d) vs.0.40 (0.20, 0.56) mg/(kg·d)] after RTX treatment significantly decreased compared with previous immunosuppressive treatment ( Z=-5.56, -5.54, all P<0.001). The relapse-free survival rates at 6, 12, 18 and 24 months after treatment were 80.9%, 72.3%, 68.1% and 68.1%, respectively, and the FRNS/SDNS-free survival rates were 93.6%, 89.4%, 89.4% and 89.4%, respectively.Univariate Cox regression analysis showed that the high frequency of relapse during previous immunosuppressive therapy was a risk factor for relapse after RTX treatment ( P<0.05). Of the 14 children who relapsed, 6 occurred in children whose CD19 + B lymphocytes<0.01, and the frequency of relapse after RTX treatment was significantly higher than those whose CD19 + B lymphocytes≥0.01 ( Z=-2.84, P=0.005). No severe adverse reactions occurred during RTX treatment and follow-up. Conclusions:The B-cell-guided RTX is effective and safe in the treatment of FRNS/SDNS in children.The high frequency of relapse during previous immunosuppressive therapy is a risk factor for relapse after RTX treatment, and relapse in the state of B lymphocyte depletion predicts poor outcomes of RTX treatment.