Objective:To conduct bioinformatics analysis by detecting and screening differentially expressed miRNAs in urine exosomes of subjects with damp heat IgA nephropathy, non damp heat IgA nephropathy, and healthy individuals; To explore the role of miRNAs in renal tubulointerstitial fibrosis.Methods:A cross-sectional study was conducted to select 40 subjects with primary IgA nephropathy diagnosed by renal biopsy in the Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University from November 2021 to February 2023, who were divided into damp-heat group and non-damp-heat group according to TCM constitution, with 20 cases in each group; 10 healthy subjects were also recruited for control observation.High-speed centrifugation and Illumina high-throughput sequencing technology were used to isolate and detect the expression of miRNA in urine exosomes from three groups of people, and their differential expression profiles were constructed. Bioinformatics analysis was performed on differentially expressed genes to determine the main biological functions of differentially expressed miRNAs and the signaling pathways they may participate in.Results:Compared with the non-damp heat group, there were 231 miRNAs with abnormal expression in the urine exosomes of the damp heat group, including 119 up-regulated and 112 down-regulated. Through GO enrichment and KEGG analysis, differentially expressed miRNAs may participate in the occurrence and development of renal tubulointerstitial fibrosis through MAPK signaling pathway, PI3K Akt signaling pathway, Hippo signaling pathway, Ras signaling pathway, Wnt signaling pathway, mTOR signaling pathway, etc., involving biological processes such as cell proliferation, apoptosis, cell deformation (EMT), migration and invasion, and tissue and organ fibrosis. MiR-29c-3p expression levels in the urinary exosome miRNA expression profiles of subjects in the three groups were lower in the damp-heat group, but higher in the non-damp-heat group versus the healthy control group, of which, the damp-heat group was lower than the non-damp-heat group versus the healthy control group ( P<0.01); there was no significant difference between the healthy control group and the non-damp-heat group ( P>0.05）. Conclusion:The expression profile of miRNAs in the urine exosomes of subjects with damp heat IgA nephropathy showed significant changes,that the significant down-regulation of miR-29c-3p may be a key factor in exacerbating tubulointerstitial fibrosis in IgA nephropathy.

Objective:To evaluate and summarize the best evidence on nutritional management of children with inflammatory bowel disease (IBD) both domestically and internationally, so as to provide reference for clinical nursing practice.Methods:According to the "6S" evidence model, the literature on nutritional management of children with IBD was systematically searched in national and international computerized decision support systems, guideline websites, relevant professional association websites, and databases. The search period was from January 2014 to July 2024. The quality of the included literature was evaluated and the evidence was extracted, evaluated and integrated to form the best evidence.Results:A total of 15 papers were included, including three clinical decisions, five guidelines, two expert consensus, two position papers, and three systematic reviews. Thirty-four pieces of best evidence were extracted, focusing on six aspects of multidisciplinary team formation, nutritional assessment and monitoring, diet and nutrient management, nutritional support methods, exercise and obesity management, and follow-up and health education.Conclusions:This study summarizes the best evidence for nutritional management of children with IBD, which may provide a basis for clinical implementation of nutritional interventions. It is recommended that healthcare professionals screen for the best evidence, translate the evidence, and develop individualized nutritional management programs, taking into account the clinical context, professional opinion, and patient wishes.

Objective:To evaluate and summarize the best evidence on nutritional management of children with inflammatory bowel disease (IBD) both domestically and internationally, so as to provide reference for clinical nursing practice.Methods:According to the "6S" evidence model, the literature on nutritional management of children with IBD was systematically searched in national and international computerized decision support systems, guideline websites, relevant professional association websites, and databases. The search period was from January 2014 to July 2024. The quality of the included literature was evaluated and the evidence was extracted, evaluated and integrated to form the best evidence.Results:A total of 15 papers were included, including three clinical decisions, five guidelines, two expert consensus, two position papers, and three systematic reviews. Thirty-four pieces of best evidence were extracted, focusing on six aspects of multidisciplinary team formation, nutritional assessment and monitoring, diet and nutrient management, nutritional support methods, exercise and obesity management, and follow-up and health education.Conclusions:This study summarizes the best evidence for nutritional management of children with IBD, which may provide a basis for clinical implementation of nutritional interventions. It is recommended that healthcare professionals screen for the best evidence, translate the evidence, and develop individualized nutritional management programs, taking into account the clinical context, professional opinion, and patient wishes.

Objective:To explore the optimization of the standardized assessment tool for clinical diagnosis of Chinese developmental dyslexia (DD).Methods:A cross-sectional study was conducted from May to December 2023, in which 130 primary school children in grades 1 to 3 with clinical signs of literacy lag and positive screening results on the screening scales were recruited from the outpatient clinic of Child Health Care Medical Division, Shanghai Children′s Hospital, Shanghai Jiao Tong University School of Medicine. Chinese dyslexia screening behavior checklist for primary students (CDSBC) was used as the screening scales, and supplemented by dyslexia checklist for Chinese children. Referring to the standard procedure of the"expert advice on diagnosis and intervention of Chinese developmental dyslexia", the developmental dyslexia scale for standard mandarin (DDSSM) was used to evaluate the children′s literacy-related cognitive abilities and conduct the diagnostic assessment, and divided the children into learning backward group and the DD group. The t-test and χ2 test were used to compare the differences in the distribution of intelligence, literacy and attention deficit hyperactivity disorder between the two groups. Spearman′s correlation was used to analyze the correlation between the scores for each cognitive ability in the DDSSM and the CDSBC. Results:Of the 130 children, 90 were male, aged (8.3±1.0) years; 40 were female, aged (8.1±0.9) years. A final diagnosis of DD was made in 59 cases, of which 41 were males. There was no statistically significant difference in operational intelligence quotient (101±15 vs.100±15, t=0.53, P>0.05) and statistically significant difference in literacy of DDSSM (32±5 vs.21±4, t=11.56, P<0.001) between the learning backward group and the DD group. Eighteen cases (25.4%) of the learning backward group were children with attention deficit subtype attention deficit hyperactivity disorder (ADHD-I), and 16 cases (27.1%) in DD group, the difference in incidence between the two groups was not statistically significant ( χ2=0.05, P>0.05). There were correlations between the DDSSM (for oral vocabulary, morphological awareness and orthographic awareness) and the CDSBC total score ( r=-0.42, -0.32, -0.35, all P<0.01), but the correlations for visuospatial perception and rapid automatized naming with CDSBC total score were not statistically significant ( r=-0.09 and -0.20,both P>0.05). Conclusion:For literacy-related cognitive abilities, screening scales CDSBC are not sufficiently useful for assessment, so the introduction of standardized assessment tools DDSSM is an optimization of the clinical diagnosis of Chinese DD, which is crucial for achieving accurate diagnosis and intervention.

Objective To observe cerebral microbleeds （CMBs）, cognitive function, and the protein expression level of hyperphosphorylated Tau （P-Tau） in patients with cerebral infarction and obstructive sleep apnea-hypopnea syndrome （OSAHS）, to analyze their differences between the cerebral infarction+OSAHS group and the control group, and to further investigate the degree of cognitive impairment in patients with cerebral infarction and OSAHS and the association between the protein expression level of P-Tau and CMBs. Methods A prospective analysis was performed for 199 patients with cerebral infarction who were admitted to Stroke Center in our hospital from December 2019 to December 2022, among whom there were 94 patients with OSAHS （cerebral infarction+OSAHS group） and 105 patients without OSAHS （control group）, and CMBs and Montreal Cognitive Assessment （MoCA） score were assessed for the two groups. The two groups were compared in terms of changes in the protein expression level of P-Tau before treatment and after 7 and 14 days of treatment. The receiver operating characteristic （ROC） curve was used to describe the predictive efficacy of P-Tau protein level before treatment for the cognitive function of patients with cerebral infarction CMBs and OSAHS, and the Pearson correlation coefficient was used to investigate the correlation of the scores of each dimension of MoCA scale with P-Tau protein level before treatment. With the score of MoCA scale as the basis for assessing the degree of cognitive impairment, 94 patients were divided into mild impairment group, moderate impairment group, and severe impairment group, and P-Tau protein level before treatment was compared between the three groups. Results Compared with the patients in the control group, the patients with cerebral infarction and OSAHS had a significantly lower MoCA score （P<0.05） and a higher occurrence rate of CMBs, especially in those with mild grade. Before treatment, the cerebral infarction+OSAHS group had a significantly higher P-Tau protein level than the control group （P<0.05）, and after 7 and 14 days of treatment, the cerebral infarction+OSAHS group had no significant change in P-Tau protein level （P>0.05）, while the control group had a significant reduction in P-Tau protein level （P<0.05）. P-Tau protein level before treatment showed a sensitivity of 67.31% and a specificity of 90.48% in the diagnosis of cognitive impairment in the patients with cerebral infarction CMBs and OSAHS, and the Pearson correlation analysis showed that the scores of visuospatial/executive, attention and computational ability, language, abstraction, and delayed memory in MoCA scale were negatively correlated with P-Tau protein level before treatment in these patients （P<0.05）. There was a significant difference in P-Tau protein level before treatment between the mild impairment group, the moderate impairment group, and the severe impairment group （P<0.05）. Conclusion P-Tau protein level before treatment is associated with cognitive impairment in patients with cerebral infarction CMBs and OSAHS, which can guide the diagnosis and severity assessment of the disease in clinical practice.

Objective To establish a quantitative polymerase chain reaction(PCR)method for the analysis of human-derived SRY DNA in mouse tissues,and to study the tissue distribution of human umbilical cord mesenchymal stem cells(HUCMSCs)in immunodeficient NOG mice after a single intravenous injection.Methods We established a quantitative PCR method for the analysis of human SRY DNA in mouse tissues,and validated the standard curve,linear range,accuracy,precision,and stability.Thirty-six NOG mice(18 male,18 female)were administered 3.5×107 HUCMSCs/kg by single intravenous injection.Six mice were then anesthetized and dissected after blood collection(EDTA anticoagulation)at 6,12,24,and 72 h,and at 1 and 2 weeks,respectively.DNA was extracted from lung,kidney,heart,liver,brain,spinal cord,stomach,small intestine,fat,skin,spleen,testis,uterus,and ovary tissues,and the distribution of HUCMSCs in each tissue was determined by the validated quantitative PCR method for detecting the human-derived SRY gene in mouse tissues.In addition,18 NOG mice(9 male,9 female)were divided into control(n = 6)and treatment groups(n = 12)injected intravenously with 0.9%sodium chloride and 3.5×107 cells/kg,respectively.Acute toxic reactions were observed during the administration period,and four animals were dissected at 72 h and at 2 and 4 weeks after administration to observe the gross organs.Mitochondrial protein expression was detected in paraffin sections of lung tissues by immunohistochemistry to analyze the colonization of HUCMSCs in lung tissues.Results The established RT-qPCR method for human-derived SRY DNA in mouse tissues met the validation criteria for each index.After a single intravenous injection in NOG mice,HUCMSCs were mainly distributed in the lungs and blood within 1 week after administration,with higher concentrations in lung tissues than in blood.The concentrations of HUCMSCs in lung tissue and blood remained relatively stable within 6～24 h and 6～72 h,respectively,and then decreased over time.The distribution of HUCMSCs in other tissues was not measured at all sampling points.The colonization result showed that HUCMSCs were detected in lungs 72 h after intravenous injection,but not at 2 and 4 weeks.No obvious acute toxicity was observed in NOG mice after single intravenous administration of HUCMSCs.Conclusions The above method for analyzing the distribution of HUCMSCs in mouse tissue is reliable and feasible.HUCMSCs were mainly distributed in lung and blood in NOG mice within 1 week after a single intravenous injection,and mainly colonized lung tissue at 72 h.A single intravenous administration of HUCMSCs has a good safety profile.

Objective:To understand the status of nurses' positive empathy and positive emotions, and to clarify the relationship between nurses' positive empathy and positive emotions, and to explore the role of positive empathy in promoting nurses' professional mental health.Methods:This study was a cross-sectional study. From June to November 2019, convenience sampling was adopted to select 568 nurses from 8 hospitals in Shanghai and Jiangsu Province to conduct a questionnaire survey. The questionnaire included the nurses' general information questionnaire, Chinese version of Positive Empathy Scale (PES) , Positive and Negative Affect Scale (PANAS) , Jefferson Scale of Empathy-Health Professionals (JSE-HP) , Psychological Capital Questionnaire (PCQ) , and Simplified Coping Style Questionnaire (SCSQ) . Single factor analysis, Pearson correlation analysis and multiple linear regression analysis were used to analyze the influencing factors and the relationship between nurses' positive empathy and positive emotions. A total of 568 questionnaires were distributed and 568 were received, of which 488 were valid questionnaires, with an effective response rate of 85.9%.Results:Among 488 nurses, the scores of positive empathy, positive emotion, negative emotion, empathy ability, and PCQ were (24.56±6.58) , (29.21±6.86) , (21.52±6.70) , (108.61±16.32) and (101.95±15.95) respectively, and the scores of positive coping and negative coping were averaged (3.06±0.52) and (2.32±0.61) respectively. Multiple linear regression analysis showed that positive empathy, hope, optimism, number of children, positive coping, self-efficacy, and monthly income were positive influencing factors of positive emotions (adjusted R2=0.383, F=43.939, P<0.05) . Conclusions:Positive empathy is an important factor influencing the positive emotions of nurses, and it is of great significance for maintaining nurses' professional mental health. In the future, it is necessary to further explore the mechanism of positive empathy affecting nurses' professional mental health.

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.

The training of professional postgraduates is one mode of medical postgraduate training,which more emphasizes the cultivation of clinical practice and ability.The problems existing in the training of professional degree postgraduates in dermatology are analyzed in this article,such as weak foundation of scientific research foundation,lack of supervision and evaluation,and the challenges from dermatology characteristics.The solutions including the training objectives,project design,the optimization of teaching process and evaluation,the training of comprehensive ability will be discussed in this article.The purpose is to improve the quality of training,to give some advice for providing high quality professional degree postgraduates.

Objective:To investigate the expression of HIF-1α in serum of rats with contrast induced nephropathy and its effect on renal tubular injury.Methods:45 SD rats were randomLy divided into three groups (n=15).The rats in the blank control group (group A)were treated with 12 h (Sodium Chloride Injection) for three 0.5 mL after fasting water for a period of about 15 minutes.Contrast nephropathy group (B group) rats after fasting 12 h,in the tail vein with 10 mg/kg injection ofindomethacin,15 minutes after the injection of 10 mg/kg nitro-L-arginine methyl ester (L-NAME),15 minutes after the injection ofiobitridol (3 G I/kg).Atorvastatin group (C group) rats in the first 3 days of the experiment started feeding atorvastatin calcium tablets,continuous feeding for 3 days,at a dose of 80 mg/kg/d,and fasting 12 h,making contrast nephropathy model,with the steps of contrast nephropathy group.The changes of renal function indexes (BUN,Cr),HIF-1α expression and renal tubular injury in three groups were observed and compared.Results:The level of BUN in rats with contrast induced nephropathy was lower than that in atorvastatin calcium group and blank control group,but the level of Scr was higher than that of atorvastatin calcium group and blank control group,the difference was statistically significant (P＜0.05).The level of BUN in atorvastatin calcium group was lower than that in blank control group,but Scr level was higher than that in blank control group,the difference was statistically significant (P＜0.05).Compared with the blank control group,the renal tubular injury in the rats with contrast induced nephropathy group was higher than that in atorvastatin calcium group and blank control group,the difference was statistically significant (P＜0.05).Compared with the control group,the expression of HIF-1 was significantly higher in rats with contrast induced nephropathy than that in atorvastatin calcium group and blank control group.The expression of HIF-1 was significantly higher than that in the control group (P＜0.05).Conclusions:It is suggested that the statins could prevent the contrast-induced nephropathy.However,the ending mechanism of statins should be further studied in the clinical practices.