ObjectiveTo explore the regulation of hypothalamic-pituitary-gonadal （HPG） axis by modified Erxian decoction in rats with perimenopausal syndrome （PMS） and to further analyze the expression of proteins related to the silent information regulator 1 （SIRT1）/hypothalamic kisspeptin （Kisspeptin）/gonadotropin-releasing hormone （GnRH） signaling pathway in the arcuate nucleus region （ARC） of the hypothalamus， so as to reveal the potential target of action and molecular biological mechanism of modified Erxian decoction for the treatment of perimenopausal syndrome. MethodsAn animal model was established via the incomplete castration method， with successful modeling confirmed by the exfoliated cervical cell smear method. The 48 rats were divided into six groups based on the randomization principle after successful modeling， including a sham operation group， a model group， an estradiol valerate group （0.09 mg∙kg^-1∙d^-1）， high-， medium-， and low-dose modified Erxian decoction groups （7.614， 3.807，1.903 5 g∙kg^-1∙d^-1）， with 8 rats in each group. The estradiol valerate group and the high-， medium- and low-dose modified Erxian decoction groups were continuously administered by gavage for 28 days， and the indicators were detected 24 hours after the last administration. Body weights and uterine indices were measured. The pathological changes of the uterus were observed by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of estradiol （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and gonadotropin-releasing hormone （GnRH）. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to determine the expression levels of SIRT1， Kisspeptin， kisspeptin receptor （GPR54）， and GnRH in the ARC region of the hypothalamus and gonadotropin-releasing hormone receptor （GnRH-R） in pituitary. ResultsCompared with the sham operation group， rats in the model group had a significantly increased body weight （P0.01）， reduced wet weight and index of uterus （P0.01）， endometrial thinning or atrophy， glandular atrophy， and a decreasing number of glands. Additionally， serum levels of E₂ and the expression of SIRT1 in the ARC region of the hypothalamus significantly decreased （P0.01）. Serum levels of FSH， LH， and GnRH， the expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus， and GnRH-R in pituitary significantly increased （P0.01）. Compared with the model group， the estradiol valerate group and the high-， medium-dose modified Erxian decoction groups had significantly reduced body weight， serum levels of FSH， LH， and GnRH， and expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus and GnRH-R in pituitary （P0.05， P0.01） and significantly increased wet weight and index of uterus， serum level of E₂， and expression of SIRT1 in the ARC region of the hypothalamus （P0.05， P0.01）. In addition， they showed thickened endometrium， increased number of endometrial glands， and improved glandular atrophy. ConclusionModified Erxian decoction regulates the function of the HPG axis through multi-targets， and its mechanism of action may be related to the up-regulation of the expression of SIRT1 in the ARC region of the hypothalamus， the inhibition of the over-activation of the Kisspeptin/GnRH signaling pathway， the regulation of the expression of GnRH-R in the pituitary， the restoration of secretion balance of gonadotropins， and the elevation of the estrogen level. This study provides an experimental basis for the interpretation of the scientific connotation of modified Erxian decoction in the treatment of perimenopausal syndrome and a theoretical reference for the development of a novel therapeutic strategy based on the SIRT1/Kisspeptin/GnRH pathway.

Objective To assay the salivary ANG-2 level of oral lichen planus(OLP)patients,and analyze its correlation with in-flammatory activity of OLP.Methods Eighty-nine OLP patients were included,and divided into four subgroups as non-erosive asymp-tomatic(NEA),non-erosive symptomatic(NES),minor-erosive(MIE)and major-erosive(MAE)groups.Fifteen healthy adults were recruited as controls.Whole unstimulated saliva was collected from each participant,and the salivary ANG-2 level was measured by chemiluminescence immunoassays(CLIA)for analysis.Normal oral mucosal tissue,non-erosive and erosive OLP tissues were collected to detect and analyze the expression of ANG-2 positive blood vessels by immunohistochemistry(IHC).Results The base-lines of age and gender between OLP and control groups showed no significant difference.Compared to controls,the salivary ANG-2 levels of OLP group,non-erosive and erosive OLP subgroups were significantly higher(P＜0.05),in which erosive OLP group was higher than non-erosive OLP group(P=0.022);NES subgroup was slightly higher than NEA(P=0.048),and there was no statistical significance between MIA and MEA subgroups(P=0.067).Spearman correlation analysis showed a positive correlation between sali-vary ANG-2 level and inflammation activity in OLP patients(r=0.314,P=0.003).The expression of ANG-2 in non-erosive OLP mu-cosal tissues slightly increased than normal oral mucosal tissue(P＞0.05),but there was no significant difference.The expression of ANG-2 in erosive OLP mucosal tissues significantly increased than normal oral mucosal tissue(P＜0.001)and non-erosive OLP group(P＜0.001).Conclusion There is a certain correlation between sali-vary ANG-2 level and inflammatory activity of OLP,indicating that salivary ANG-2 level is probable to be one of the inflammatory activity indicators to monitor the state-variation of OLP as a clinical non-inva-sive method.

Objective To investigate the current status of sleep quality,depression,anxiety and stress of special service convalescents and their correlation.Methods A questionnaire survey was conducted on 311 special service convalescents by the Pittsburgh sleep quality index(PSQI)and the depression-anxiety-stress self-rating scale-21(DASS-21)from May to July 2022.Results The mean total PSQI score of 311 special service convalescents was 4.93±3.14,and 63 of them(20.26%)had sleep quality problems(total score of PSQI>7).The proportions of respondents with the scores≥2 in sleep time,daytime dysfunction,subjective sleep quality,and fall-asleep time were 30.87%,26.05%,21.22%,and 20.26%,respectively.The proportions of respondents with mild depression,anxiety and stress were 6.11%,4.50%and 2.57%,respectively,which were higher than the other three grades(moderate,severe and very serious).The incidence of sleep quality problems,depression,anxiety,and stress in respondents aged 40 years and above was higher than those in the other age groups,and there was a tendency to increase with age.The total score of PSQI and all factors(except hypnotic drugs)were positively correlated with depression,anxiety,and stress in special service convalescents(all P<0.01).Regression analysis showed that depression and stress were the direct influencing factors of sleep quality.Conclusion The special service convalescents have varying degrees of sleep quality problems and negative emotions such as depression,anxiety,and stress,especially those aged 40 years and above.Sleep quality is closely related to depression,anxiety,and stress.

Objective To investigate the epidemiological survey of pulmonary Aspergillus infection in a district of Hefei City, Anhui Province, from 2019 to 2023. Methods The data of 302 patients who attended and were treated in the respiratory department, thoracic surgery department, oncology department, tuberculosis department and RICU ward of Anhui Chest Hospital from January 2019 to September 2023 were selected, and patients with Aspergillus infections were taken as the observation group, patients with Candida infections were taken as the control group, and bacterial infections were taken as the blank group. The general information of patients, pre-treatment infection, underlying diseases, and use of antifungal drugs were analyzed. Compare the data of observation group and control group, and analyze the risk factors affecting pulmonary Aspergillus infection. Results Pulmonary Aspergillus infection 100 cases, accounting for 33.11%. Pulmonary Candida infection was 80 cases, accounting for 26.49%. The other 122 cases were other lung diseases, accounting for 40.40%. The most common causative agent of pulmonary Aspergillus infection was Aspergillus fumigatus (57.00%), cough, sputum and occasional blood were found in most of the patients (88.00%), most of the lesions were located in the right upper lobe of the lungs (55.00%), and most of the single or multiple cavities were seen on imaging (47.00%). Specimens mostly originated from the deep airways of hospitalized patients and there was a predominance of male patients. Risk factors for pulmonary Aspergillus infection were history of hospital transfer, ICU admission, mechanical ventilation, extracorporeal catheterization (intravenous catheter and urinary catheter), history of surgery within 15 days, history of diabetes mellitus, history of respiratory chronic disease, history of antifungal prophylaxis and abnormal serum indicators. History of hospital transfer (OR=2.951, P=0.008), history of diabetes mellitus (OR=5.073, P=0.018), history of chronic respiratory disease (OR=7.523 , P=0.028), extracorporeal catheterization (OR=3.142, P=0.022), and history of anti-fungal prophylaxis (OR=6.334, P<0.001) were Aspergillus pulmonaryis infection independent risk factors for infection. Conclusion Aspergillus fumigatus and Aspergillus flavus are the main pathogens of pulmonary Aspergillus infections in the region, and a history of nosocomial transfer, extracorporeal tubes, diabetes mellitus, chronic respiratory disease, and antifungal prophylaxis are independent risk factors for pulmonary Aspergillus infections.

BackgroundDepression has become a public health concern that affects the physical and mental health of college students. acute stress response is a risk factor of depression. Exploring the relationship and mechanism between acute stress response and depression is of great significance for preventing and intervening depression in college students. ObjectiveTo examine the relationship between acute stress response and depression among college students， and to analyze the mediating role of rumination and the moderated effect of perceived social support， so as to provide references for the prevention and intervention of depression in college student . MethodsFrom March to April 2020， a cluster sampling method was employed to select 1 355 college students from three universities in Hubei， Jiangxi and Guangxi Zhuang Autonomous Region. Participants were assessed with Acute Stress Disorder Scale （ASDS）， Ruminative Responses Scale （RRS）， Brief form of Perceived Social Support Questionnaire （F-SozU） and Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）. Pearson correlation analysis was adopted to examine the correlation between the scores of each scale. The mediating role of rumination between acute stress response and depression and the moderated role of perceived social support were examined respectively by using Model 4 and Model 14 in Macro Program Process 3.3. ResultsA total of 1 303 valid questionnaires were collected， yielding a valid response rate of 96.16%. The results of Pearson correlation analysis showed that ASDS score was positively correlated with RRS score and PHQ-9 score （r=0.649， 0.528， P<0.01） among college students. The mediation analysis results demonstrated that rumination played a partial mediating role between acute stress response and depression， with the mediating effect value of 0.273 （95% CI：0.222~0.328）， accounting for 68.59% of the total effect. Perceived social support played a moderated role in the latter path of the mediation model （rumination → depression） （β=-0.004， 95% CI： -0.017~-0.004， P<0.01）. ConclusionRumination played a partial mediating role between acute stress response and depression in college students， and perceptive social support played a moderated role between rumination and depression. ［Funded by Scientific Research Fund Project of Education Department of Yunnan Province （number， 2025J0437）］

Organ transplantation has emerged as a therapeutic modality for children with end-stage organ failure.With advancements in surgical techniques,organ preservation methods,and immunosuppressive thera-pies,both the success rate of transplantation and the long-term quality of life of recipients have continued to im-prove.Initially applied primarily in cardiothoracic transplantation,extracorporeal membrane oxygenation(ECMO)has gradually expanded its role in pediatric organ transplant recipients to include perioperative support for cardiopulmonary complications in abdominal organ transplants such as liver and kidney,as well as in the maintenance of deceased donors.With ongoing refinements in ECMO technology and equipment,its sig-nificance in supporting children with end-stage organ failure has become increasingly prominent,offering re-newed hope and survival for a growing number of pediatric patients with organ failure.

Objective:To investigate the regulatory effect of follistatin-like 1 protein (FSTL1) on the differentiation of mesenchymal stem cells (MSCs) into myofibroblasts in renal tissue and on renal fibrosis induced by renal ischemia-reperfusion injury (IRI).Method:In animal experiments, a unilateral renal IRI-induced fibrosis model was established by clamping the left renal pedicle (IRI 7 d group, n=3), with a sham-operated group as control (Sham 7 d group, n=3). Twelve male C57BL/6 mice were randomly assigned to sham operation (Sham group, n=4), model (IRI group, n=4) and FSTL1 treatment (IRI+FSTL1 group, n=4) groups. The Sham group underwent laparotomy sham surgery, while the IRI group and IRI+FSTL1 group underwent unilateral renal IRI surgery. From 1 day before surgery to 7 days after surgery, mice received daily intraperitoneal injections of phosphate buffered saline (Sham group and IRI group) or recombinant FSTL1 protein (IRI+FSTL1 group). The mice were sacrificed 14 days after surgery. Renal histopathological damage was evaluated by hematoxylin-eosin (HE) staining. Collagen fiber deposition and fibronectin (FN) accumulation in renal interstitium were assessed by Sirius red staining, Masson’s trichrome staining and immunohistochemical staining. The co-expression level of stem cell antigen-1 (SCA-1) and α-smooth muscle actin (α-SMA) was detected by double immunofluorescence staining. The mRNA expression levels of fibrosis-related genes ( Col1a1, Col3a1, Fn1) and myofibroblast marker gene ( Acta2) were detected by real time quantitative polymerase chain reaction (RT-qPCR). In cell experiments, a differentiation model of mouse MSCs into myofibroblasts was established through TGF-β1 induction (MSC+TGF-β1 group, n=3), with a blank control group (MSC group, n=3) set up for comparison. Bone marrow MSCs from C57BL/6 mice were randomly divided into 4 groups: the TGF-β1 induction group (MSC+TGF-β1, n=6), the FSTL1 treatment group (MSC+TGF-β1+FSTL1, n=6), the negative control siRNA transfection group (MSC-siNC+TGF-β1, n=6), and the Fstl1-targeted siRNA transfection group (MSC-si Fstl1+TGF-β1, n=6). The mRNA and protein expression levels of Col1a1, Col3a1, Fn1 and Acta2 were detected by RT-qPCR and Western blot respectively. The concentration of FSTL1 protein in cell culture supernatant was measured by enzyme-linked immunosorbent assay. Result:The expression of Col1a1 and Acta2 mRNA in the kidney tissue of IRI 7 d group mice was higher than that of the Sham 7 d group (both P<0.05), successfully establishing a mouse model of renal fibrosis. The mRNA expression of Fstl1 in kidney tissues of the IRI 7 d group mice was upregulated ( P<0.01). Immunofluorescence double staining revealed increased co-expression of SCA-1/α-SMA and SCA-1/FSTL1 in the renal interstitium. At 14 days after surgery, HE staining results showed reduced pathological damage in kidney tissues of the IRI+FSTL1 group compared to the IRI group, and Sirius Red and Masson staining revealed decreased collagen fiber deposition in the renal interstitium, while immunohistochemical staining demonstrated reduced FN accumulation in the renal interstitium (all P<0.05). The mRNA expression levels of Col1a1, Col3a1, Fn1 and Acta2 in renal tissue of IRI+FSTL1 group were lower than IRI group (all P<0.05). Double immunofluorescence staining showed a decrease in the co-expression of SCA-1 and α-SMA in renal interstitium. In cell experiments, the mRNA expression levels of Col1a1, Col3a1, Fn1, and Acta2 in the MSC+TGF-β1 group were higher than those in the MSC group (all P<0.05), confirming successful TGF-β1-induced myofibroblast differentiation of MSCs. Additionally, both intracellular FSTL1 protein expression and FSTL1 protein concentration in the cell supernatant were elevated in the MSC+TGF-β1 group (both P<0.05). Compared with MSC+TGF-β1 group, the mRNA levels of Acta2 and Col1a1 in MSC+TGF-β1+FSTL1 group were decreased (both P<0.01), and the protein expression levels of collagen Ⅰ and α-SMA were significantly decreased (both P<0.001). Compared with MSC-siNC+TGF-β1 group, the protein level of FSTL1 in cell culture supernatant of MSC-si Fstl1+TGF-β1 group were decreased ( P<0.001), while the protein expression levels of FN and α-SMA were increased (both P<0.001), and the mRNA expression levels of Fn1 and Acta2 were increased (both P<0.05). Conclusions:During unilateral renal IRI-induced renal fibrosis, MSCs in renal interstitium may differentiate into myofibroblasts. FSTL1 may alleviate renal fibrosis after unilateral renal IRI by inhibiting the differentiation of MSCs into myofibroblasts.

Objective To explore the characteristics of the inhibitory effect of Evodiamine on the proliferation of activated T cells. Methods Mononuclear cells from peripheral blood (PBMCs) were obtained from healthy donors through density gradient centrifugation, and T cells were subsequently purified by using immunomagnetic bead separation. T cell activation was induced by employing anti-human CD3 and anti-human CD28 antibodies. T cells were treated with different concentrations of EVO (0.37, 1.11, 3.33, and 10)μmol/L. Flow cytometry was applied to evaluate the proliferation index, apoptosis rate, viability, CD25 expression levels, and cell cycle distribution of T cells. The expression levels of cytokines IL-2, IL-17A, IL-4, and IL-10 were quantified by using ELISA. Results 1.11, 3.33 and 10 μmol/L EVO effectively inhibited the proliferation of activated T cells, with an IC₅₀ of (1.5±0.3)μmol/L. EVO did not induce apoptosis in activated T cells and affect the survival rate of resting T cells. EVO did not affect the expression of CD25 and the secretion of IL-2 in activated T cells. EVO arrested the T cell cycle at the G2/M phase, resulting in an increase in G2/M phase cells, and exhibited a concentration-dependent effect. EVO did not affect the secretion of IL-4, IL-10 by activated T cells, but significantly inhibited the secretion of IL-17A. Conclusion EVO did not significantly affect the activation process of T cells but inhibited T cell proliferation by arresting the cell cycle at the G2/M phase and significantly suppressed the secretion of the pro-inflammatory cytokine IL-17A, which suggests that EVO has the potential to serve as a lead compound for the development of low-toxicity and high-efficiency immunosuppressants and elucidates the mechanisms underlying the anti-inflammatory and immunomodulatory effects of the traditional Chinese medicine Evodia rutaecarpa.
Humans ; Cell Proliferation/drug effects* ; Quinazolines/pharmacology* ; T-Lymphocytes/metabolism* ; Lymphocyte Activation/drug effects* ; Apoptosis/drug effects* ; Interleukin-4/metabolism* ; Interleukin-10/metabolism* ; Interleukin-2 Receptor alpha Subunit/metabolism* ; Interleukin-17/metabolism* ; Interleukin-2/metabolism* ; Cell Cycle/drug effects* ; Cells, Cultured

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Pulmonary siderosis caused by iron and its compound dust is prone to misdiagnosis and underdiagnosis due to its insidious exposure pathways and non-specific imaging manifestations. This study analyzes the occupational histories and clinical data of six patients with occupational pulmonary siderosis diagnosed at Qingdao Central Hospital between January 2017 and December 2023, summarizes its characteristics, and evaluates the value of AI-assisted diagnosis. All six patients were male, with five being welders. The median dust exposure duration was 9.4 years, and the median latency period was 8.4 years. The main symptoms were chest tightness, cough, and shortness of breath. High-kilovolt chest radiographs were negative in four cases and showed thickened bronchovascular markings in two cases. High-resolution computed tomography (HRCT) revealed centrilobular nodules and tree-in-bud opacities in all cases. Pulmonary siderosis caused by iron and its compound dust is characterized by mild symptoms and a favorable prognosis. Comprehensive assessment and HRCT are crucial for early diagnosis. The development of AI models could enhance diagnostic recognition efficiency and promote precision diagnosis in the future.