Objective To investigate the feasibility of hernia needle assisted suture in single-incision laparoscopic transabdominal preperitoneal repair(SIL-TAPP).Methods From February 2023 to April 2024,20 young patients with indirect inguinal hernia were treated with SIL-TAPP.A 2 cm curved incision was made at the navel,and a three channel port was inserted for transabdominal preperitoneal repair.A hernia needle was inserted into the affected side lower abdominal wall to assist in one handed suturing and closure of the peritoneum.Results All the operations were successful.The operation time was 85-125 min,with an average of(91.3±10.0)min.The closure of the peritoneum took 18-30 min,with an average of(23.4±3.2)min.Intraoperative blood loss was 5-25 ml.The Visual Analogue Scale(VAS)score at 24 h after surgery was 1-3 points.Postoperative hospitalization lasted 1-5 d,with an average of(2.4±1.0)d.After surgery,one patient had seroma in the groin area and one patient had fat liquefaction in the umbilical cord.All the patients were followed up for 8-22 months after operation,with an average of(15.3±3.4)months.No recurrence after operation or umbilical hernia was noted.Conclusion The use of hernia needle assisted suturing to close the peritoneum during SIL-TAPP surgery can reduce the difficulty of one handed suturing,especially suitable for the early stage of single-incision laparoscopic surgery.

Objective To investigate the feasibility of hernia needle assisted suture in single-incision laparoscopic transabdominal preperitoneal repair(SIL-TAPP).Methods From February 2023 to April 2024,20 young patients with indirect inguinal hernia were treated with SIL-TAPP.A 2 cm curved incision was made at the navel,and a three channel port was inserted for transabdominal preperitoneal repair.A hernia needle was inserted into the affected side lower abdominal wall to assist in one handed suturing and closure of the peritoneum.Results All the operations were successful.The operation time was 85-125 min,with an average of(91.3±10.0)min.The closure of the peritoneum took 18-30 min,with an average of(23.4±3.2)min.Intraoperative blood loss was 5-25 ml.The Visual Analogue Scale(VAS)score at 24 h after surgery was 1-3 points.Postoperative hospitalization lasted 1-5 d,with an average of(2.4±1.0)d.After surgery,one patient had seroma in the groin area and one patient had fat liquefaction in the umbilical cord.All the patients were followed up for 8-22 months after operation,with an average of(15.3±3.4)months.No recurrence after operation or umbilical hernia was noted.Conclusion The use of hernia needle assisted suturing to close the peritoneum during SIL-TAPP surgery can reduce the difficulty of one handed suturing,especially suitable for the early stage of single-incision laparoscopic surgery.

Objective To study the therapeutic effects of Yigan Fupi decoction(YGFP)on irritable bowel syndrome(IBS)and its mechanism of action in repairing the intestinal barrier and reducing IBS sensitivity through the PKA/PKC-CREB pathway.Methods Baby rats separated from their mother were randomly divided into a model control(M)and a YGFP group,while baby rats without maternal separation were used as a normal control(N)group.The YGFP group was given YGFP for 4 weeks.Abdominal withdrawal reflux was used to evaluate intestinal sensitivity.Liquid chromatography tandem mass spectrometry and ELISA were used to detect bile acid metabolite concentrations and serum levels of interleukin(IL)-6 and CXCL1,respectively.HE staining was used to observe pathological changes in the colon,and Western Blot and immunohistochemistry were used to analyze the relative protein expression levels of PKA,PKC,CREB,5HT2AR,5-HT7R,ZO-1,and Claudin 1.Results Compared with the normal control group,the M group showed a significantly decreased visceral pain threshold,significantly increased levels of total bile acid metabolites,IL-6,and CXCL1,significantly increased relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and significantly decreased relative expression of ZO-1 and Claudin 1.Compared with the M group,the YGFP group showed a significantly increased visceral pain threshold,significantly reduced levels of total bile acid metabolites,IL-6,and CXCL1,significantly reduced relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and increased relative expression of ZO-1 and Claudin 1.Conclusions YGFP effectively improved IBS through a mechanism that may involve repair of the intestinal barrier and reduced sensitivity through the PKA/PKC-CREB pathway.

Objective To study the therapeutic effects of Yigan Fupi decoction(YGFP)on irritable bowel syndrome(IBS)and its mechanism of action in repairing the intestinal barrier and reducing IBS sensitivity through the PKA/PKC-CREB pathway.Methods Baby rats separated from their mother were randomly divided into a model control(M)and a YGFP group,while baby rats without maternal separation were used as a normal control(N)group.The YGFP group was given YGFP for 4 weeks.Abdominal withdrawal reflux was used to evaluate intestinal sensitivity.Liquid chromatography tandem mass spectrometry and ELISA were used to detect bile acid metabolite concentrations and serum levels of interleukin(IL)-6 and CXCL1,respectively.HE staining was used to observe pathological changes in the colon,and Western Blot and immunohistochemistry were used to analyze the relative protein expression levels of PKA,PKC,CREB,5HT2AR,5-HT7R,ZO-1,and Claudin 1.Results Compared with the normal control group,the M group showed a significantly decreased visceral pain threshold,significantly increased levels of total bile acid metabolites,IL-6,and CXCL1,significantly increased relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and significantly decreased relative expression of ZO-1 and Claudin 1.Compared with the M group,the YGFP group showed a significantly increased visceral pain threshold,significantly reduced levels of total bile acid metabolites,IL-6,and CXCL1,significantly reduced relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and increased relative expression of ZO-1 and Claudin 1.Conclusions YGFP effectively improved IBS through a mechanism that may involve repair of the intestinal barrier and reduced sensitivity through the PKA/PKC-CREB pathway.

[摘 要] 目的：分析干扰素基因刺激因子（STING）在肺腺癌中的表达及其与肺腺癌患者临床特征间的关系，探讨STING与内质网应激的相关性及其在调控肺腺癌进展中的作用机制。方法：利用TIMER数据库分析STING基因在泛癌水平的表达情况，利用UALCAN和HPA数据库分析STING在肺腺癌组织中的表达及其与肺腺癌患者临床特征间的关系，利用Kaplan-Meier生存函数分析STING表达与肺腺癌患者OS率间的关系。利用LinkedOmics数据库对肺腺癌表达谱数据进行STING基因共表达分析，对STING相关差异表达基因（DEG）进行GO功能与KEGG通路富集分析，通过GSEA筛选STING调控肺腺癌的潜在通路。使用STING激动剂diABZI及内质网应激抑制剂TUDCA对肺腺癌A549与H460细胞进行处理，通过qPCR、WB法检测STING及内质网应激相关分子的表达，通过CCK-8法检测细胞增殖活力。结果：肺腺癌组织和细胞中STING的表达水平均显著低于正常肺组织（均P<0.01），STING高表达肺腺癌患者5年OS率显著高于低表达患者（P<0.01），STING的表达与肺腺癌患者的年龄、性别等临床特征密切相关（均P<0.01）。STING高表达在肺腺癌外源性抗原处理及提呈等通路上存在富集（均P<0.01）。使用STING激动剂可显著诱导肺腺癌细胞发生内质网应激（P<0.05），STING诱导活化后肺腺癌细胞增殖活力显著下降（均P<0.01），内质网应激抑制剂能部分恢复STING活化诱导后下降的细胞活力（P<0.05）。结论：STING基因在肺腺癌中低表达，其表达下调与肺腺癌患者预后不良相关，其机制可能是STING通过诱导内质网应激而抑制肺腺癌细胞活力。

Objective To analyze the effect of different environments risks on the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 231 patients diagnosed with COPD who visited Mianyang Hospital of Traditional Chinese Medicine from April 2018 to January 2021 were selected as the study subjects and divided into two groups according to whether the residence was changed after discharge, that is, Mianyang Environmental Living Suzhou Environmental Living Group. The follow-up time was 2019 December to September 2021. The contents include relative humidity, temperature, PM_2.5, PM₁₀, air quality index, exposure to household smoking environment, and open windows for ventilation. The regional environment was mainly measured three times, namely October to February (expressed as cold period), June to August (expressed as warm period), March to May and September to October (expressed as suitable period). The family environment was followed up every 2 months by means of questionnaires and interviews, and detailed records were recorded. After the follow-up, the COPD Assessment Test (CAT) and Modified Dyspnea Rating Score (mMRC) were analyzed. Concentration-response curves were used to analyze the influence of living environment exposure on the prognosis of COPD patients. The generalized additive model with semi-Poisson distribution as the connection function was used to study the influence of univariate and multifactor environmental factors on COPD. Results The air quality index of Mianyang was higher than that of Suzhou during the cold period, while that of Mianyang was lower than that of Suzhou during the suitable period. Meanwhile, the average relative humidity of Suzhou was higher than that of Mianyang during the warm period. The comparison of CAT and mMRC scores of COPD patients in the two regions in different quarters showed that the CAT and mMRC scores of COPD patients in Mianyang City were lower than those in Suzhou City during the cold period, and the difference between groups was statistically significant (P<0.01). PM_2.5 (warm period), PM₁₀ (warm period) and NO2 (suitable period) increased by 10μg/m³, 8μg/m³, 12μg/m³ and CO (suitable period) increased by 0.3mg/m³ respectively caused COPD function The scores of indicators CAT and mMRC increased. After adjusting for other pollutants, PM_2.5, CO were still related to the prognosis of COPD. Concentration-response curve results showed that the risk of increasing CAT score decreased with increasing daily windowing time; conversely, the risk of increasing CAT score was increasing with increasing environmental exposure to smoking. Conclusion Pollutant exposure and living environment factors have a significant impact on the prognosis of COPD, and improving the environment is of great significance for the recovery of COPD pulmonary function.

Glioblastoma (GBM) is a highly aggressive and lethal brain tumor with an immunosuppressive tumor microenvironment (TME). In this environment, myeloid cells, such as myeloid-derived suppressor cells (MDSCs), play a pivotal role in suppressing antitumor immunity. Lipometabolism is closely related to the function of myeloid cells. Here, our study reports that acetyl-CoA acetyltransferase 1 (ACAT1), the key enzyme of fatty acid oxidation (FAO) and ketogenesis, is significantly downregulated in the MDSCs infiltrated in GBM patients. To investigate the effects of ACAT1 on myeloid cells, we generated mice with myeloid-specific (LyzM-cre) depletion of ACAT1. The results show that these mice exhibited a remarkable accumulation of MDSCs and increased tumor progression both ectopically and orthotopically. The mechanism behind this effect is elevated secretion of C-X-C motif ligand 1 (CXCL1) of macrophages (Mφ). Overall, our findings demonstrate that ACAT1 could serve as a promising drug target for GBM by regulating the function of MDSCs in the TME.

Objective:To evaluate the clinical efficacy of modified all-arthroscopic reconstruction of medial patella femoral ligament (MPFL) for the treatment of recurrent patellar dislocation.Methods:A retrospective case series study was conducted to analyze the clinical data of 38 patients (46 knees) with recurrent patellar dislocation, who were treated at First Affiliated Hospital of Shenzhen University from January 2017 to January 2020. The patients included 12 males (12 knees) and 26 females (34 knees), aged 14-40 years [(24.6±5.4)years]. All patients underwent the modified all-arthroscopic MPFL reconstruction procedure. The femoral tunnel locations were assessed by 3D-CT immediately after surgery. The MRI was performed at 6 and 12 months after operation to assess the healing morphology of the reconstructed MPFL. The Lysholm score and Kujala score were used to assess the knee function before operation, at 6 months after operation, at 12 months after operation and at the last follow-up. The time to return to sports as well as complications were observed.Results:All patients were followed up for 26-48 months [(32.4±8.6)months]. Postoperative 3D-CT examination showed that the femoral tunnels were located in the groove area of the medial epicondyle of the femur and the adductor tubercle. At 6 and 12 months after operation, MRI T2 images showed that the reconstructed MPFL had a low signal and well tensioned ligament tissue, indicating that the MPFL was healed well. The Lysholm scores at 6 and 12 months postoperatively and at the last follow-up were (81.1±12.0)points, (91.2±3.8)points, and (92.2±9.8)points, respectively, being significantly higher than the preoperative (52.4±10.6)points (all P<0.01). The Kujala scores at 6 and 12 months postoperatively and at the last follow-up were (85.4±3.9)points, (91.4±3.6)points, and (93.1±8.5)points, respectively, being significantly higher than the preoperative (55.2±6.8)points (all P<0.01). Compared with 6 months postoperatively, the Lysholm score and Kujala score were significantly improved at 12 months postoperatively and at the last follow-up (all P<0.05). All patients returned to sports, with the time to return to sports for 3-12 months [(8.7±2.3)months] after operation. One patient had poor wound healing but was healed after dressing changes. No wound infection, nerve injury, joint stiffness, patella re-dislocation or other complications occurred. Conclusion:For recurrent patellar dislocation, the modified all-arthroscopic MPFL reconstruction has advantages of accurate bone tunnel positioning, good ligament healing, good function recovery, early return to sports, and less postoperative complications.

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

ObjectiveTo investigate the current status of knowledge， attitude and practice of nurses in mental health hospitals on the prevention and control of nosocomial infections， and to analyze the influencing factors. MethodsFrom June to August 2020， 402 clinical nurses from 8 mental health hospitals in a city were enrolled using simple random sampling method， and were assessed using a self-compiled knowledge-attitude-practice questionnaire related to the nosocomial infection prevention and control， thereafter， the influencing factors were screened. ResultsThe scores of knowledge， attitude and practice dimensions in relation to the nosocomial infection prevention and control among the nurses were （8.43±1.84）， （76.01±5.70） and （57.42±3.75）， respectively. Univariate analysis showed that the knowledge dimension score demonstrated significant difference among nurses of different types of hospital， grades of hospital， professional titles， education levels， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The attitude dimension scores yielded significant difference among nurses of different types of hospital， position， grades of hospital， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The practice dimension scores manifested significant difference among nurses of different types of hospital， grades of hospital， professional titles， emphasis degrees of hospital and individual on nosocomial infection， and training frequency （P<0.05 or 0.01）. Multiple linear regression analysis showed that professional titles and individual emphasis on nosocomial infection entered the regression model of nurses' knowledge dimension of nosocomial infection prevention and control （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types and position entered the regression model of attitude dimension （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types， professional titles， and hospital emphasis on nosocomial infection entered the regression model of practice dimension （P<0.05 or 0.01）. ConclusionNurses in mental health hospital have a positive attitude towards nosocomial infection prevention and control， but their knowledge base needs to be strengthened.