ObjectiveTo investigate the mechanisms of Runmu Dihuang decoction （RMDHD） in treating perimenopausal dry eye with liver-kidney Yin deficiency syndrome based on the silent information regulator 3 （SIRT3）/hypoxia-inducible factor-1α （HIF-1α）/nuclear factor-κB （NF-κB） signaling pathway. MethodsSixty female Sprague-Dawley rats were randomly divided into six groups （n=10 per group）： Sham operation group， model group， sodium hyaluronate eye drop group， and low-， medium-， and high-dose RMDHD groups （5.625， 11.25， 22.50 g·kg^-1）. Except for the sham operation group， all rats underwent bilateral ovariectomy and were administered 0.1% benzalkonium chloride eye drops combined with long-term chronic irritation to establish a perimenopausal dry eye model with liver-kidney Yin deficiency syndrome. Drug administration began in the 11th week after modeling and continued for 21 days. General conditions， screen-grip test scores， tear secretion volume， tear film breakup time （TFBUT）， and corneal fluorescein staining were recorded. Serum levels of reactive oxygen species （ROS）， follicle-stimulating hormone （FSH）， estradiol （E₂）， and progesterone （PROG） were measured by enzyme-linked immunosorbent assay （ELISA）. Pathological changes in the lacrimal glands， corneas， and uteri were observed using hematoxylin-eosin （HE） staining. Protein expression levels of SIRT3， HIF-1α， phosphorylated NF-κB p65 （p-NF-κB p65）， and total NF-κB p65 in the lacrimal glands were detected by Western blot. The expression of inflammatory cytokines interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） in the lacrimal glands was assessed by immunohistochemistry （IHC）. ResultsAfter model establishment， no significant differences were observed among the groups except the sham operation group. Compared with the sham operation group， the other groups exhibited slowed movement， dull responses， increased irritability， reduced body weight， elevated rectal temperature， decreased screen-grip test scores， reduced tear secretion， and significantly shortened TFBUT （P<0.05）. After treatment， compared with the model group， the sodium hyaluronate eye drop group and all RMDHD groups showed improved general conditions， significantly increased tear secretion （P<0.05）， prolonged TFBUT （P<0.05）， and elevated screen-grip test scores （P<0.05）. Serum ROS and FSH levels were significantly decreased， while E₂ and PROG levels were significantly increased （P<0.05）. Pathological damage to the cornea， lacrimal glands， and uterus was ameliorated. In addition， protein expression levels of SIRT3 and HIF-1α in the lacrimal glands were significantly upregulated （P<0.05）， whereas the expression of p-NF-κB p65， IL-1β， and TNF-α was significantly downregulated （P<0.05）. ConclusionRMDHD increases tear secretion and TFBUT， improves lacrimal gland and corneal injury， and alleviates dry eye symptoms in a perimenopausal dry eye rat model with liver-kidney Yin deficiency syndrome. The underlying mechanism may be related to regulation of the SIRT3/HIF-1α/NF-κB signaling pathway， inhibition of oxidative stress and inflammatory responses， and reduction of ocular surface tissue damage.

ObjectiveTo investigate somatization symptoms in adolescents during frequent earthquakes in Hefei， and to explore their correlation with earthquake experiences. MethodsA cross-sectional survey was used to select 324 adolescents in Hefei as the survey objects. The self-rating scale of somatization symptoms （SSS） and the fatigue intensity scale （FIS） were used to evaluate the somatization symptoms and fatigue degree of middle school students， and multivariate Logistic regression analysis was used to explore the related factors of somatization symptoms and fatigue among middle school students. ResultsA total of 324 adolescents were included， and the overall detection rate of somatization symptoms was 6.5%， and the detection rate of moderate or above fatigue was 20.1%. The results of regression analysis showed that adolescents who were concerned about the earthquake for a longer time （≥1 h） had a higher risk of somatization symptoms （OR=5.430， 95%CI： 1.547-19.058）， and adolescents who received pre-earthquake training had a lower degree of fatigue （OR=0.535， 95%CI： 0.292-0.981） （P<0.05）. ConclusionDuring the frequent earthquakes， adolescents have more somatization symptoms and fatigue. Therefore， it is crucial to enhance health education， reduce the emphasis on event-related reports， and implement earthquake prevention and disaster reduction training to improve the physical and mental health of adolescents.

ObjectiveTo investigate the effects of Liuwei Dihuangwan on mammalian target of rapamycin （mTOR）-mediated synaptic plasticity in the prefrontal cortex-hippocampus circuit in the rat model of valproic acid （VPA）-induced autism spectrum disorder （ASD） and to explore its potential mechanism for reducing behavioral abnormalities in ASD rats. MethodsThirteen SD pregnant rats were randomized into the VPA group （10 rats） and the control group （3 rats）. On gestational day 13， the VPA group was intraperitoneally injected with VPA solution （600 mg·kg^-1）， while the control group was injected with an equal volume of normal saline. Male pups of 21 days old from both groups underwent behavioral tests to screen the ASD model rats （32 rats）. These rats were then randomly assigned to the model （distilled water）， vitamin D （1 480 U·kg^-1）， low-dose （0.75 g·kg^-1） Liuwei Dihuangwan， and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan groups， and normal male pups were selected as the blank group （distilled water）， with 8 rats in each group. Each group was treated with the corresponding drug or an equal volume of distilled water via gavage daily. After drug administration， behavioral tests were conducted again， followed by anesthesia and tissue collection. Nissl staining was carried out to observe the morphological changes of neurons in the prefrontal cortex and hippocampus. Transmission electron microscopy was used to observe changes in hippocampal synaptic structure. Immunohistochemistry and Western blot were employed to determine the expression of mTOR， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the prefrontal cortex， as well as synaptophysin-1 （SYP-1）， postsynaptic density 95 （PSD95）， and N-methyl-D-aspartate receptors （NMDARs） in the hippocampus. ResultsCompared with the control group， the model group exhibited severe growth retardation and developmental deformities， with abnormal behavioral performance and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus. Compared with the model group， all treatment groups showed reduced behavioral abnormalities and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus， with the most significant effects in the high-dose Liuwei Dihuangwan group. Immunohistochemistry and Western blotting results showed that compared with the control group， the model group exhibited significantly increased protein levels and phosphorylation ratios of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex （P<0.05， P<0.01）， and decreased protein levels of SYP-1 and PSD95 and increased protein level of NMDARs in the hippocampus （P<0.01）. Compared with those in the model group， the protein levels of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.05）， and the p-mTOR/mTOR， p-Akt/Akt， and p-PI3K/PI3K ratios in the prefrontal cortex declined in the vitamin D group （P<0.05）. The high-dose Liuwei Dihuangwan group showed a reduction in p-PI3K/PI3K ratio （P<0.05）. The protein level of SYP-1 and PSD95 in the hippocampus increased in the vitamin D， low-dose Liuwei Dihuangwan， and high-dose Liuwei Dihuangwan groups （P<0.05， P<0.01）， while the protein level of NMDARs decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.01）. ConclusionLiuwei Dihuangwan significantly reduces VPA-induced ASD-like behaviors and enhances the regeneration and repair of neurons in the prefrontal cortex and synaptic structures in the hippocampus by downregulating of PI3K/Akt/mTOR expression in the prefrontal cortex， upregulating SYP-1 and PSD95 expression in the hippocampus， and inhibiting NMDARs expression.

Objective:To explore clinical and genetic features of persistent asymptomatic microscopic hematuria in children.Methods:A retrospective case analysis of 135 individuals admitted to Xi ′an Children′s Hospital with persistent asymptomatic microscopic haematuria between January 2016 to December 2023 was conducted. The demographic characteristics, kidney pathology and gene results of 135 individuals were analyzed. One hundred and thirty-five individuals were divided into 2 groups (positive group and negative group) according to family history of glomerulogenic hematuria in first-degree relatives. The differences of hematuria remission, proteinuria and gene variation were compared between the 2 groups. Two independent sample t test, Wilcoxon rank sum test, Pearson Chi-square, Yates′ corrected Chi-squared test or Fisher exact test were used for comparison between groups. Results:All 135 children, with 48 males and 87 females, were 8.5 (6.5, 9.5) years old at first presentation. Kidney biopsy was performed in 73 cases (54.1%). Kidney pathology showed mild lesions in 41 cases (56.2%), thin basement membrane disease (TBMD) in 24 cases (32.9%), typical pathological features of Alport syndrome in 5 cases (6.8%), and other manifestations in 3 cases (4.1%). The positive group comprised 52 individuals, whereas the negative group consisted of 83 individuals. The positive group demonstrated a higher susceptibility in proteinuria and gene variation, while the negative group exhibited a greater rate of hematuria remission ( χ2=5.00, 5.27, 8.52, all P<0.05). Whole exome sequencing was performed in 80 individuals and 18 individuals (22.5%) had a pathogenic or likely pathogenic variant in COL4A3-5. COL4A5 was the most common gene afected, accounting for 11 cases. The 135 individuals were followed up for 4.2 (2.9, 5.1) years, of which 31 cases (22.9%) had complete hematuria remission at 2.1 (1.4, 2.7) years. Up to March 2024, there were also 7 individuals (5.2%) with varying degrees of proteinuria, and 3 individuals (2.2%) with proteinuria progressed to chronic kidney insufficiency. Conclusions:The most common kidney pathological types in children with persistent asymptomatic microscopic hematuria are minor lesions and TBMD. Children with microscopic hematuria whose first-degree relatives have a family history of hematuria are more likely to have proteinuria and gene variants. COL4A3-5 genetic screening could be considered a priority in these children.

Objective:To analyze the medication law of Professor Liu Guangzhen in the treatment of diabetic nephropathy (DN) with qi-yin deficiency and blood stasis syndrome using data mining methods.Methods:From March 2023 to April 2024, the TCM outpatient prescriptions used by Professor Liu to treat DN with qi-yin deficiency and blood stasis syndrome were collected. The database was established by Excel 2019, and the property, taste, meridian, and use frequency of drugs were analyzed through the TCM inheritance assistance system V2.5. The Apriori algorithm in IBM SPSS Modeler 18.0 was used to analyze the association rules and draw the network diagram of high-frequency drugs, and the two-step hidden tree analysis algorithm (LTM-EAST) in the Lantern 5.0 was used to establish the hidden structure model of high-frequency Chinese materia medica. The obtained hidden variables were clustered and interpreted comprehensively, and scored by Bayesian information measure (BIC).Results:A total of 314 prescriptions were included, involving 182 kinds of Chinese materia medica, with a total frequency of 9 242 times. High frequency Chinese materia medica included Astragali Radix, Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran, Litchi Semen, Hedyotis diffusa willd, Benincasae Exocarpium, Mori Folium, etc. The medicinal property was mainly warm, the tastes were mainly sweet, bitter and pungent, and the meridian tropism was mainly spleen, stomach, liver and kidney meridians. The efficacy classification was mainly tonic drugs, heat-clearing drugs, water-clearing and dampness-percolating drugs, and blood circulation-activating drugs. There were 150 association rules of high-frequency Chinese materia medica, including Astragali Radix-Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran-Hedyotis diffusa willd, Saposheikovize Radix-Benincasae Exocarpium, etc. A total of 15 hidden variables, 30 hidden classes and 5 comprehensive clustering models were obtained by hidden structure model analysis.Conclusions:Professor Liu's treatment of DN withqi-yin deficiency and blood stasis syndrome is mainly based on tonifying qi and yin, tonifying spleen and kidney, removing dampness and turbidity and removing blood stasis. According to different conditions, the focus of medication has changed.

Objective To evaluate the clinical efficacy of Modified Buyang Huanwu Decoction combined with Ningxin Jieyu Electroacupuncture in treating post-stroke depression(PSD)and explore its potential mechanisms.Methods A total of 120 PSD patients diagnosed at Shaanxi Provincial Hospital of Traditional Chinese Medicine(inpatient and outpatient departments)from October 2021 to October 2023 were enrolled and randomly divided into an observation group and a control group using a random number table,with 60 cases in each group.Both groups received conventional therapy.The control group additionally received oral administration of Escitalopram Oxalate Tablets,while the observation group underwent Modified Buyang Huanwu Decoction combined with Ningxin Jieyu Electroacupuncture.Both groups were treated for 4 weeks.The clinical efficacy,24-item Hamilton Depression Scale(HAMD-24)scores,National Institutes of Health Stroke Scale(NIHSS)scores,cerebral blood volume(CBV),cerebral blood flow(CBF),serum neurotransmitter levels[norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT)],and inflammatory cytokines[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]were evaluated after one-month treatment.Results(1)After treatment,the HAMD-24 scores and NIHSS scores of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the HAMD-24 scores and NIHSS scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the cerebral blood flow and cerebral blood volume of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving cerebral blood flow and cerebral blood volume,with statistically significant differences(P＜0.05).(3)After treatment,the serum NE,DA,and 5-HT levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving serum NE,DA,and 5-HT levels,with statistically significant differences(P＜0.05).(4)After treatment,the serum TNF-α and IL-6 levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving serum TNF-α and IL-6 levels,with statistically significant differences(P＜0.05).(5)The total effective rate was 93.33%(56/60)in the observation group and 76.67%(46/60)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Modified Buyang Huanwu Decoction combined with Ningxin Jieyu Electroacupuncture effectively alleviates depressive symptoms,enhances neurological function,and improves cerebrovascular perfusion in PSD patients.The therapeutic mechanism may involve modulation of neurotransmitter levels and inflammatory cytokines.

Aim To establish the cells co-expressing 5-HT2C re-ceptor(5-HT2C R)and enhanced green fluorescent protein(EG-FP)-tagged nuclear factor of activated T cells 2(NFAT2)in U2OS cells.Methods The 5-HT2CR stably expressed U2OS-EGFP-NFAT2-5-HT2CR cells were screened by hygromycin B af-ter 5-HT2C plasmid was transfected into U2OS-EGFP-NFAT2 cells.The mRNA and protein expression of 5-HT2CR in the se-lected U2OS-EGFP-NFAT2-5-HT2CR cells were detected by RT-qPCR and Western blot.The activation of U2OS-EGFP-NFAT2-5-HT2CR cells was verified by nuclear translocation level assay.The effects of 5-HT,LSD,DOM,DOI,psilocybin(PSI),lisuride(LIS)on the U2OS-EGFP-NFAT2-5-HT2CR cells were detected by the high throughout screening assay.Results Among these cells,No 56 had the highest nuclear translocation function.5-HT2CR mRNA and protein were stably expressed in U2OS-EG-FP-NFAT2-5-HT2CR transfected cell line for 1-15 generations by RT-qPCR and Western blot.Vabicaserin increased the EGFP-NFAT2 nuclear translocation in U2OS-EGFP-NFAT2-5-HT2C R during 1-15 generations.The 5-HT2CR antagonist SB242084 significantly decreased EGFP-NFAT2 nuclear translocation in-duced by Vabicaserin in U2OS-EGFP-NFAT2-5-HT2CR cells.5-HT,LIS,PSI slightly increased the EGFP-NFAT2 nuclear trans-location in U2OS-EGFP-NFAT2-5-HT2C R cells,whereas LSD,DOI,DOM had no effect.Conclusions U2OS-EGFP-NFAT2-5-HT2CR cells co-expressing 5-HT2CR and EGFP-NFAT2 are es-tablished,which can be used for high throughout screening of chemicals and the study on the mechanism of the5-HT2CR.

Objective:To explore the influencing factors of the use of intravenous therapy specialist nurses and construct a theoretical framework, so as to provide reference for developing intervention measures and improving the use of intravenous therapy specialist nurses.Methods:The grounded theory research method was used. From July to August 2024, 17 intravenous therapy managers/specialist nurses from six ClassⅢ Grade A hospitals in Beijing City and Hebei Province were selected through purposive and theoretical sampling for semi-structured interviews. NVivo 12.0 was used for data analysis, including open, axial, and selective coding.Results:A total of 79 initial concepts were extracted and summarized into 25 domains, which were consolidated into five main domains, including organizational management and support, personal characteristics and professional identity, team collaboration and communication, work performance and incentive mechanisms, and external environment and opportunities. On this basis, a theoretical framework for factors influencing the use of intravenous therapy specialist nurses was constructed.Conclusions:This study constructs a theoretical framework for factors influencing the use of intravenous therapy specialist nurses. Managers can leverage this theoretical framework to develop targeted intervention strategies that enhance the effectiveness of intravenous therapy specialist nurses and optimize the allocation of nursing human resources.

Objective:To explore the intervention effect of ultra-pure double-lumen dialyzer paired with online hemodiafiltration (PHF) on the microinflammatory state in maintenance hemodialysis patients.Methods:A total of 112 maintenance hemodialysis patients admitted to the Huadu District People′s Hospital of Guangzhou from January 2020 to December 2023 were prospectively enrolled. Using a parallel control and before-after control method, the patients were divided into an observation group and a control group according to the odd and even numbers of their enrollment sequence, with 56 cases in each group. The observation group received PHF during hemodiafiltration, while the control group received hemodiafiltration with a high-flux dialyzer. Venous blood samples were collected from both groups before treatment and 6 months after treatment to detect the levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon (IFN)-γ. The dialysis efficacy of the two groups was compared by evaluating the changes in microinflammatory index levels.Results:Before treatment, there were no significant differences in serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, and hs-CRP between the two groups (all P>0.05). After treatment, various inflammatory indicators in the observation group were significantly lower than those before treatment (all P<0.05), while there were no significant differences in inflammatory indicators in the control group before and after treatment (all P>0.05). Moreover, there were significant differences in inflammatory indicators between the observation group and the control group after treatment ( P<0.05). Conclusions:Ultra-pure double-lumen dialyzer paired with online hemodiafiltration can significantly improve the inflammatory state in hemodialysis patients.

Background:Duodenal papillary adenoma is a benign tumor with relatively low incidence but significant carcinogenesis potential.Despite the minimal invasiveness and low complication rate,endoscopic papillectomy is associated with a definite risk of recurrence for duodenal papillary adenoma.Investigating the driver genes of duodenal papillary adenoma and establishing predictive models for recurrence and malignant progression could facilitate the precision medicine.Aims:To identify the key driver genes for tumor occurrence,carcinogenesis and recurrence in duodenal papillary adenoma by integrating multi-dimensional bioinformatics approaches based on transcriptomics data,and validate clinically.Methods:Expression profiles of duodenal papillary adenoma and adenocarcinoma were obtained from the GEO database(including data sets GSE189035,GSE94919,GSE111156,and GSE102208).Differentially expressed genes(DEGs)between adenomatous and normal tissues were screened.Weighted gene co-expression network analysis(WGCNA)and pseudo-time analysis were combined to identify the core genes exhibiting an"initial rise followed by decline"expression pattern during the dynamic progression from normal tissue to adenoma and adenocarcinoma.Functional annotation,immune microenvironment profiling,and protein-protein interaction network analysis were performed to explore the tumor-promoting mechanisms of these core genes.Clinical validation was conducted using immunohistochemistry to estimate the gene expression level and its relationship with tumor recurrence.Results:A total of 469 common DEGs were identified.WGCNA revealed that the blue module(including 1 051 genes)was associated with adenoma development and progression(Cor=-0.29,0.15,and 0.11 for normal tissue,adenoma,and adenocarcinoma,respectively).Intersection with DEGs pinpointed four key genes:SLC12A2,BEST4,SLC37A2,and SOAT2.Pseudo-time analysis demonstrated that only SLC12A2 maintained sustained high expression in both adenoma and adenocarcinoma tissues.KEGG enrichment analysis indicated that SLC12A2 was linked to various malignant pathways(e.g.,PD-1/PD-L1 signaling pathway),and its high expression correlated with the reduced immune cell infiltration(e.g.,γδ T cells,CD8+T cells,etc.).Clinical validation by immunohistochemistry confirmed the trend of initial upregulation and subsequent downregulation of SLC12A2 expression in normal,adenoma,and adenocarcinoma tissues.Patients with tumor recurrence showed higher SLC12A2 expression level(P=0.004);likewise,SLC12A2 high expression was associated with an elevated recurrence risk(P=0.034).Conclusions:SLC12A2 serves as a critical driver of tumorigenesis and progression for duodenal papillary adenoma,and might be a promising biomarker for recurrence prediction.