To investigate the effect of Xuebijing injection (XBJ) on cGAS/STING pathway in alleviating sepsis-induced acute lung injury (ALI), the mouse sepsis-induced ALI model was established by cecal ligation and puncture (CLP), and the cell inflammation model was constructed by LPS stimulating RAW264.7 cells. The effects of XBJ on lung tissue injury and cGAS/STING pathway-related protein expression in septic mice were investigated by HE staining, ELISA, and Western blot. The results showed that XBJ intervention could alleviate lung tissue injury, reduce serum IL-6, TNF-α, IFN-β, IL-1-β levels, and the expression of cGAS, STING, p-TBK1, and p-IRF3 proteins in lung tissue in vivo, and reduce the mRNA level of related inflammatory factors in RAW264.7 cells and the expression of cGAS/STING pathway proteins in vitro. The results showed that XBJ could play a role in the prevention and treatment of sepsis-induced ALI by inhibiting the inflammatory response via inhibition of the activation of cGAS/STING pathway. This study provides a new molecular mechanism for the clinical prevention and treatment of sepsis-induced acute lung injury with XBJ.

Objective:To translate the Self-Confidence Scale for Clean Intermittent Self-Catheterization (SCSCISC) into Chinese and test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, the English version of SCCSISC was translated, back translated, culturally adapted, consulted with experts, and pre-surveyed to form the Chinese version of SCCSISC. From June to September 2023, 237 patients with neurogenic bladder admitted to the First Hospital of Shanxi Medical University were selected as survey subjects by the convenient sampling method. The critical ratio method was used for project analysis, and Cronbach's α coefficient, split half reliability, and test-retest reliability were used to evaluate the reliability of the scale. Content validity and construct validity were used to test the validity of the scale.Results:The Cronbach's α coefficient of the Chinese version of SCCSISC was 0.976, the split half coefficient was 0.962, and the test-retest reliability was 0.876. The item-level content validity index ( I- CVI) of the Chinese version of SCCSISC was 0.86 to 1.00, and the scale-level content validity index ( S- CVI) was 0.93, with Kappa consistency coefficients above 0.74. Two common factors were extracted through exploratory factor analysis, with a cumulative variance contribution rate of 73.42%. Conclusions:The Chinese version of SCCSISC has good reliability and validity, and can be used as a tool for self-confidence measurement of clean intermittent self-catheterization among patients with neurogenic bladder in China.

Objective:To translate the Intermittent Catheterization Difficulty Questionnaire (ICDQ) into Chinese, and to test its reliability and validity in neurogenic bladder patients.Methods:After translation, back-translation, cross-cultural debugging, expert consultation and pre-investigation, a Chinese version of ICDQ was formed. A total of 248 patients with neurogenic bladder clean intermittent self-catheterization who were treated and followed up in the First Hospital of Shanxi Medical University in October 2022 were selected as research objects by the convenient sampling method, and the Chinese version of ICDQ was used for investigation. The critical ratio method was used for project analysis. Content validity and structure validity were used to test the validity of the questionnaire. Cronbach's α coefficient, split half reliability coefficient and retest reliability coefficient were used to test the reliability of the questionnaire. A total of 248 questionnaires were sent out in this study, and 238 were effectively collected, with a recovery rate of 95.97% (238/248) .Results:The Cronbach's α coefficient of the Chinese version of ICDQ was 0.857, the split half coefficient was 0.711, and the retest reliability coefficient was 0.954. The content validity index of the Chinese version of ICDQ item level was 0.860 to 1.000, and the content validity index of the scale level was 0.930. Seven common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.38%. The results of confirmatory factor analysis showed RMSEA < 0.080, GFI, AGFI, TLI, CFI > 0.800. Conclusions:Through confirmatory factor analysis, the Chinese version of ICDQ shows that the model fitting indicators of the scale meet the corresponding requirements, indicating that the scale has high structural validity and overall model fitting. It can be used as an evaluation tool for intermittent self catheterization difficulties in patients with neurogenic bladder.

Objective:To explore the effect of comprehensive gastrointestinal training on the recovery of gastrointestinal function after radical cystectomy (Bricker′s operation).Methods:Seventy-one elderly bladder cancer patients who had undergone Bricker′s operation were randomly divided into a control group of 34 and an observation group of 37. Both groups were given routine treatment, while the observation group was additionally provided with comprehensive gastrointestinal training immediately after the operation. Plasma gastrin was measured before the operation and on the 1st and 3rd day afterward. The return of peristaltic sounds, the exhausting and defecation time, the incidence of intestinal obstruction and the average hospital stay were recorded. On the 7th, 14th, 21st and 28th day after the operation, both groups′ gastrointestinal functioning was scored by using Gastrointestinal Symptom Rating Scale (GSRS).Results:The levels of plasma gastrin in the observation group were significantly higher than before the surgery and significantly higher than those in the control group on the 1st and 3rd day after the surgery, though there had been no significant difference between the two groups before the operation. Compared with the control group, peristaltic sounds returned significantly earlier in the observation group (after 1.22±0.15d), and the group′s exhaust time (1.88±0.22d) and first defecation time (2.95±0.19d) were also better. The incidence of intestinal obstruction (23.53%) was significantly lower in the observation group as well. The observation group recorded lower average GSRS values than the control group throughout the observation and follow-up periods, and their average hospital stay was significantly shorter.Conclusion:Comprehensive gastrointestinal training can effectively promote recovery after radical bladder cystectomy.

Objective:To investigate the different outcomes of two types of acute kidney injury (AKI) according to standard of Kidney Disease: Improving Global Outcomes-AKI (KDIGO-AKI), and to analyze the risk factors that affect the prognosis of intensive care unit (ICU) patients in China.Methods:A secondary analysis was performed on the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a multicenter prospective study involving 3 063 patients in 22 tertiary ICUs in 19 provinces and autonomous regions of China. The demographic data, scores reflecting severity of illness, laboratory findings, intervention during ICU stay were extracted. All patients were divided into pure AKI (PAKI) and acute on chronic kidney disease (AoCKD). PAKI was defined as meeting the serum creatinine (SCr) standard of KDIGO-AKI (KDIGO-AKI SCr) and the estimated glomerular filtration rate (eGFR) at baseline was ≥ 60 mL·min -1·1.73 m -2, and AoCKD was defined as meeting the KDIGO-AKI SCr standard and baseline eGFR was 15-59 mL·min -1·1.73 m -2. All-cause mortality in ICU within 28 days was the primary outcome, while the length of ICU stay and renal replacement therapy (RRT) were the secondary outcome. The differences in baseline data and outcomes between the two groups were compared. The cumulative survival rate of ICU within 28 days was analyzed by Kaplan-Meier survival curve, and the risk factors of ICU death within 28 days were screened by Cox multivariate analysis. Results:Of the 3 063 patients, 1 042 were enrolled, 345 with AKI, 697 without AKI. The AKI incidence was 33.11%, while ICU mortality within 28 days of AKI patients was 13.91% (48/345). Compared with PAKI patients ( n = 322), AoCKD patients ( n = 23) were older [years old: 74 (59, 77) vs. 58 (41, 72)] and more critical when entering ICU [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score: 23 (19, 27) vs. 15 (11, 22)], had worse basic renal function [eGFR (mL·min -1·1.73 m -2): 49 (38, 54) vs. 115 (94, 136)], more basic complications [Charlson comorbidity index (CCI): 3 (2, 4) vs. 0 (0, 1)] and higher SCr during ICU stay [peak SCr for diagnosis of AKI (μmol/L): 412 (280, 515) vs. 176 (124, 340), all P < 0.01]. The mortality and RRT incidence within 28 days in ICU of AoCKD patients were significantly higher than those of PAKI patients [39.13% (9/23) vs. 12.11% (39/322), 26.09% (6/23) vs. 4.04% (13/322), both P < 0.01], while no significant difference was found in the length of ICU stay. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate in ICU in AoCKD patients was significantly lower than PAKI patients (Log-Rank: χ2 = 5.939, P = 0.015). Multivariate Cox regression analysis showed that admission to ICU due to respiratory failure [hazard ratio ( HR) = 4.458, 95% confidence interval (95% CI) was 1.141-17.413, P = 0.032], vasoactive agents treatment in ICU ( HR = 5.181, 95% CI was 2.033-13.199, P = 0.001), and AoCKD ( HR = 5.377, 95% CI was 1.303-22.186, P = 0.020) were independent risk factors for ICU death within 28 days. Conclusion:Further detailed classification (PAKI, AoCKD) based on KDIGO-AKI SCr standard combined with eGFR is related to ICU mortality in critical patients within 28 days.

Objective: To investigate the expression of inhibitory receptor TIGIT gene in peripheral NK cells of patients with rheumatoid arthritis (RA) and its clinical significance. Methods: A case control study was conducted of 58 RA patients(30 patients with active RA disease, 28 patients with remission of RA) and 22 healthy controls (HC) in the department of rheumatology and immunology from Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine during December 2018 to June 2019, the related clinical data were collected. Flow cytometry was used to compare the expression of TIGIT gene on peripheral NK cells. The IFN-γ secretion level of cytokines in peripheral blood was detected by ELISA, and analyzed the correlations between TIGIT gene and disease activity and IFN-γ level. T-test or non-parametric test was used for comparison between the two groups, and Pearson correlation analysis was used for correlation between the two variables. Results: Compared with HC group, the number of NK cells in RA disease group was reduced, which was (13.88±4.56) ×10⁷ cells/L in RA disease group and (25.69± 2.48) ×10⁷ cells/L in HC group (t=-2.036, P=0.041). The percentage of TIGIT gene expression in peripheral blood NK cells was not statistically different between RA disease group (39.73±9.37)% and HC group (45.64±9.91)% (t=-1.241, P=0.218). However, the average fluorescence intensity (MFI) of TIGIT gene expression was decreased, which was (7.21±2.03) in RA group and (9.01±3.29) in HC group (t=-2.947, P=0.004).MFI of TIGIT gene in NK cells of the disease active subgroup was (6.72±2.01), lower than that of the disease remission subgroup (8.75±2.64), (t=-3.316, P=0.002), and MFI of TIGIT gene in NK cells of the disease active subgroup was negatively correlated with DAS28 score (r²=0.649 6, P<0.000 1).The secretion level of IFN-γ cytokine in the RA disease group was (67.13±14.84) pg/ml, higher than that in the HC group (57.21±14.23) pg/ml (t=2.757, P=0.017), and the secretion level of IFN-γ cytokine in the disease active subgroup was negatively correlated with the MFI of TIGIT gene on NK cells (r²=0.662 2, P<0.000 1). Experimental results of peripheral blood mononuclear cell stimulation in the RA disease activity subgroup showed that the secretion level of cytokines IFN-γ was reduced after stimulation compared with that before stimulation (t=11.38, P<0.000 1). Conclusion The abnormal expression of TIGIT gene on peripheral NK cells are observed in patients with RA, which correlate with disease activity and IFN-γ secretion level.

Objective To compare the effects of spinal anesthesia and general anesthesia on early postoperative cognitive function in elderly patients undergoing hip replacement.Methods One hundred and four elderly patients of both sexes,aged ≥ 60 yr,with body mass index of 18.5-24.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective unilateral hip replacement,were randomized into 2 groups (n =52 each) using a random number table method:general anesthesia group (group G) and spinal anesthesia group (group S).Total intravenous general anesthesia was adopted to maintain the bispectral index value at 40-60 during surgery in group G.In group S,spinal anesthesia was applied by injecting 0.5％ bupivacaine 1.5-3.0 ml at the L3-4 vertebral interspace,and the level of anesthesia was regulated and maintained at T10.Mini-Mental State Examination scale was used to evaluate the cognitive function on 1 day before surgery (T0) and 7 days after surgery (T,).Difference value method,1 standard deviation method and Z score method were applied to diagnose postoperative cognitive dysfunction.Patients' spouses in two groups were recruited as control group (group C) according to the Z-scoring method.Results There were 47 and 49 cases in G and S groups,respectively,and 33 cases in group C.Compared with group C,the memory score was significantly decreased at T1 (P＜0.01),and no significant change was found in group S (P＞0.05).The memory score was significantly higher at T1in group S than in group G (P＜0.01).There were no significant differences in the incidence of postoperative cognitive dysfunction between group G and group S (P＞0.05).Conclusion Spinal anesthesia and general anesthesia exerts no effect on early postoperative cognitive function in elderly patients undergoing hip replacement.

Objective To investigate the effects of stellate ganglion block(SGB)on attention and executive function in middle-aged and elderly patients after surgery.Methods Middle-aged and elderly patients aged 55-75 years who underwent hip replacement surgery under lumbar anesthesia were randomized into a control group and an SGB group.Patients in the SGB group received ultrasound-guided stellate ganglion block 30 min before surgery,and patients in the control group were given no additional treatment before surgery.All patients were tested with a modified version of the Trail Making Test-Part A (TMT-A)and a modified version of the Symbol Digit Modalities Test (SDMT)1 day before surgery and 7 days after surgery.The Z-score method was used to diagnose postoperative attention and/or executive function impairment.Results The modified versions of TMT-A and SDMT had good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Age was the main influencing factor for the two tests,and their two parallel versions had good alternate-form reliability.There was no significant difference between the control group and the SGB group in scores of modified TMT-A and SDMT at 7 days after surgery(P＞0.1).However,the incidence of attention and/or executive function impairment was lower in the SGB group than in the control group(19.3％ vs.36.6％,P＜0.05).Conclusions The modified TMT-A and SDMT have good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Preoperative SGB may protect attention and executive function in middle-aged and elderly patients.

Objective To measure the actual absorbed dose of the target in the QUASAR Respiratory Motion Phantom using the CyberKnife Synchrony Respiratory Tracking System, and to evaluate the effect of density heterogeneity on the absorbed dose of tumor gross target volume ( GTV ) . Methods Nine groups were obtained by making different patterns of QUASAR phantom:rib thickness of 0, 20, and 50 mm, and motion amplitudes of 0, 10, and 15 mm. The nine groups were treated with static computed tomography (CT) in different time phases of four-dimensional CT (4DCT) plan, with the same beam and number of monitor units, and the 4D accumulated dose was calculated. The doses of static and 4D plans were calculated using Ray-tracing and Monte Carlo algorithms, and the absorbed doses of GTV in the nine groups were measured at the same time. Results There were a decrease in calculated absorbed dose of GTV and an increase in deviation between the planned and actual dose, with the increases in simulated rib thickness and motion amplitude. Conclusions The density heterogeneity has an impact on the absorbed dose of GTV. Both static CT and 4DCT plan can evaluate the absorbed dose of GTV in case of small rib thickness and motion amplitude, and 4DCT plan with Monte Carlo algorithm may be the optimal method for evaluation of the absorbed dose of GTV in case of large rib thickness and motion amplitude ( deviation<3%)

Objective To investigate the effect of phloroglucinol on pregnancy outcome in patients with recurrent implantation failure (RIF).Methods A total of 146 patients with RIF from March 2014 to March 2016 from the reproductive medical center of the Guangxi Zhuang Autonomous Region people's Hospital was randomly divided into two groups,73 cases were included in study group [16 cases of in vitro fertilization and embryo transfer (IVF-ET) and 57 cases of frozen/thawed embryo transfer (FET)].Patients in study group were given intramuscular injection of phloroglucino140mg,two times a day before the transplantation day to three days after transplantation,73 cases without phloroglucinol injection were included as control group.The biochemical pregnancy rate,clinical pregnancy rate,embryo implantation rate,abortion rate,ectopic pregnancy rate,multiple pregnancy rate and live birth rate were compared between two groups.Results The biochemical pregnancy rate in study group of FET was significantly higher than the control group (57.9％ vs 36.8％,P ＜0.05);the biochemical pregnancy rate in study group of IVF-ET was higher than the control group (50％ vs 37.5％,P ＞ 0.05),but there was no significant difference between the study group and control group;compared to the control group,the study group was increased clinical pregnancy rate,implantation rate,live birth rate,and decreased abortion rate (P ＞ 0.05),but the difference was not statistically significant.Conclusions The application of phloroglucinol in women with RIF may improve the biochemical pregnancy rate,especially in FET cycles.