Objective:To examine the therapeutic effects and molecular mechanisms of nuclear receptor NR4A1 in alleviating postoperative ileus (POI) in a rat model.Methods:Twenty-four Sprague-Dawley rats were randomly(random number) divided into four groups ( n=6/group): sham-operated control, POI model, POI model + NR4A1 stimultior (Cytosporone B, 13 mg/kg), and POI model + NR4A1 antagonist (DIM-C-pPhCO2Me, 2 mg/kg). After 24 hours, intestinal tissues and serum were collected for analysis. We assessed: (1) histopathological changes, (2) intestinal motility via propulsion rate, (3) NR4A1 expression by immunohistochemistry, (4) epithelial apoptosis via TUNEL assay, (5) inflammatory cytokines (IL-6, IL-4) by ELISA, (6) tight junction protein (occludin) by Western blot, and (7) p38MAPK/NF-κB pathway activation through combined western blot and immunofluorescence analyses. Results:Compared with sham controls, POI model rats showed (all P<0.05): significantly reduced NR4A1 expression, severe mucosal damage, increased inflammatory infiltration, elevated epithelial apoptosis, decreased occludin expression, impaired intestinal motility, upregulated pro-inflammatory cytokines (IL-6, IL-4), and activated p38MAPK/NF-κB signaling. NR4A1 activation with Cytosporone B significantly reversed these pathological changes (all P<0.05), while NR4A1 inhibition exacerbated them. Conclusions:NR4A1 activation attenuates POI by suppressing p38MAPK/NF-κB-mediated inflammation and preserving intestinal barrier function, suggesting its potential as a therapeutic target for postoperative ileus.

Objective To explore the diagnostic value of magnetic resonance imaging(MRI)and high-frequency ultrasound for synovitis of the hip in children(SHC).Methods A total of 107 children suffering from hip pain were enrolled and underwent MRI and ultrasound examinations.The value of MRI and ultrasound for diagnosing SHC and identifying different types of SHC was analyzed.Results The result consistency between high-frequency ultrasound and clinical diagnosis was higher than that between MRI and clinical diagnosis(Kappa:0.717 vs 0.586).The AUC of the combined detection for diagnosing SHC was greater than that of MRI(0.844 vs 0.812,P<0.05).For the differential diagnosis of different types of SHC,the result consistency between high-frequency ultrasound and clinical diagnosis was higher than that between MRI and clinical diagnosis(Kappa:0.813 vs 0.630).The AUC of high-frequency ultrasound and the combined detection for differentiation between joint swelling type and joint effusion type of SHC was 0.903 and 0.912,higher than 0.815 of MRI(P<0.05).The detection rates of joint space abnormality,joint effusion,joint swelling and joint cartilage changes were 92.45%(49/53),73.91%(17/23),90.70%(39/43),and 77.78%(14/18)when using MRI,and those were 96.23%(51/53),91.30%(21/23),95.35%(41/43),and 88.89%(16/18)when using high-frequency ultrasound.There was no significant difference in the detection rates of pathological changes such as joint space abnormality between the two methods(P>0.05).Conclusion The combined detection of MRI and high-frequency ultrasound has high diagnostic value for SHC.

Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.

Objectives:To study the computed tomography features of banded adhesions(BA) and matted adhesions(MA) of adhesive small bowel obstruction(ASBO).Methods:We enrolled 150 patients operated on for ASBO. According to intraoperated findings, ASBO were classified into those caused by BA or MA. A multivariable logistic regression was established to analyze independent risk factors on Computed Tomography features.Results:There were significant differences in closed-loop sign (36.8% vs. 14.3%, P=0.002) mesenteric haziness (43.7% vs. 17.5%, P=0.001), beak sign (48.3% vs. 17.5%, P<0.001), fat notch sign (39.1% vs. 9.5%, P<0.001) and peritoneal fluid (54.0% vs. 34.9%, P=0.015) between the two groups. The presence of beak sign [ OR=6.15, 95% CI (2.55-14.84), P<0.001], fat notch sign [ OR=6.19, 95% CI (2.16-17.82), P=0.001] and mesenteric haziness [ OR=3.34, 95% CI (1.34-8.32), P=0.009] were independent risk factors with BA. Conclusion:Beak sign, fat notch sign and mesenteric haziness were independent risk factors for diagnosing BA.

Objective:To explore the self-management cognition and inner experience of adult fixed orthodontic patients, so as to provide evidence support for subsequent research.Methods:This was a qualitative study. By using the purposive sampling method, a total of 12 adult patients who underwent orthodontic treatment in the Affiliated Stomatology Hospital of Guangzhou Medical University from June to July 2022 were selected for face-to-face semi-structured in-depth interviews. Using Nvivo 12 software, the interview data was analyzed and summarized using the Colaizzi 7-step analysis method.Results:Self-management cognition and inner experience of adult fixed orthodontics patients were extracted into 3 core themes and 7 sub-themes. They were the multiple psychological feelings in the face of orthodontic treatment (positive psychological feelings, negative psychological feelings) , impediments to orthodontic treatment (lack of support from family members, obstacles to medical follow-up) , and differences in self-management behaviours (positive self-management, negative self-management, and phased changes in behaviours) .Conclusions:Adult fixed orthodontic patients suffer from negative psychological feelings, obstruction of medical follow-up and insufficient self-management ability, etc. Nursing staff should focus on the feelings and experiences of such patients during the treatment process, conduct a dynamic assessment of the patient's psychology and behaviours throughout the treatment phase, and adopt patient-centred nursing interventions in conjunction with the information technology platform, to improve the patient's negative emotions and enhance their oral health self-management ability.

Otorhinolaryngology is a high-risk department of a hospital, where there are many emergency critical diseases, common multiple diseases and major malignant diseases. Therefore, it is easy to cause many medical ethical problems. This paper analyzed the clinical status and characteristics of various otolaryngology diseases systematically, and expounded the related medical ethical issues in the diagnosis and treatment of otorhinolaryngology, including doctor-patient trust, safety and informed consent. Finally, the paper put forward a number of measures to do well the psychological evaluation and nursing care of patients, improve the professional skills of medical and nursing care, formulate the treatment plan of diseases, enhance the supervision and management of the network, and promote the social support of patients. The aim was to alleviate the "doctor-patient conflict" and create a harmonious medical environment.

Objective To study the relationship between glutamine metabolism and radiotherapy resistance in nasopharyngeal carcinoma (NPC).Methods The glutaminase 1 (GLS1) knockout CNE1,6-10B cell lines and the control cell lines were established by lentivirus transfection technology.The CNE2 cell lines with GLS1 overexpression and control cell lines were established by liposome transfection technology.BPTES,one of Glutamine enzyme inhibitors,was used to inhibit the activity of GLS1.Glutamine/Glutamate(Gln/Glu) and Glu kits were used to detect glutamine metabolism in NPC cells;in vitro radiation clone formation experiment and flow cytometre mediated apoptosis assay were adopted to detect the effects of glutamine metabolism modulation on NPC radiosensitivity.Western blot and autophagic puncta monitor assay were carried out to detect the effects of glutamine metabolism modulation on autophagy status in NPC cells.Results Inhibiting the glutamine metabolism led to decreased clone formation,increased apoptotic rates,and decreased autophagic level in NPC cells;while activating the glutamine metabolism led to increased clone formation,decreased apoptotic rates and increased autophagic level in NPC cells.Conclusions The reduction of glutamine metabolism inhibits autophagy and increases radio sensitivity of NPC.

Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.

Objective: To investigate the effect of hypoxia inducible factor 2α (HIF-2α) on regulating CUB domain-containing protein 1 (CDCP1) and its role in hepatocellular carcinoma metastasis. Methods: HIF-2α-knocked down and HIF-2α-stably overexpressing cells (MHCC97H) were prepared by small interfering RNA (siRNA) and lentivirus transfection, respectively. The expression of CDCP1 protein and mRNA in the above cells was detected by western blot and real-time PCR. The effect of HIF-2α on cell invasion ability was determined by Transwell assay. Furthermore, immunohistochemical staining was performed to detect the expression of CDCP1 in human HCC tissue samples. Results: Both HIF-2α and CDCP1 were induced under hypoxic conditions. The activation of CDCP1 under hypoxic conditions was dependent on the expression of HIF-2α.When HIF-2α was overexpressed, the mRNA level of CDCP1 was greatly upregulated (5.92±0.28, P<0.05). When HIF-2α was knocked down by siRNA for 48 h and 72 h, the expression of CDCP1 was significantly downregulated (48 h: 0.25±0.04; 72 h: 0.18±0.02, all P<0.05). Moreover, analysis of human HCC samples showed that CDCP1 expression was correlated with tumor-free survival (P<0.05). Conclusions The results of this study indicate that the expression of CDCP1 is regulated by HIF-2α and is correlated with the progression of HCC. Inhibition of HIF-2α/CDCP1 may play certain inhibitory role in the metastasis of HCC.

OBJECTIVE: To investigate the effect of IL-17 and IL-23 in the pathogenesis of allergic rhinitis(AR) and non. allergic rhinitis(NAR). METHOD: Selected 156 cases of patients with allergic rhinitis (AR group) and 59 cases of patients with non-allergic rhinitis (NAR group), 60 cases of healthy people (control group). All cases in AR group and NAR groups were evaluated by a visual analog scale (VAS) score of nasal symptoms. Collected peripheral blood and nasal secretions in all cases and then detected IL-17 and IL-23 expression levels. RESULT: There was no significant difference in VAS score of AR group and NAR group (P>0. 05). IL-17 and IL-23 levels of serum and nasal secretions in AR group and NAR group were both higher than control group, with a highly significant difference (P <0. 05). The research showed a clear correlation between expression of IL-17 and IL-23 both in serum and nasal secretions of AR group and NAR(P<0. 05). CONCLUSION IL-17 and IL-23 may be important cytokines and IL-23/IL-17 pathway may play a significant role in the pathogenesis of allergic rhinitis and non-allergic rhinitis.
Case-Control Studies ; Humans ; Interleukin-17 ; blood ; metabolism ; Interleukin-23 ; blood ; metabolism ; Nasal Mucosa ; metabolism ; Rhinitis ; blood ; metabolism ; Rhinitis, Allergic ; blood ; metabolism