ObjectiveTo investigate the effects of Chaihu Jia Longgu Mulitang（CJLM） on depression-like behaviors and neuroinflammation in rats subjected to social isolation combined with chronic unpredictable mild stress（CUMS）， and to explore the potential underlying mechanisms. MethodsSixty male SD rats were randomly divided into a normal group， a model group， and low-， medium-， and high-dose CJLM groups（2.89， 5.78， 11.56 g·kg^-1）， as well as a fluoxetine group（10 mg·kg^-1）. Except for the normal group， all other groups were subjected to social isolation combined with CUMS for 63 d. During the first 35 d， depression models were established only， and from day 36 onward， modeling and drug administration were conducted simultaneously for a total intervention period of 28 d. Depression-like behaviors were evaluated using the sucrose preference test， open-field test， and forced swimming test. Hematoxylin-eosin（HE） staining was performed to observe hippocampal histomorphology. Immunohistochemistry（IHC） was used to detect the expression levels of ionized calcium-binding adapter molecule 1（Iba1） and gasdermin D（GSDMD） proteins in the hippocampus. Western blot analysis was employed to determine the protein expression levels of adenosine 5′-monophosphate（AMP）-activated protein kinase（AMPK） and phosphorylated（p）-AMPK， silent information regulator 1（SIRT1）， nuclear factor-κB（NF-κB） and p-NF-κB， NOD-like receptor protein 3（NLRP3）， and Caspase-1 in the hippocampus. Real-time quantitative polymerase chain reaction（Real-time PCR） was used to detect the mRNA expression levels of tumor necrosis factor-α（TNF-α）， interleukin（IL）-6， and IL-1β in the hippocampus. ResultsCompared with the normal group， the model group showed a decreased sucrose preference rate（P<0.01）， reduced total movement distance（P<0.01）， prolonged immobility time（P<0.01）， and decreased central zone residence time（P<0.01） in the open-field test， and increased immobility time in the forced swimming test（P<0.01）. Hippocampal neuronal structure was damaged. The contents of Iba1 and GSDMD in the hippocampus were significantly increased（P<0.01）. The protein expression levels of p-AMPK and SIRT1 in the hippocampus were significantly decreased（P<0.01）， whereas the protein expression levels of p-NF-κB， NLRP3， and Caspase-1 were significantly increased（P<0.01）. The mRNA expression levels of IL-1β， IL-6， and TNF-α in the hippocampus were significantly upregulated（P<0.01）. Compared with the model group， the low-， medium-， and high-dose CJLM groups and the fluoxetine group all were able to reverse depression-like behavioral changes， as evidenced by increased sucrose preference rate， increased total movement distance with shortened immobility time in the open-field test， prolonged central zone residence time， and reduced immobility time in the forced swimming test（P<0.05， P<0.01）. Meanwhile， hippocampal neuronal structural damage was alleviated. In the hippocampus， the expression levels of Iba1 and GSDMD were downregulated， the expression levels of p-AMPK and SIRT1 were upregulated， and the abnormal elevations of p-NF-κB， NLRP3， Caspase-1， as well as IL-1β， IL-6， and TNF-α mRNA were suppressed（P<0.05， P<0.01）. ConclusionCJLM can ameliorate depression-like behaviors in rats subjected to social isolation combined with CUMS and attenuate hippocampal neuroinflammation and pyroptosis， suggesting that its effects may be associated with the regulation of AMPK/SIRT1/NF-κB/NLRP3 signaling pathway.

Objective To investigate the impact of mitophagy,mediated by the long non-coding RNA SNHG16(LncRNA SNHG16)on diabetes-associated cognitive impairment(DCI).Methods 29 male C57BL/J mice were randomly divided into normal control(NC)group,DCI group and DCI+mitochondrial autophagy inhibitor(DCI+Mdivi-1)group.Morris water maze and new object recognition test were used to detect the cognitive function of mice,qRT-CPR was used to detect the expression of LncRNA SNHG16 and mitochondrial autophagy marker mRNA.Western blot were used to detect the expression of related protein.The mouse hippocampal neurons HT22 were divided into control(Con)group,high glucose(HG)group,HG+SNHG16 silencing(HG+sh-SNHG16)group and HG+no-load control(HG+sh-NC)group.CCK8 method and lactate dehydrogenase(LDH)method were used to detect neuronal damage.JC-1 method was used to detect mitochondrial membrane potential.Results Compared with NC group,the expression of LncRNA SNHG16 and the expression of autophagy-related gene 5,PTEN-induced putative kinase 1(PINK1),Parkin and microtubule associated protein light chain 3(LC3)Ⅱ/Ⅰ increased(P<0.05),while the expression of mitochondrial autophagy-related proteins P62 and mitochondrial outer membrane transposase 20(TOMM20)decreased in T2DM group.Compared with DCI group,the cognitive dysfunction of mice improved,and the expression level of LncRNA SNHG16 decreased in the DCI+Mdivi-1 group(P<0.05).The expressions of LncRNA SNHG16,LC3 Ⅱ/Ⅰ,PINK1 and Parkin were higher in HG group than in Con group(P<0.05),while the cell survival rate and TOMM20 protein expression were lower in HG group than in Con group(P<0.05).Silence of LncRNA SNHG16 can restore the activity of HT22 cells and mitochondrial membrane potential,and reduce the level of mitochondrial autophagy under HG condition.Conclusions The expression level of LncRNA SNHG16 was up-regulated in the hippocampus brain region of mice with diabetic cognitive dysfunction,and mitophagy was overactivated.Silencing of LncRNA SNHG16 inhibits mitophagy in hippocampal neurons and alleviates HG induced hippocampal neuronal damage.

Respiratory viral infections such as influenza and respiratory syncytial virus infections continue to rapidly increase in patients worldwide.Host immune responses to respiratory viruses play a key role in the pathogenesis and clinical manifestations of the disease.Respiratory viruses not only activate antiviral immune responses,but also may lead to uncontrolled inflammatory re-sponses,characterized by significant release of pro-inflammatory cytokines in severely infected patients,resulting in lymphopenia,lymphocyte dysfunction,and abnormalities in immune cells such as neutrophils and macrophages.These respiratory virus-induced im-mune abnormalities may lead to microbial infection,septic shock,and severe multiorgan dysfunction.Therefore,clarifying the immu-nopathogenic mechanisms of patients with respiratory viral infections can guide clinical treatment and patient prognosis;in addition,rational regulation of the immune response of respiratory viruses in the host,including enhancing antiviral immunity while suppressing systemic inflammation,may be the key to successful treatment.This review mainly discusses the immunomodulation and related clini-cal treatment strategies for respiratory viral infections to help develop new therapeutic strategies for respiratory viral infections and pa-tient prognosis.

AIM:To explore the influence of microRNA-193b-5p(miR-193b-5p)on apoptosis of cardiomyo-cytes in an ischemia-hypoxia(IH)environment and the possible mechanism.METHODS:Human AC16 cardiomyocytes were cultured in vitro,and an IH model of cardiomyocytes was established.The cardiomyocytes were divided into control group,IH group,IH+miR-193b-5p inhibitor group,and IH+inhibitor NC group.The cells in control group were regularly cultured,those in IH group were treated with a hypoxia chamber for 24 h to induce cardiomyocyte apoptosis,while those IH+miR-193b-5p inhibitor and IH+inhibitor NC groups were transfected with corresponding plasmids by the same opera-tion method and then underwent IH treatment for 24 h to induce cardiomyocyte apoptosis.RT-qPCR was used to detect the expression of miR-193b-5p in cardiomyocytes after IH.The viability of cardiomyocytes was detected by CCK-8 method.Lactate dehydrogenase(LDH)was detected to understand the damage of cardiomyocytes.The apoptotic rate was detected by flow cytometry.The protein levels of Bax,Bcl-2 and cleaved caspase-3 were detected by Western blot.Finally,down-stream target genes were predicted by RNA sequencing combined with bioinformatics methods,and the interaction relation-ship between miR-193b-5p and RING(really interesting new gene)finger protein 4(RNF4)gene was verified by RT-qPCR and Western blot experiments.RESULTS:Compared with control group,miR-193b-5p was highly expressed in cardio-myocytes with IH.Furthermore,in the IH environment,the viability of cardiomyocytes decreased,and cell damage and cell apoptosis increased,while inhibiting the expression level of miR-193b-5p could enhance the viability of cardiomyo-cytes,reduce cell damage,and alleviate the apoptosis of cardiomyocytes induced by IH.The results of RNA sequencing and further experiments verified that miR-193b-5p might act on the RNF4 gene to exert its effect.CONCLUSION:Inhi-bition of miR-193b-5p can alleviate the IH injury and apoptosis of cardiomyocytes.The mechanism might be that miR-193b-5p inhibition exerts a cardioprotective effect against apoptosis by mediating the expression of the RNF4 gene.

OBJECTIVE To analyze the characteristics of 57 acquired immune deficiency syndrome(AIDS)patients complicated with cryptococcal meningitis and observe the treatment outcomes.METHODS Totally 57 AIDS pa-tients with complicated cryptococcal meningitis who were treated in Guiyang Public Health Treatment Center from Jan.2019 to Jun.2023 were continuously assigned as the cryptococcal meningitis group,meanwhile,57 patients with simple AIDS were chosen as the simple AIDS group based on a 1∶1 ratio matching case-control study.Both groups received standardized therapies on basis of the criteria.The clinical characteristics,T lymphocyte subsets,biochemical indexes and treatment outcomes were observed and compared between the two groups.RESULTS There were no significant differences in gastrointestinal reactions,fever and eye discomfort between the two groups;the incidence of neurological symptoms of the cryptococcal meningitis group was higher than that of the simple AIDS group(P＜0.05).There was significant difference in the peripheral blood T lymphocyte subsets be-tween the cryptococcal meningitis group and the simple AIDS group(P＜0.05).The levels of whole blood CD4+,CD4+/CD8+and CD8+of the cryptococcal meningitis group were lower than those of the simple AIDS group;the serum glucose(GLU)level of the cryptococcal meningitis group was lower than that of the simple AIDS group;the serum adenosine deaminase(ADA)level of the cryptococcal meningitis group was higher than that of the sim-ple AIDS group;the serum immunoglobulin A(IgA)level of the cryptococcal meningitis group was higher than that of the simple AIDS group(P＜0.05).There were no significant differences in the immunological failure,vir-ological failure and immunological failure plus virological failure between the two groups after the treatment for 6 months.CONCLUSIONS The incidence of neurological symptoms is higher among the patients with AIDS com-plicated with cryptococcal meningitis than among the patients with simple AIDS.The patients have poor treatment outcomes and more severe damage of T lymphocyte subset functions,and the levels of biochemical indexes vary a-mong the patients,which may provide bases for diagnosis of diseases and assessment of curative effect and prog-nosis.

Objective:To explore the construction and validation of a nomogram model for predicting poor survival prognosis in patients with clear cell renal cell carcinoma（ccRCC）based on deep learning of pathological images.Methods:This study was an observational cohort study. The original pathological images and clinicopathological data（TCGA cohort）of 378 patients with ccRCC were obtained from the Cancer Genome Atlas Database（TCGA）for model training. A total of 301 patients with ccRCC who underwent surgical treatment at Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2020（Renji cohort）and 214 patients with ccRCC who underwent surgical treatment at the First People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2012 to December 2018（General cohort）were included for model validation. Their original pathological images and clinical pathological data were collected. A clustering-constrained attention and multi-instance learning method was used to accurately identify sub-regions of the images to classify and extract features of the pathological images. A deep learning-based disease-free survival prognosis prediction model（DL-DFS）was constructed through a weakly supervised learning strategy. The clinical pathological features and DL-DFS were further combined to construct a nomogram model for the clinical prognosis of ccRCC patients. Univariate and multivariate Cox regression analyses were employed to evaluate the independent risk factors for disease-free survival（DFS）. The efficacy of the predictive model were evaluated by the receiver operating characteristic curve（ROC）with area under the curve（AUC），respectively. Survival analysis was conducted using the Kaplan-Meier curve.Results:DL-DFS could accurately predict the DFS status of ccRCC patients in 5 years after surgery. Through ROC analysis in the training cohort，the AUC value reached 0.75（ P < 0.001）. In the Renji cohort and the General cohort，the AUC values were 0.65（ P < 0.001）and 0.81（ P < 0.001），respectively. Through Kaplan-Meier survival analysis，we found that DL-DFS could identify ccRCC patients with high survival risks. The hazard ratio in the training cohort was 3.86（95% CI 2.36-6.30， P < 0.001）. The hazard ratio in the Renji cohort and General cohort were 1.97（95% CI 1.03-3.80， P = 0.009）and 4.66（95% CI 1.80-12.06， P = 0.008），respectively. Univariate and multivariate Cox regression analyses indicated that DL-DFS risk score，tumor grade，and tumor stage could act as prognostic risk factors for patients with ccRCC（ P < 0.05）. Considering that age was a common prognostic risk factor for patients with renal cancer，a nomogram model was constructed by combining the DL-DFS risk score with patient age，tumor grade，and tumor stage. The AUC of this model for predicting the 5-year DFS of ccRCC patients after surgery was 0.87，which was significantly higher than that of DL-DFS（AUC = 0.74），tumor stage（AUC = 0.84），tumor grade（AUC = 0.72），and patient age（AUC = 0.56）in the TCGA cohort（all P<0.05）. In the Renji cohort and the General cohort，the AUC of the nomogram model were 0.78 and 0.86 respectively，which was significantly higher than that of DL-DFS（0.65 and 0.81），tumor stage（0.72 and 0.69），tumor grade（0.64 and 0.77），and patient age（0.56 and 0.63）. Conclusions:In this study a DL-DFS for ccRCC patients was constructed. Then a nomogram model was constructed by combining the DL-DFS risk value with patient age，tumor grade，and tumor stage. This nomogram model demonstrated superior predictive performance compared to DL-DFS alone in evaluating the DFS prognosis of ccRCC patients，which still needs to be further verified in prospective clinical studies.

Objective To investigate the impact of mitophagy,mediated by the long non-coding RNA SNHG16(LncRNA SNHG16)on diabetes-associated cognitive impairment(DCI).Methods 29 male C57BL/J mice were randomly divided into normal control(NC)group,DCI group and DCI+mitochondrial autophagy inhibitor(DCI+Mdivi-1)group.Morris water maze and new object recognition test were used to detect the cognitive function of mice,qRT-CPR was used to detect the expression of LncRNA SNHG16 and mitochondrial autophagy marker mRNA.Western blot were used to detect the expression of related protein.The mouse hippocampal neurons HT22 were divided into control(Con)group,high glucose(HG)group,HG+SNHG16 silencing(HG+sh-SNHG16)group and HG+no-load control(HG+sh-NC)group.CCK8 method and lactate dehydrogenase(LDH)method were used to detect neuronal damage.JC-1 method was used to detect mitochondrial membrane potential.Results Compared with NC group,the expression of LncRNA SNHG16 and the expression of autophagy-related gene 5,PTEN-induced putative kinase 1(PINK1),Parkin and microtubule associated protein light chain 3(LC3)Ⅱ/Ⅰ increased(P<0.05),while the expression of mitochondrial autophagy-related proteins P62 and mitochondrial outer membrane transposase 20(TOMM20)decreased in T2DM group.Compared with DCI group,the cognitive dysfunction of mice improved,and the expression level of LncRNA SNHG16 decreased in the DCI+Mdivi-1 group(P<0.05).The expressions of LncRNA SNHG16,LC3 Ⅱ/Ⅰ,PINK1 and Parkin were higher in HG group than in Con group(P<0.05),while the cell survival rate and TOMM20 protein expression were lower in HG group than in Con group(P<0.05).Silence of LncRNA SNHG16 can restore the activity of HT22 cells and mitochondrial membrane potential,and reduce the level of mitochondrial autophagy under HG condition.Conclusions The expression level of LncRNA SNHG16 was up-regulated in the hippocampus brain region of mice with diabetic cognitive dysfunction,and mitophagy was overactivated.Silencing of LncRNA SNHG16 inhibits mitophagy in hippocampal neurons and alleviates HG induced hippocampal neuronal damage.

To investigate the current status of sleep quality among nurses in tertiary hospitals in China, analyze the correlations of work stress and perceived organizational support with the risk of sleep problems, and further examine the mediating effect of perceived organizational support between work stress and sleep problems in nurses.

Objective To investigate the clinical efficacy of tetrandrine tablets combined with celecoxib in treating knee osteoarthritis(KOA).Methods A total of 234 patients with KOA admitted and treated in this hospital from February 2022 to January 2024 served as the study subjects.According to the random num-ber table method,the patients were assigned into the single group and combination group,117 cases in each group.The single group was treated with celecoxib capsules,while the combination group was treated with tetrandrine tablets on the basis of the single group treatment.The Western Ontario and McMaster Universi-ties Osteoarthritis Index(WOMAC)score,Hospital for Special Surgery(HSS)score,visual analogue scale(VAS)score,inflammatory factor level,bone metabolism related indicators levels,clinical efficacy and adverse reactions before treatment(T0)and in 24 weeks after treatment(T1)were observed and compared between the two groups.Results At T1,the WOMAC score,VAS score,levels of interleukin-iβ(IL-1β),tumor necro-sis factor-α(TNF-α)and CTX-Ⅱ in the two groups were significantly decreased compared with those at T0,moreover the combination group was lower than the single group,and the differences were statistically signifi-cant(P＜0.001).The HSS score,serum osteoprotegerin(OPG)and fibroblast growth factor-2(FGF-2)lev-els in the two groups were significantly increased compared with those at T0,moreover the combination group was higher than the single group,and the differences were statistically significant(P＜0.001).At T1,the to-tal effective rate in the combination group was 89.74％,which was significantly higher than 77.78％in the single group,and the difference was statistically significant(P＜0.05).During the treatment period,the total incidence rate of adverse reactions in the combination group was 3.42％,which was significantly lower than 12.82％in the single group,and the difference was statistically significant(P＜0.05).Conclusion The clinical efficacy of tetrandrine tablets combined with celecoxib in treating KOA is prominent,it could effectively allevi-ate the joint pain,improve the inflammation and bone metabolism level of the patients,and has certain safety.

Objective To analyze the research hotspots,frontiers,and trends in clinical randomized controlled trials(RCTs)on acupuncture-moxibustion for post-stroke shoulder-hand syndrome(SHS)over the past decade using bibliometric and knowledge mapping methods.Methods The clinical RCTs on acupuncture-moxibustion for post-stroke SHS from five Chinese and English databases were retrieved,including CNKI,Wanfang,VIP,PubMed,and Web of Science(WOS).CiteSpace and VOSviewer were employed for analysis,and visualized knowledge maps were generated.Results A total of 1 226 Chinese and 20 English articles were included,with both reaching publication peaks in 2021.The top three institutions in terms of output were Huguosi Traditional Chinese Medicine Hospital Affiliated to Beijing University of Chinese Medicine,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,and Heilongjiang University of Chinese Medicine.The most prolific author was Song Fengjun,while Pei Jian had the highest centrality.The five most frequently used keywords were shoulder-hand syndrome,stroke,acupuncture-moxibustion,rehabilitation training,and joint mobility.Emerging research topics included activities of daily living,limb function,and range of motion.Conclusion Clinical research on acupuncture-moxibustion for post-stroke SHS holds significant developmental potential.Strengthening international collaboration to explore therapeutic mechanisms is recommended,and researchers should continue optimizing treatment protocols to enhance the quality of clinical evidence.