ObjectiveTo investigate the therapeutic effects of the Anemarrhenae Rhizoma water extract （AR） on Alzheimer's disease （AD） model rats and to explore its potential underlying mechanisms. MethodsMale rats were intraperitoneally injected with D-galactose （100 mg·kg^-1） for 42 days， and on day 14， 1 μL of β-amyloid （Aβ_25-35， 2 g·L^-1） solution was injected into the hippocampus. Rats were randomly divided into a model group， low-dose AR （0.6 g·kg^-1）， medium-dose AR （1.2 g·kg^-1）， high-dose AR （2.4 g·kg^-1）， and a positive control group （donepezil， 5 mg·kg^-1）. Healthy rats receiving only a hippocampal injection of 1 μL of sterile saline served as the sham-operated group. From day 21， rats in the treatment groups were administered the corresponding drugs by gavage once daily for 21 consecutive days， while the blank control and model groups received an equal volume of saline. Learning and memory abilities were assessed using the Morris water maze. Brain tissue damage was observed by hematoxylin and eosin （HE） staining， and neuronal apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） staining. Levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and interleukin-10 （IL-10） in brain tissues were measured by enzyme-linked immunosorbent assay （ELISA）. BV2 microglial cells were co-cultured with Aβ_25-35 （40 μmol·L^-1） for 2 h， and cell viability was determined by the CCK-8 assay to screen the optimal concentration of AR-containing serum （S-AR）. Cells were divided into blank control， Aβ_25-35， S-AR， EX527 ［silent information regulator 1 （SIRT1） inhibitor］， and S-AR+EX527 groups. Immunofluorescence staining was used to detect the expression of CD16， CD206， and high-mobility group box 1 （HMGB1）. Western blot analysis was performed to measure the protein expression of CD16， inducible nitric oxide synthase （iNOS）， CD206， arginase （Arg）， and proteins related to the SIRT1/HMGB1/nuclear factor-κB （NF-κB） signaling pathway. ResultsIn vivo experiments showed that， compared with the sham-operated group， the model group exhibited reduced platform crossings and time spent in the target quadrant （P<0.01）， prolonged escape latency， increased hippocampal neuronal apoptosis （P<0.01）， and obvious hippocampal damage. The expression levels of IL-6， TNF-α， IL-10， CD16， and iNOS in brain tissues were significantly elevated （P<0.01）， while CD206 and Arg protein expression showed an increasing trend without statistical significance. Compared with the model group， all AR-treated groups significantly increased platform crossings and target quadrant time （P<0.05， P<0.01）， alleviated hippocampal damage， reduced escape latency and neuronal apoptosis， downregulated the expression of TNF-α， IL-6， CD16， and iNOS （P<0.05， P<0.01）， and upregulated the expression of IL-10， CD206 and Arg （P<0.05， P<0.01）. In vitro experiments demonstrated that， compared with the blank control group， the Aβ_25-35 group showed increased fluorescence intensity of CD206， CD16， and HMGB1， as well as elevated protein expression of iNOS and CD16 （P<0.01）， while CD206 and Arg protein expression exhibited an increasing trend without statistical significance. After S-AR intervention， CD206 fluorescence intensity and the protein expression of Arg and CD206 were significantly increased （P<0.01）， whereas the fluorescence intensity of CD16 and HMGB1 and the protein expression of iNOS and CD16 were significantly decreased （P<0.01）. These effects were reversed by EX527 （P<0.05， P<0.01）. Furthermore， compared with the blank control group， the Aβ_25-35 group showed significantly increased cytoplasmic HMGB1 expression and p-p65/p65 ratio （P<0.01）， along with significantly decreased SIRT1 and nuclear HMGB1 expression （P<0.01）. In contrast， the S-AR group exhibited opposite trends compared with the Aβ_25-35 group， and the regulatory effects of S-AR on these proteins were reversed by EX527 （P<0.01）. ConclusionAR exerts neuroprotective effects in AD model rats by regulating microglial polarization and alleviating neuroinflammation， potentially through modulation of the SIRT1/HMGB1/NF-κB signaling pathway.

Background and aims The mechanism of cholestatic liver injury (CLI) is unclear, and effective therapies are lacking. While peroxisome proliferator-activated receptor alpha (PPARα) agonists show potential hepatoprotective effect and pyroptosis is implicated in hepatocellular damage, how PPARα activation mitigates lithocholic acid (LCA)-induced pyroptosis remains unknown. Methods The hepatoprotective effect of PPARα agonists was evaluated in a mouse model of intrahepatic cholestasis induced by LCA. Liver injury was assessed via serum biochemistry, hematoxylin and eosin and TUNEL staining, and electron microscopy. Pyroptosis pathways were analyzed using real-time quantitative polymerase chain reaction, Western blot, and co-immunoprecipitation. Results Combined morphological, histopathological, and biochemical analyses confirmed that PPARα activation protects against CLI. Compared with LCA treatment alone, PPARα activation significantly attenuated the elevation of serum lactate dehydrogenase (LDH), the increased TUNEL-positive cells, and the formation of hepatocyte membrane pores. Mechanistically, PPARα activation suppressed both NOD-like receptor protein 3 (NLRP3) inflammasome-mediated pyroptosis and apoptosis protease-activating factor-1 (APAF-1)/CASPASE-3/GSDME-mediated pyroptosis. Furthermore, PPARα agonist pretreatment inhibited activation of the nuclear factor-kappa B (NF-κB) and forkhead box O1 (FOXO1) signaling pathways. Conclusions PPARα protects against LCA-induced CLI by inhibiting both NLRP3 inflammasome-mediated pyroptosis associated with NF-κB and APAF-1/CASPASE-3/GSDME-mediated pyroptosis associated with the FOXO1 signaling pathway.

ObjectiveTo investigate the clinical effects and safety of Shuhe Granules （舒和颗粒） in patients with rheumatoid arthritis （RA） comorbid with insomnia. MethodsA single-arm prospective exploratory design was adopted. Thirty RA patients comorbid with insomnia and diagnosed with the traditional Chinese medicine （TCM） syndrome of kidney-heart deficiency and qi-blood disharmony were enrolled. On the basis of maintaining their original RA treatment regimens， all patients received oral Shuhe Granules， one dose per day， for 12 consecutive weeks. The outcomes were assessed before treatment and at weeks 4， 8， and 12 after treatment. Sleep and related psychosomatic function were evaluated using the insomnia severity index （ISI）， Pittsburgh sleep quality index （PSQI）， fatigue severity scale （FSS）， patient health questionnaire-9 （PHQ-9）， generalized anxiety disorder-7 （GAD-7）， and Montreal cognitive assessment （MoCA） scores. RA-related assessments included the 28-joint disease activity score based on C-reactive protein （DAS28-CRP）， pain visual analog scale （VAS）， tender joint count （TJC28）， swollen joint count （SJC28）， morning stiffness duration， and health assessment questionnaire （HAQ） score. Laboratory parameters included erythrocyte sedimentation rate （ESR）， serum C-reactive protein （CRP）， anti-cyclic citrullinated peptide antibody （anti-CCP）， and rheumatoid factor （RF） levels. A literature-based historical control group was established through literature retrieval and meta-analysis. The ISI， PSQI， DAS28-CRP， and pain VAS scores were compared between the treatment group in the present study and the historical control group. Safety assessments were also performed. ResultsCompared with baseline before treatment， ISI and PSQI scores decreased at weeks 4， 8， and 12， while MoCA scores increased at weeks 4， 8， and 12. FSS scores decreased at weeks 4 and 12. At weeks 8 and 12， GAD-7 scores， DAS28-CRP scores， duration of morning stiffness， TJC28， and SJC28 were reduced. At week 12， PHQ-9， pain VAS， and HAQ scores significantly decreased （P＜0.05）. FSS and DAS28-CRP scores at week 12 were lower than those at week 4， and CRP levels at week 8 were lower than those at week 4 （P＜0.05）. Compared with the historical control group， the treatment group showed superior improvement in ISI and PSQI scores （P＜0.001）； however， no statistically significant differences were observed between the two groups in DAS28-CRP or pain VAS scores （P＞0.05）. No serious adverse events occurred during the study， and the 4 reported mild adverse events were all considered unrelated to the study medication. ConclusionShuhe Granules significantly improve sleep quality， fatigue， emotional status， cognitive function， RA-related symptoms， and joint function in patients with RA comorbid insomnia， with good safety and tolerability.

Objective To investigate the relationship between monocyte-to-lymphocyte ratio(MLR),sys-temic immune inflammation index(SII),and mean platelet volume to platelet count ratio(MPR)and the prognosis of maintenance hemodialysis patients with chronic kidney disease(CKD).Methods The medical re-cords of totally 152 patients with CKD who received maintenance hemodialysis in the hospital from July 2022 to September 2023 were retrospectively analyzed.The patients were divided into the death group and the sur-vival group according to the prognosis.General data such as age,gender,height,weight,and dialysis age,as well as clinical and laboratory indicators such as blood cell count,hemoglobin,albumin,blood creatinine,blood urea,and blood uric acid were collected and analyzed.MLR,SII and MPR were calculated for each patient,and multivariate Logistic regression analysis was used to identify risk factors affecting the survival prognosis of CKD patients after maintenance hemodialysis treatment,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the above indicators for patients'prognosis.Results Among 152 CKD patients,11.8%died,and the main causes of death include cardiovascular events,infections,multiple or-gan failure,and so on.Compared with the survival group,the levels of blood urea,blood uric acid,MLR,SII and MPR in the death group were significantly increased(P<0.05).Multivariate Logistic regression analysis revealed that MLR,SII and MPR were independent risk factors affecting the survival prognosis of CKD pa-tients after receiving maintenance hemodialysis treatment(P<0.05).ROC curve analysis showed that the are-a under the curve(AUC)of MLR for predicting the survival prognosis of CKD patients after maintenance he-modialysis treatment was 0.783,the cut off value was 0.58,the sensitivity was 72.22%,and the specificity was 76.87%.The AUC of SII for predicting the survival prognosis of CKD patients after maintenance hemodi-alysis treatment was 0.714,the cut off value was 480.50,the sensitivity was 66.67%,and the specificity was 70.15%.The AUC of MPR for predicting the survival prognosis of CKD patients after maintenance hemodial-ysis treatment was 0.706,the cut off value was 0.095,the sensitivity was 61.11%,and the specificity was 75.37%.The AUC of the combined detection was 0.843,which was better than the individual predictions(P<0.05).Conclusion MLR,SII and MPR are closely related to the prognosis of maintenance hemodialysis patients with CKD,and these indexes could be used as important reference for assessing the prognosis of pa-tients,which could help in the clinical decision-making and the development of individualized treatment plans.

Large vessel occlusion due to intracranial atherosclerotic disease (ICAD-LVO) is one of the types of ischemic stroke with poor outcome. This article summarizes the relevant studies of ICAD-LVO in recent years, and reviews the imaging evaluation and treatment regimens to provide reference for clinical practice.

Objective To explore the current status and its influencing factors of electronic health literacy of caregivers of total laryngectomy patients and its influencing factors.Methods A total of 145 caregivers of total laryngectomy patients who were admitted to The First Affiliated Hospital of Naval Medical University from August 2018 to August 2023 were selected by convenience sampling.A questionnaire survey was conducted on these caregivers by demographic data questionnaire,electronic health literacy scale(e-HLS),and general self-efficacy scale.Results The average total score of electronic health literacy among the caregivers was 25.09±5.31.One-way analysis of variance showed that there were significant differences in the scores of e-HLS among caregivers with different age,education level,self-efficacy,frequency of online health information search,and disease course(P<0.05).Multivariate logistic regression analysis showed that age,education level,self-efficacy,frequency of online health information search,and disease course were the main factors affecting the electronic health literacy of caregivers of total laryngectomy patients.Conclusion Electronic literacy of caregivers of total laryngectomy patients is at a low level,and it was affected by many factors.Appropriate guidance can be provided to caregivers with low electronic health literacy,so as to improve the electronic health literacy of caregivers and the quality of care for total laryngectomy patients.

Objective To compare the filtration effects of different models of leukocyte filters on erythrocyte suspensions,so as to provide a reference for the selection of leukocyte filters in clinic.Methods The erythrocyte suspensions prepared by Department of Blood Transfusion of The First Affiliated Hospital of Naval Medical University were used for filtration.The test was categorized into three groups based on the model of leukocyte filters,namely,AKTT-type(group Ⅰ),STTB-type(group Ⅱ),and STTA-type(groupⅢ).Each group was randomly assigned 8 bags of erythrocyte suspensions(specification 2U)with hematocrit≤55%and 10 bags of erythrocyte suspensions(specification 2U)with hematocrit>55%,and leukapheresis was applied.The quality indexes of the blood were detected before and after filtration,and the experimental data were comprehensively analyzed to evaluate the leukocyte filtration effect of various filters.Results When the hematocrit of the filtered erythrocyte suspensions was≤55%,there were significant differences in the platelet count after filtration(F=49.94,P<0.001)and filtration time(F=73.45,P<0.001)between groups,and the two indexes in group Ⅰ were superior to those in groups Ⅱ and Ⅲ.When the hematocrit of the filtered erythrocyte suspensions was>55%,there were significant differences in the platelet count after filtration(F=160.69,P<0.000 1),filtration time(F=366.09,P<0.000 1),residual leukocytes(F=4.28,P<0.05),and hemolytic rate(F=8.16,P<0.01)between groups.The platelet count after filtration and filtration time in group I were superior to those in group II and III.The indexes of residual leukocyte and hemolytic rate in groups I and II were superior to those in group III.Conclusion In order to ensure the safety and effectiveness of erythrocyte suspension transfusion,AKTT-type filter can be chosen to perform leukocyte filtration,which can further lower the blood transfusion complications.

Oxygen generation technologies with lower requirement and higher performance urgently need to be developed to meet the challenges of manned lunar landing and Mars exploration.In this paper,the mission requirements,technical characteristics,key technologies and operation status of oxygen generation assembly by water electrolysis(OGAWE)in China Space Station(CSS)are introduced.Furthermore,the latest developments about oxygen generation by electrolyzing carbon dioxide based on solid oxide electroyte is reported.The application effects and research achievements demonstrate the oxygen generation by electrolysis is one of the most suitable techniques for oxygen regeneration in manned space mission.In addition,the oxygen generation by novel electrolysis technology provides feasible approach for improving the performance of oxygen regeneration and producing oxygen by in-situ utilization of extraterrestrial resource.These development experiments of OGAWE in CSS and research results of novel electrolysis provide valuable references for the technical progress of oxygen generation by electrolysis for manned spaceflight.

Objective To investigate the learning curve of CT-guided percutaneous lung biopsy.Methods Using cumulative sum(CUSUM)analysis method,the clinical data from 110 patients,who underwent CT-guided percutaneous lung biopsy performed by the same physician at the First Affiliated Hospital of Zhengzhou University of China between May 2024 and October 2024,were retrospectively analyzed.The CUSUM learning curve was fitted,and R2 was used to assess the goodness of fit.The baseline and perioperative data were compared between different stages of the learning curve so as to determine the number of accomplished surgical cases that was required for a physician to reach the proficiency stage from the learning stage in performing CT-guided percutaneous lung biopsy.Results Successful CT-guided percutaneous lung biopsy was accomplished in all patients,with a mean operation time of(20.2+3.4)minutes(range of 15-29 minutes).With the accumulation of surgical cases,the operation time showed a gradual downward trend.The learning curve was best fitted with a cubic equation,the equation was as follows:CUSUM(110)=0.000 3x3-0.081 3x2+5.597 9x+0.774 3(where x representing the number of cases),with a goodness-of-fit coefficient R2=0.991.The fitted curve reached its peak at the performance of the 46th case,which was used as the cutoff point to divide the learning curve into two phases.Compared with the learning phase,in the proficiency phase the incidence of complications was significantly lower(pneumothorax:18.8％vs 37.0％,P=0.033)and the mean operation time was obviously shorter[(18.33+2.31)min vs(22.80±3.02)min,P＜0.001].Conclusion Through precise CUSUM analysis of the learning curves obtained from 110 patients receiving CT-guided percutaneous lung biopsy,the results of this study indicates that it requires to accomplish 46 operations before a physician can skillfully master the technique of CT-guided percutaneous lung biopsy.

Objective : To assess and to compare the diagnostic performance of cervical ultrasound and 18F fluorodeoxyglucose(18F-FDG PET/CT) in identifying cervical lymph node metastases in patients with differentiated thyroid cancer(DTC) following total thyroidectomy, focusing on both early and delayed imaging phases. Methods : A retrospective review was performed on 83 DTC patients with DTC who had undergone total thyroidectomy. A total of 143 cervical lymph nodes, comprising both metastatic and non-metastatic nodes, were evaluated using 18F-FDG PET/CT and ultrasound. Sensitivity, specificity, and overall diagnostic accuracy were calculated for each imaging modality. Differences in lymph node detection rates across cervical regions using ultrasound were analyzed, along with nodal size parameters(long and short axis diameters), to investigate potential limitations of ultrasound in this context. Additionally, PET/CT parameters including axial ratio, early and delayed maximum standardized uptake values(SUVmax), and changes in SUVmax between imaging timepoints(ΔSUVmax) were compared between metastatic and non-metastatic lymph nodes to evaluate the diagnostic value and underlying mechanisms of PET/CT in this clinical setting. Results : 18 F-FDG PET/CT demonstrated a sensitivity of 91 . 58% (98/107) , a specificity of 72. 22% (26/36) , and an overall diagnostic accuracy of 86. 71% (124/143) in identifying cervical lymph node metastases post-total thyroidectomy in DTC patients . In comparison , ultrasound showed a lower sensitivity of 50. 47% (54/107) , but a higher specificity of 97. 22% (35/36) , with an overall accuracy of 62. 24% (89/ 143) . Notably , ultrasound exhibited a significantly higher false-negative rate in the first cervical lymph node group compared to the second group [56. 6% (30/53 ) vs 43 . 4% (23/53 ) ; χ2 = 20. 396 , P < 0. 001] . In delayed PET/CT imaging , metastatic lymph nodes showed a significantly increased SUV max compared to early-phase imaging (Z = - 8. 147 , P < 0. 001) . Using an SUV max threshold of 2. 5 , delayed imaging identified a greater number of positive lymph nodes than early imaging ( χ2 = 18. 127 , P < 0. 001) . Furthermore , metastatic lymph nodes exhibi- ted a significantly lower axial ratio than non-metastatic nodes (Z = - 4. 529 , P < 0. 001) . Both early and delayed SUV max values were significantly higher in malignant nodes compared to benign ones (Z = - 3 . 689 , P < 0. 001 and Z = - 4. 550 , P < 0. 001 , respectively) . Additionally , ΔSUV max was markedly elevated in metastatic lymph nodes (Z = - 4. 189 , P < 0. 001) . Conclusion Dual-phase 18 F-FDG PET/CT proves to be superior to ultrasound in di- agnosing cervical lymph node metastasis in patients with differentiated thyroid cancer (DTC) following total thyroid- ectomy . Delayed-phase imaging offers higher tumor-to-background ratio , which enhances the visibility of metastatic lymph nodes . In addition , dual-phase 18 F-FDG PET/CT plays greater advantages in the differential diagnosis be- tween metastatic lymph nodes and non-metastatic lymph nodes .