Objective To evaluate the efficacy of Puerariae lobatae radix （PLR） and Anemarrhenae Rhizoma （AR） in preventing and treating Alzheimer’s disease （AD） and explore its potential mechanism of action by LC-MS serum metabolomics strategy. Methods The AD rat model was established by administering aluminum chloride （AlCl₃） and D-galactose （D-gal） for 20 weeks. The traditional Chinese medicine intervention group was given the PLR, AR, and PLR-AR extracts for 8 weeks by gavage. The model effect and efficacy were evaluated by Morris water maze test and biochemical indicators including SOD, NO, and MDA; Metabolomics research based on the UHPLC-Q/TOF-MS method was conducted, and relevant metabolic pathways were analyzed through the MetaboAnalyst online website. Results The learning and memory abilities of AD model rats were significantly decreased compared with the control group, and the levels of oxidative stress and lipid peroxides were significantly increased （P<0.05）, while the SOD content was decreased considerably （P<0.01）. The learning and memory abilities of AD model rats were improved, oxidative stress and lipid peroxidation levels were reversed, and serum SOD content was increased significantly after the intervention of PLR-AR, with better effects than single drugs. Through metabolomics, 70 differential metabolites were identified between the AD model group and the control group, mainly involving 10 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, phenylalanine metabolism, and unsaturated fatty acid biosynthesis, et.al. The intervention of PLR-AR could adjust 47 metabolites, with 20 metabolites showing significant differences （P<0.05）. The significantly adjusted metabolites involve 6 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, et al. Conclusion The combination of PLR and AR could significantly improve the learning and memory abilities of AD rat models. The mechanism may be related to the improvement of oxidative stress and lipid peroxidation levels, the increase of serum SOD content, and the regulation of phenylalanine, tyrosine, and tryptophan biosynthesis pathways.

Objective To explore clinical effect of closed reduction percutaneous elastic intramedullary nail assisted by arthrography in the treatment of radial neck fracture in children.Methods A retrospective analysis was performed on 23 chil-dren with radial neck fracture treated with arthrography assisted closed reduction and percutaneous elastic intramedullary nail internal fixation(arthrography with elastic nail group)from January 2019 to December 2022,including 12 males and 11 fe-males,aged from 2 to 12 years old with an average of(7.36±1.89)years old;According to Judet fracture types,14 children were type Ⅲ and 9 children were type Ⅳ.In addition,23 children with radial neck fracture were selected from January 2015 to December 2018 who were treated with closed reduction and percutaneous elastic intramedullary nail fixation(elastic nail group),including 11 males and 12 females,aged from 2 to 14 years old with an average of(7.50±1.91)years old;Judet classi-fication included 15 children were type Ⅲ and 8 children were type Ⅳ.Operative time and intraoperative fluoroscopy times were compared between two groups.Metaizeau evaluation criteria was used to evaluate fracture reduction,and Tibone-Stoltz evaluation criteria was used to evaluate functional recovery of elbow between two groups.Results Both groups were followed up for 12 to 24 months with an average of(16.56±6.34)months.Operative time and intraoperative fluoroscopy times of elastic nail group were(56.64±19.27)min and(21.13±7.87)times,while those of joint angiography with elastic nail group were(40.33±1 1.50)min and(12.10±3.52)times;there were difference between two groups(P＜0.05).According to Metaizeau evaluation,11 patients got excellent result,9 good and 3 fair in joint angiography with elastic nail group,while in elastic nail group,5 ex-cellent,13 good,4 acceptable,and 1 poor;the difference between two groups was statistically significant(P＜0.05).According to Tibone-Stoltz criteria,14 patients got excellent result,8 good,and 1 fair in joint arthrography with elastic nail group;while in elastic nail group,12 patients got excellent result,9 good,1 fair and 1 poor;there was no significant difference between two groups(P＞0.05).Conclusion Compared to percutaneous elastic intramedullary nail fixation,closed reduction assisted by arthrography has advantages of reduced operation time,decreased intraoperative fluoroscopy frequency,and improved fracture reduction.Arthrography enables clear visualization of the anatomical structures of radius,head,neck,bone,and cartilage in children,facilitating comprehensive display of fracture reduction and brachioradial joint alignment.This technique more pre-cisely guides the depth of elastic intramedullary nail implantation in radius neck,thereby enhancing surgical efficiency and success rate.

Objective To investigate the therapeutic effect and underlying mechanism of Qishishenshu Capsule on renal fibrosis in mice with early diabetic nephropathy(DN).Methods A DN mouse model was established by multiple injections of streptozotocin.The mice were randomly divided into a normal group(NC),model group(DN),and Qishi group(QS)(0.9 g/(kg·d)),with eight mice in each group.Mice were gavaged continuously for 4 weeks,and fasting blood glucose(FBG)was measured weekly.Four weeks later,urinary albumin/creatinine(UACR),serum creatinine,and blood urea nitrogen were measured.Hematoxylin-eosin,periodicacid-Schiff,and Sirius red staining were used to analyze renal pathological changes.Real-time fluorescence quantitative reverse-transcription polymerase chain reaction was used to detect the mRNA levels of fibronectin(FN),collagen type Ⅰ alpha 1(Col1a1),and α-smooth muscle actin(α-SMA).Immunohistochemistry and Western blot were performed to detect FN,collagen type Ⅰ(Collagen Ⅰ),collagen typeⅢ(Collagen Ⅲ),α-SMA,Podocin,Nephrin,and transforming growth factor-β1/SMAD family member2/3(TGF-β1/Smad2/3)pathway-related proteins.Results Compared with mice in the NC group,those in the DN group showed significantly higher levels of FBG and UACR(P＜0.001),and mesangial hyperplasia,basement membrane thickening,and collagen deposition in the renal tissue.The mRNA levels of FN,Col1a1,and α-SMA were increased(P＜0.05).Protein levels of Podocin and Nephrin were decreased(P＜0.05).The levels of FN,Collagen I,Collagen Ⅲ,α-SMA,and TGF-β1/Smad2/3 pathway proteins were increased(P＜0.05).Compared with the DN group,the QS group's level of UACR was decreased(P＜0.05),their renal pathological injury was alleviated,and mRNA levels of FN,Collagen Ⅰ,andα-SMA were attenuated(P＜0.05);whereas their protein levels of Podocin and Nephrin were elevated(P＜0.05).The levels of FN,Collagen Ⅰ,Collagen Ⅲ,α-SMA,and TGF-β1/Smad2/3 pathway proteins were also decreased(P＜0.05).Conclusions Qishishenshu Capsule improved renal fibrosis in DN mice,probably through the inhibition of the TGF-β1/Smad2/3 signaling pathway.

Objective To summarize the best evidence of nutrition management in patients with severe pneumonia,aiming to offer evidence-based guidance for clinical healthcare professionals.Methods All evidence on nutrition management in patients with severe pneumonia was retrieved from various databases and websites including BMJ Best Practice,UpToDate,National Guideline Clearinghous(NGC),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),National Institute for Health and Care Excellence(NICE),Cochrane Library,OVID,PubMed,Embase,Web of Science,CINAHL,Chinese Medical Journal Full-text Database,CNKI,VIP,Wanfang,CBM,American Society for Parenteral and Enteral Nutrition(ASPEN),European Society for Clinical Nutrition and Metabolism(ESPEN),Society of Critical Care Medicine(SCCM)and European Society of Intensive Care Medicine(ESICM).The retrieved evidence included clinical decisions,guidelines,systematic reviews,expert consensuses and evidence summaries.The search period ranged from January 1st,2012 to December 31st,2022.There were 2 researchers who independently assessed the quality of the included studies and then extracted and summarized the evidence by topic.Results A total of 13 articles were involved,including 3 clinical decisions,4 guidelines,1 systematic review,and 5 expert consensuses.A total of 24 pieces of evidence were summarized across 6 aspects which encompassed team building,nutrition screening and assessment,nutritional requirements,nutrition intervention,nutrition monitoring,and health education.Conclusion The production process of this evidence summary followed standardized procedures,ensuring comprehensive content.Medical professionals should integrate clinical conditions,patient factors,and family preferences to select the most optimal evidence in order to enhance patient prognosis and improve medical quality.

Objective:To evaluate the role of hypoxia-inducible factor 1α (HIF-1α)-glycolytic pathway in propofol-induced attenuation of brain injury in acute sleep-deprived aged rats.Methods:Forty-eight male SPF-grade healthy Sprague-Dawley rats, aged 20-22 weeks, weighing 500-600 g, were divided into 4 groups ( n=12 each) using a random number table method: control group (Con group), sleep deprivation group (SD group), sleep deprivation + propofol group (SP group), and sleep deprivation + propofol + DMOG group (SPD group). The sleep deprivation model was developed using a sleep deprivation apparatus in rats. At 20 and 3 h before sleep deprivation, 1% propofol at a dose of 0.04 mg/g was intraperitoneally injected in SP group, and 1% propofol at a dose of 0.04 mg/g and HIF-1α activator DMOG at a dose of 0.05 mg/g were intraperitoneally injected in SPD group. Cognitive function was assessed by fear conditioning test and novel object recognition test. After the behavioral testing, the blood and brain tissue samples were collected for determination of blood-brain barrier permeability (by Evans blue staining), apoptosis rate (by TUNEL staining), serum levels of neurofilament light chain protein (NfL) and neuron-specific enolase (NSE), contents of reactive oxygen species (ROS), interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS), lactate and pyruvate (by enzyme-linked immunosorbent assay) and expression of HIF-1α, pyruvate kinase M2 (PKM2), hexokinase 2 (HK2), ionized calcium-binding adaptor molecule 1 (IBA1), and cleaved caspase-3 (by Western blot) and for microscopic examination of pathological changes of the hippocampal tissues. The lactate/pyruvate ratio was calculated. Results:Compared to Con group, the percentage of freezing time and recognition index were significantly decreased, serum concentrations of NSE and NfL, EB content in brain tissues, contents of ROS, IL-6 and iNOS in hippocampal tissues, and lactate/pyruvate ratio were increased, the expression of HIF-1α, PKM2, HK2, IBA1 and cleaved caspase-3 was up-regulated, the apoptosis rate was increased ( P<0.05), and the pathological damage to nerve cells in the hippocampus was found in SD group and SPD group. Compared to SD group, the percentage of freezing time and recognition index were significantly increased, serum concentrations of NSE and NfL, EB content in brain tissues, contents of ROS, IL-6 and iNOS in hippocampal tissues, and lactate/pyruvate ratio were decreased, the expression of HIF-1α, PKM2, HK2, IBA1 and cleaved caspase-3 was down-regulated, the apoptosis rate was decreased ( P<0.05), and the pathological damage to nerve cells in the hippocampus was significantly attenuated in SP group. Compared to SP group, the percentage of freezing time and recognition index were significantly decreased, the serum concentrations of NSE and NfL, EB content in brain tissues, contents of ROS, IL-6 and iNOS in hippocampal tissues, and lactate/pyruvate ratio were increased, the expression of HIF-1α, PKM2, HK2, IBA1 and cleaved caspase-3 was up-regulated, the apoptosis rate was increased ( P<0.05), and the pathological damage to nerve cells in the hippocampus was aggravated in SPD group. Conclusions:Propofol can attenuate acute sleep deprivation-induced brain injury in aged rats, and the mechanism may be related to inhibition of the HIF-1α-glycolytic pathway and reduction of neuroinflammatory responses.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

Objective To investigate the value of polar residual network(PResNet)model for assisting evaluation on rat myocardial infarction(MI)segment in myocardial contrast echocardiography(MCE).Methods Twenty-five male SD rats were randomly divided into MI group(n=15)and sham operation group(n=10).MI models were established in MI group through ligation of the left anterior descending coronary artery using atraumatic suture,while no intervention was given to those in sham operation group after thoracotomy.MCE images of both basal and papillary muscle levels on the short axis section of left ventricles were acquired after 1 week,which were assessed independently by 2 junior and 2 senior ultrasound physicians.The evaluating efficacy of MI segment,the mean interpretation time and the consistency were compared whether under the assistance of PResNet model or not.Results No significant difference of efficacy of evaluation on MI segment was found for senior physicians with or without assistance of PResNet model(both P＞0.05).Under the assistance of PResNet model,the efficacy of junior physicians for diagnosing MI segment was significantly improved compared with that without the assistance of PResNet model(both P＜0.01),and was comparable to that of senior physicians.Under the assistance of PResNet model,the mean interpretation time of each physician was significantly shorter than that without assistance(all P＜0.001),and the consistency between junior physicians and among junior and senior physicians were both moderate(Kappa=0.692,0.542),which became better under the assistance(Kappa=0.763,0.749).Conclusion PResNet could improve the efficacy of junior physicians for evaluation on rat MI segment in MCE images,shorten interpretation time with different aptitudes,also improve the consistency to some extent.

Objective:To analyze the research status,research hot topics and trends in the field of domestic medical device disinfection supply,and to provide reference for clinical practice and scientific research of disinfection supply.Methods:Literature related to disinfection supply included in CNKI database from January 1,2008 to December 31,2023 were searched.CiteSpace visualization software was used to perform keyword co-occurrence analysis,cluster analysis,and emergence analysis.Results:A preliminary search of 1 527 articles was obtained,and 1,499 valid articles were finally included in the study,including 87 in 2008,and the number of publications related to disinfection supply increased year by year,reaching a peak of 258 articles in 2012,and gradually decreased and stabilized since then.A total of 12 keyword cluster tags were formed in 1 499 articles,and the three keywords with the highest frequency were cleaning quality,nosocomial infection and management.The implant keyword appeared in 2019 and lasted until 2023,which can be studied in depth as a potential research topic.Conclusion:Cleaning quality,nosocomial infection and management were the focus of researchers in the field of disinfection supply from 2008 to 2023,and the research direction has gradually developed from management research around industry standards to refinement,specialization and technology,and has become a research trend in the future.

Biosensor analysis technology is a kind of technology with high specificity that can convert biological reactions into optical and electrical signals. In the development of drugs for Alzheimer's disease (AD), according to different disease hypotheses and targets, this technology plays an important role in confirming targets and screening active compounds. This paper briefly describes the pathogenesis of AD and the current situation of therapeutic drugs, introduces three biosensor analysis techniques commonly used in the discovery of AD drugs, such as surface plasmon resonance (SPR), biolayer interferometry (BLI) and fluorescence analysis technology, explains its basic principle and application progress, and summarizes their advantages and limitations respectively.

A novel technology is proposed for non-contact and real-time detection of atrial fibrillation using millimeter-wave radar.A 60 GHz PCR millimeter wave radar is used to continuously detect the chest echo signal of the subject.After signal acquisition,I-Q signal is generated through I-Q demodulation,and the signal phase information is extracted using effective points phase trend evaluation for obtaining the signals from oscillations in the chest wall,from which the respiratory signals and cardiac signals are extracted through digital filtering for the analysis of cardiac movement.Whether the atrial fibrillation occurs or not is determined by the characteristics of atrial fibrillation wave in the time domain.The effective points phase trend evaluation for extracting more accurate signal phase information and the time-domain method for real-time atrial fibrillation detection are the innovations of the study.The experimental results show that the proposed method achieves a detection accuracy of 99.2%in clinic.