ObjectiveTo investigate the effect of trophoblast-derived mesenchymal stem cell （T-MSC） on concanavalin A （Con A）-induced immune-mediated liver injury in mice， as well as its association with the changes in inflammatory response. MethodsMorphological assessment， flow cytometry， and tri-lineage differentiation assay were used to observe the biological characteristics of T-MSC. In the pilot experiment， mice were divided into PBS group， T-MSC monotherapy group， and Con A groups at a concentration of 10， 15， or 20 mg/kg to evaluate the safety of T-MSC monotherapy on liver function and determine the appropriate dose for modeling. In the formal experiment， mice were divided into healthy control group （HC group）， Con A group， and Con A+T-MSC group， with 5 mice in each group. The mice were given injection of Con A （15 mg/kg） via the caudal vein to establish a mouse model of immune-mediated liver injury， while the mice in the T-MSC monotherapy group were given transfusion of 1×10⁶ T-MSCs via the caudal vein at 3 hours after modeling， and samples were collected 12 hours later. The serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and lactate dehydrogenase （LDH） were measured； liver histopathological changes were observed， and Ishak inflammatory activity score and inflammatory necrosis area were assessed； the serum levels of inflammatory cytokines were measured； transcriptome sequencing， immunofluorescence assay， and Western blot were used to measure the changes in inflammation-related molecules in liver tissue. The Shapiro-Wilk test was used to assess the normality of continuous data， and the homogeneity of variance test was also performed； a one-way analysis of variance was used for comparison of normally distributed data with homogeneity of variance between multiple groups， and the Tukey’s post-hoc test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed data with heterogeneity of variance between multiple groups， and the Wilcoxon test was used for further comparison between two groups. ResultsT-MSC had a long spindle shape， showed the characteristics of fibroblast-like morphology and adherent growth， and possessed the osteogenic， chondrogenic， and adipogenic differentiation abilities. Flow cytometry showed high expression levels of CD90， CD105， and CD73 in T-MSC， with a positive rate of 96.8%， 99.0%， and 99.9%， respectively， while there was low or no expression of CD31， human leukocyte antigen DR， CD45， and CD34， with a positive rate of 0.120%， 0， 0.061%， and 0， respectively. Administration of T-MSC alone did not cause obvious abnormalities in ALT， AST， or LDH. Con A at the concentrations of 10， 15， and 20 mg/kg all increased the serum levels of biochemical parameters for liver injury in a dose-dependent manner， with mortality observed in the 20 mg/kg group. In the formal experiment， compared with the HC group， the Con A group had significant increases in the serum levels of ALT， AST， and LDH （P<0.01）， and after T-MSC treatment， there were significant reductions in these markers compared with the Con A group （P<0.01）. HE staining showed that the Con A group had disordered structure of the liver， accompanied by marked inflammatory cell infiltration and focal/patchy necrosis， and these pathological changes were alleviated after T-MSC treatment. Compared with the HC group， the Con A group had significant increases in Ishak score and the percentage of inflammatory necrosis area （P<0.001）， while there were significant reductions in these indicators after T-MSC treatment compared with the Con A group （P<0.01）. ELISA showed that compared with the HC group， the Con A group had significant increases in the serum levels of interleukin-21 （IL-21）， interleukin-1β （IL-1β）， interleukin-2 （IL-2）， interleukin-17A （IL-17A）， and tumor necrosis factor-α （TNF-α） （P<0.05）， and there were significant reductions in these markers after T-MSC treatment compared with the Con A group （P<0.05）， with no significant differences in IL-21， IL-1β， IL-17A， and TNF-α compared with the HC group （P>0.05）； although there was a significant reduction in the level of IL-2， the Con A+T-MSC group still had a significantly higher level of IL-2 than the HC group （P=0.001）. In contrast， compared with the HC group， the Con A group had a significant increase in IL-10 （P<0.05）， with a further increase after T-MSC treatment （P<0.05）. The transcriptome analysis showed that T-MSC treatment downregulated the expression of the inflammation- and chemokine-related genes including Ccl2， Cxcl10， Il-21， and Il-6 and inhibited the inflammation-related pathways such as TNF， IL-17， nuclear factor-κB， and JAK-STAT. Immunofluorescence assay showed that compared with the HC group， the Con A group had a significant increase in the expression of IL-21 in the liver （P<0.001）， and there was a significant reduction in IL-21 after T-MSC treatment compared with the Con A group （P<0.001）； the results of Western blot showed the same trend. ConclusionT-MSC can alleviate Con A-induced immune-mediated liver injury in mice， as evidenced by the improvement in liver biochemical parameters， the alleviation of histopathological damage， and the overall downregulation of inflammation-related molecules. T-MSC exerts marked anti-inflammatory and immunomodulatory effects in this model， and IL-21 shows a significant change in inflammatory response and can be used as a candidate molecule for further investigation.

Objective To observe the clinical efficacy of Lingnan fire needling in the treatment of plaque psoriasis.Methods A total of 60 cases of patients with plaque psoriasis admitted to Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from August 2021 to January 2023 were selected,and the patients were randomly divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The observation group was given Lingnan fire needling for treatment,and the control group was given topical application of Calcipotriol Ointment.The course of treatment covered eight weeks continuously.After eight weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Psoriasis Area and Severity Index(PASI)scores and Dermatology Life Quality Index(DLQI)scores,as well as the diameter of glomus under dermoscopy of the patients in the two groups were observed before the treatment and after 2,4,6,and 8 weeks of treatment.Changes in Generalized Anxiety Disorder Scale(GAD-7)scores before treatment and after 2,4,6,and 8 weeks of treatment were compared between the two groups.Results(1)After 2,4,6 and 8 weeks of treatment,the scores of PASI,DLQI and GAD-7 of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(2)The cured and markedly rate of the observation group was 86.67%(26/30);and that of the control group was 66.67%(20/30).The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(3)After 2,4,6,and 8 weeks of treatment,the diameter of glomus under dermoscopy of the patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Lingnan fire needling therapy for plaque psoriasis can effectively improve the clinical symptoms of the patients,relieve the anxiety symptoms induced by skin lesions and itching,so as to improve their quality of life.

Objective To enhance the patient's medical experience by facilitating real-time reading monitoring of their offline outpatient medical progress,providing a centralized display of the status of various medical processes,and proactively de-livering the essential message notifications to patients at designated intervals.Methods The system was developed by adopting a message reminder functionality and integrating with the display of critical diagnostic and treatment processes(including registra-tion,payment,examination,testing,medication collection,and evaluation)so as to ensure that patients receive timely informa-tion that guides their subsequent actions.Results Following the developement and implementation of the system,empirical evi-dence demonstrated that patients were able to clearly comprehend their diagnostic and treatment progress.The system reduced waiting time and confusion.In addition,it enhanced the coherence and convenience of medical services.Conclusion The out-patient medical guidance system,grounded on the Internet hospital model,has effectively minimized patient confusion and stre-amlined operational procedures through an active service approach.Future enhancements are anticipated to further elevate the in-telligence of medical services by broadening business coverage and integrating advanced technologies such as big data and artificial intelligence and other technologies in the future.

Objective:To examine the spatial and temporal distribution characteristics of first-time callers with suicidal ideation and risk factors related to suicidal ideation in a psychological assistance hotline in Henan Province.Methods:The computerised counselling operating system of the Henan Provincial Psychological Assis-tance Hotline was used to extract data from 31 401 callers who called the hotline between January 2020 and October 2023.A circular distribution and kernel density analysis were employed to investigate the spatial and temporal distri-bution of first-time callers with suicidal ideation.Binary logistic regression analysis was employed to investigate the risk factors for suicidal ideation.Results:A total of 5 494 first-time callers were included in the study,of whom 1 697(30.9％)reported suicidal ideation in the previous two weeks.The temporal distribution of suicidal ideation calls indicated a peak between 12:36 and 01:08.The weekly distribution further revealed that the majority of calls occurred on Fridays.In terms of spatial distribution,the primary hotspots for callers with suicidal ideation were clus-tered around Zhengzhou and Xinxiang.Meanwhile,the secondary hotspots exhibited a dispersed distribution across multiple centers within the province.Logistic regression analysis revealed that being under 20 years old(OR=11.85),being unemployed(OR=1.78),having psychological issues(OR=5.03),experiencing family relation-ship problems(OR=3.67),and facing economic hardships(OR=7.08)were risk factors for suicidal ideation.Conclusion:The time distribution of calls from individuals with suicidal ideation to the psychological as-sistance hotline in Henan Province exhibits a centralized trend,while the spatial distribution of calls demonstrates an imbalance.When receiving initial calls from individuals with suicidal ideation,particular attention should be paid to those aged 20 years old or younger,those who are unemployed,and those experiencing psychiatric,psychological,familial,and economic difficulties.

Objective:To examine the spatial and temporal distribution characteristics of first-time callers with suicidal ideation and risk factors related to suicidal ideation in a psychological assistance hotline in Henan Province.Methods:The computerised counselling operating system of the Henan Provincial Psychological Assis-tance Hotline was used to extract data from 31 401 callers who called the hotline between January 2020 and October 2023.A circular distribution and kernel density analysis were employed to investigate the spatial and temporal distri-bution of first-time callers with suicidal ideation.Binary logistic regression analysis was employed to investigate the risk factors for suicidal ideation.Results:A total of 5 494 first-time callers were included in the study,of whom 1 697(30.9％)reported suicidal ideation in the previous two weeks.The temporal distribution of suicidal ideation calls indicated a peak between 12:36 and 01:08.The weekly distribution further revealed that the majority of calls occurred on Fridays.In terms of spatial distribution,the primary hotspots for callers with suicidal ideation were clus-tered around Zhengzhou and Xinxiang.Meanwhile,the secondary hotspots exhibited a dispersed distribution across multiple centers within the province.Logistic regression analysis revealed that being under 20 years old(OR=11.85),being unemployed(OR=1.78),having psychological issues(OR=5.03),experiencing family relation-ship problems(OR=3.67),and facing economic hardships(OR=7.08)were risk factors for suicidal ideation.Conclusion:The time distribution of calls from individuals with suicidal ideation to the psychological as-sistance hotline in Henan Province exhibits a centralized trend,while the spatial distribution of calls demonstrates an imbalance.When receiving initial calls from individuals with suicidal ideation,particular attention should be paid to those aged 20 years old or younger,those who are unemployed,and those experiencing psychiatric,psychological,familial,and economic difficulties.

Objective To enhance the patient's medical experience by facilitating real-time reading monitoring of their offline outpatient medical progress,providing a centralized display of the status of various medical processes,and proactively de-livering the essential message notifications to patients at designated intervals.Methods The system was developed by adopting a message reminder functionality and integrating with the display of critical diagnostic and treatment processes(including registra-tion,payment,examination,testing,medication collection,and evaluation)so as to ensure that patients receive timely informa-tion that guides their subsequent actions.Results Following the developement and implementation of the system,empirical evi-dence demonstrated that patients were able to clearly comprehend their diagnostic and treatment progress.The system reduced waiting time and confusion.In addition,it enhanced the coherence and convenience of medical services.Conclusion The out-patient medical guidance system,grounded on the Internet hospital model,has effectively minimized patient confusion and stre-amlined operational procedures through an active service approach.Future enhancements are anticipated to further elevate the in-telligence of medical services by broadening business coverage and integrating advanced technologies such as big data and artificial intelligence and other technologies in the future.

Objective To understand the changing trend of Internet outpatient visits in public hospitals,and provide support for the development planning of Internet hospitals.Methods Using the data of Internet outpatient visits in a public hos-pital from January 2021 to June 2023,the ARIMA model and GM(1,1)model were constructed respectively.The mean absolute error(MAE)and root mean square error(RMSE)were used to evaluate the fitting effect,and the Internet outpatient visits from July to December 2023 were predicted based on the dominance model.Results ARIMA(1,2,1)model and GM(1,1)model were used to predict the number of return visits of Internet outpatient service.The average absolute errors were 369.86 and 978.84,and the root-mean-square errors were 479.49 and 1444.83,respectively.The ARIMA(0,1,0)model and GM(1,1)model were used to predict the number of Internet outpatient consultations.The average absolute errors were 297.23 and 369.62,and the root-mean-square errors were 413.61 and 496.30,respectively,indicating that the ARIMA model has a good prediction effect.The forecast results show that the predicted value of Internet outpatient visits in December 2023 is 14,831 cases,and the predicted value of consultation visits is 7461 cases.Conclusion The number of Internet outpatient visits in a public hospital will continue to rise from 2021 to 2023.Therefore,hospitals should fully realize the importance of Internet medical services,take ac-tive measures to continuously optimize the medical service model,and provide patients with high-quality,efficient and convenient Internet medical services.

Objective To investigate the changing trend of the current situation of Internet-based oncology outpatient treatment and provide support for the development and management of Internet hospitals.Methods The ARIMA and GM(1,1)models were constructed based on the Internet-based outpatient data of a cancer hospital from January 2021 to June 2023,and the fitting effect was evaluated by mean absolute error(MAE)and root mean square error(RMSE).Based on the model,the pro-portion of Internet-based outpatient visits and the offline outpatient visits were predicted from July to December 2023.Results ARIMA(1,1,2)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits.The average abso-lute errors were 2.06%and 2.41%,and the root-mean-square errors were 3.01%and 3.17%,respectively.The ARIMA(0,1,1)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits to the offline outpatient visits,with the rate of the average absolute errors of 0.58%and 1.08%,respectively,and the rate of the root mean square errors 0.75%and 1.31%,respectively.The figures indicated that the ARIMA model had a better prediction effect.The forecast results showed that the predicted value of Internet outpatient service in December 2023 was 90.35%,and the predicted value of Internet-based outpatient service accounted for 16.46%of the offline outpatient service.Conclusion In 2021-2023,the proportion of Inter-net-based outpatient visits in the cancer hospital showed a steady trend,and the proportion of Internet outpatient visits in the off-line outpatient visits showed a rising trend.Therefore,hospitals need to establish a continuous monitoring mechanism,constantly adjust management strategies and measures to meet the needs of patients and continue to promote the high-quality development of Internet-based medical services.

The formation of learning and memory is regulated by synaptic plasticity in hippocampal neurons. Here we explored how gestational exposure to dexamethasone, a synthetic glucocorticoid commonly used in clinical practice, has lasting effects on offspring's learning and memory. Adult offspring rats of prenatal dexamethasone exposure (PDE) displayed significant impairments in novelty recognition and spatial learning memory, with some phenotypes maintained transgenerationally. PDE impaired synaptic transmission of hippocampal excitatory neurons in offspring of F1 to F3 generations, and abnormalities of neurotransmitters and receptors would impair synaptic plasticity and lead to impaired learning and memory, but these changes failed to carry over to offspring of F5 and F7 generations. Mechanistically, altered hippocampal miR-133a-3p-SIRT1-CDK5-NR2B signaling axis in PDE multigeneration caused inhibition of excitatory synaptic transmission, which might be related to oocyte-specific high expression and transmission of miR-133a-3p. Together, PDE affects hippocampal excitatory synaptic transmission, with lasting consequences across generations, and CDK5 in offspring's peripheral blood might be used as an early-warning marker for fetal-originated learning and memory impairment.

Objective:To investigate the risk factors affecting in-hospital mortality in patients with acute mesenteric ischemia (AMI).Methods:From January 1, 2014 to June 30, 2022, the clinical data of 67 patients diagnosed with AMI at Renmin Hospital of Wuhan University were retrospectively analyzed, which included basic data (age, gender, past medical history and comorbidities, etc.), laboratory results (white blood cell count (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, prothrombin time (PT), etc.), and imaging manifestations (intestinal pneumatosis, intestinal wall thickening, intestinal dilation, ascites). The clinical data of AMI patients who died during hospitalization were compared with that of AMI patients who survived. Binary logistic regression was used to analyze the independent risk factors of in-hospital mortality in patients with AMI. Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Among the 67 patients with AMI, 17 died and 50 survived. There were significant differences between died and survived patients with AMI in age, the proportion of patients with organ failure, WBC, ALT, AST, creatinine, PT, and the proportion of patients with intestinal dilatation and ascites (76 years old(68 years old, 79 years old) vs. 61 years old (50 years old, 74 years old), 12/17 vs.12.0%(6/50), 15.8×10 9/L(13.5×10 9/L, 23.7×10 9/L) vs. 12.1×10 9/L (9.1×10 9/L, 19.4×10 9/L), 32.0 U/L(19.0 U/L, 88.5 U/L) vs. 20.5 U/L(14.8 U/L, 29.0 U/L), 64.0 U/L(33.8 U/L, 117.0 U/L) vs. 26.0 U/L (18.5 U/L, 36.8 U/L), 135.0 μmol/L(61.5 μmol/L, 198.5 μmol/L) vs. 73.5 μmol/L(60.5 μmol/L, 85.0 μmol/L), 13.7 s(12.9 s, 16.3 s) vs. 12.7 s (11.9 s, 13.6 s), 13/17 vs. 38.0%(19/50), 10/17 vs. 24.0% (12/50); Z=3.06, χ2=22.16, Z=2.01, 2.69, 4.08, 2.45 and 2.78, χ2=7.53 and 6.98; P=0.002, <0.001, =0.044, =0.007, <0.001, =0.014, =0.006, =0.006 and =0.008). The results of binary logistic regression analysis showed that age ( OR=1.224, 95% confidence interval 1.011 to 1.482, P=0.038), organ failure ( OR=113.989, 95% confidence interval 1.353 to 9 604.644, P=0.036), and ascites ( OR=348.289, 95% confidence interval 1.676 to 72 357.934, P=0.032) were independent risk factors of in-hospital mortality in AMI patients. Conclusion:Age, organ failure and ascites are independent risk factors of in-hospital mortality in AMI patients.