BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

Insufficient future liver remnant volume remains a critical limitation for single-stage resection in patients with hepatic malignancies. The techniques for promoting future liver remnant hypertrophy to realize two-stage hepatectomy include portal vein embolization， associating liver partition and portal vein ligation for staged hepatectomy， and portal vein ligation. In recent years， the application of auxiliary liver transplantation has further facilitated two-stage total hepatectomy. This article systematically reviews the clinical applications of these techniques and analyzes their advantages and limitations， so as to provide a reference for optimizing clinical decision-making.

This paper reported a type 1 diabetes patient who had severe diabetic nephropathy, retinopathy, hypertension, and hypothyroidism before pregnancy. The patient's blood glucose control was poor before pregnancy, and the complications were not properly treated. This was an unintended pregnancy, with a pre-pregnancy glycated hemoglobin A1c of 7.8% and early pregnancy urine protein of 3.81-4.53 g/24 h. Considering the patient's poor blood glucose control before pregnancy and the lack of proper treatment for multiple complications including nephropathy, a multidisciplinary consultation at an external hospital recommended termination of the pregnancy. However, the patient was determined to continue the pregnancy and was referred to Peking University First Hospital. Through strict blood glucose control, monitoring and evaluation of complications, and comprehensive management, the patient's blood glucose and blood pressure were well controlled during pregnancy. Regular monitoring of urine protein, renal function, and ocular fundus was conducted. At 31 weeks and 4 days of gestation, the patient's 24-hour urine protein significantly increased. After promoting fetal lung maturity, a cesarean section was performed at 34 weeks and 1 day of gestation, resulting in a successful delivery with good maternal and neonatal outcomes. At the 42-day postpartum follow-up, the patient's blood glucose and blood pressure were stable, urine protein returned to pre-pregnancy levels, and the infant was in good general condition.

Allergen immunotherapy（AIT）can alter the natural course of allergic diseases through immunomodulatory mechanisms and maintain the efficacy after completion. The induction of immune tolerance by AIT is considered to be effective treatment and the mechanism involves the participation of a variety of immune cells，including effector T cells，B cells，dendritic cells，innate lymphoid cells，mast cells and basophils. Studies have found that a variety of immune cells in peripheral blood changed during AIT treatment and the changes of some immune cells were related to the efficacy of AIT，which may provide some theoretical reference for practical clinical activities and may become potential biomarkers for predicting and evaluating the efficacy of AIT. This article reviews the changes of peripheral blood immune cells in the treatment of AIT.

This paper reported a type 1 diabetes patient who had severe diabetic nephropathy, retinopathy, hypertension, and hypothyroidism before pregnancy. The patient's blood glucose control was poor before pregnancy, and the complications were not properly treated. This was an unintended pregnancy, with a pre-pregnancy glycated hemoglobin A1c of 7.8% and early pregnancy urine protein of 3.81-4.53 g/24 h. Considering the patient's poor blood glucose control before pregnancy and the lack of proper treatment for multiple complications including nephropathy, a multidisciplinary consultation at an external hospital recommended termination of the pregnancy. However, the patient was determined to continue the pregnancy and was referred to Peking University First Hospital. Through strict blood glucose control, monitoring and evaluation of complications, and comprehensive management, the patient's blood glucose and blood pressure were well controlled during pregnancy. Regular monitoring of urine protein, renal function, and ocular fundus was conducted. At 31 weeks and 4 days of gestation, the patient's 24-hour urine protein significantly increased. After promoting fetal lung maturity, a cesarean section was performed at 34 weeks and 1 day of gestation, resulting in a successful delivery with good maternal and neonatal outcomes. At the 42-day postpartum follow-up, the patient's blood glucose and blood pressure were stable, urine protein returned to pre-pregnancy levels, and the infant was in good general condition.

The ATP-binding cassette(ABC)transporter superfamily comprises membrane proteins that efflux various substrates across extra-and intracellular membranes.Among them,ABCB1,ABCG2,and ABCC1 are directly linked to tumor multidrug resistance(MDR).This review provides an overview of the current understanding on the novel mechanisms and functions of ABCB1,ABCG2,and ABCC1 transporters in tumor MDR,discusses the latest strategies to target these transporters,and explores further opportunities to overcome MDR.

ObjectiveTo determine the characteristics， viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive， and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunan Province. MethodsData on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information， age at diagnosis， exposure history， CD4⁺T lymphocyte count， and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses. ResultsA total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them， 72.7% （40/55） of pre-HIV-positive spouses were husbands. The most recent CD4⁺T lymphocyte count in the pre-HIV-positive spouses was （328.31±246.27） cells·μL^-1 at the time of diagnosis of their seroconverted spouses， of which 36.3% （20/55） had a CD4⁺T lymphocyte count of less than 200 cells·μL^-1. Furthermore， of those pre-HIV-positive spouses with low CD4⁺T lymphocyte count， 45.0% （9/20） had an undetectable viral load， 15.0% （3/20） <400 copies·mL^-1， and 25.0%（5/20） ≥400 copies·mL^-1. Additionally， 16.4% （9/55） of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use， poor compliance with antiviral therapy， and treatment discontinuation. ConclusionThe follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture， especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses， to improve their compliance with antiviral therapy and reduce treatment discontinuation， which would effectively prevent and control HIV transmission between spouses.

Objective To assess the alterations of negative functional connectivity(FC),its relationship with clinical symptoms,and its potential value in schizophrenia(SZ).Methods Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from patients with SZ and healthy controls(HC).For each participant,the whole brain image was first divided into 272 regions and then the FC between each pair of these regions was calculated using Pearson's correlation coefficient.Group-level negative FCs were identified using permutation test for each group.Each of the identified negative FCs was then compared between patients and controls to identify the altered negative FCs.Then,Spearman rank correlation was adopted to examine the relationship between the altered negative FCs and clinical variables.Finally,to evaluate the diagnostic value of negative FC in SZ,a multivariate pattern analysis(MVPA)was performed to distinguish between SZ and HC based on negative FCs.Results Ninety-one patients with SZ and 91 HC were included in this study,and 207 negative FCs in total were identified.Among the identified 207 negative FCs,12(constituting 5.80％of the total 207 negative FCs)were significantly altered in SZ compared with HC(Bonferroni correction,P<0.05),of which 11 were significantly decreased(i.e.,closer to 0)in SZ.The correlation analyses identified 2 significant associations-one was between a negative FC and the total score of the psychotic symptoms rating scales-auditory hallucinations(r=-0.24,P=0.02)and the other was between a negative FC and the weighted total score of the scale for the assessment of thought,language,and communication(r=0.26,P=0.01).Furthermore,the model for distinguishing between SZ and HC based on negative FCs achieved a classification accuracy of 72.6％that was significantly higher than chance-level accuracy(permutation test,P<0.001).Conclusion Negative FCs are altered in patients with SZ.Given that negative FCs are associated with clinical symptoms,thus they may serve as an imaging biomarker for assisting the diagnosis of SZ.

ObjectiveTo investigate the demographic characteristics， high-risk behavior and first CD4⁺T cell（CD4 cell） counts among newly reported HIV-infected Burmese in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture） from 2019 to 2020. MethodsA cross-sectional survey was conducted among newly reported HIV-infected Burmese cases in Dehong Prefecture from 2019 to 2020 to collect related information and measure their first CD4 cell counts. ResultsAmong 1 228 HIV-infected Burmese cases， 846 （68.9%） were males and 382 （31.1%） were females； 445 （36.2%） were from Kachin， and 210（17.1%） were from Shan. Of them， 960 cases （78.2%） had participated in the first CD4 cell counts testing， and 405 cases （42.2%） had a first CD4 cell counts <350 cells·μL^-1. In the multivariable logistic regression analysis， age ≥30 years （adjusted OR=1.44， 95%CI： 1.07‒1.92） and history of illicit drug use in Myanmar （adjusted OR=0.41， 95%CI： 0.21‒0.79） were independently associated with first CD4 cell counts <350 cells·μL^-1. ConclusionThe first CD4 cell counts are generally low among newly reported HIV-infected Burmese in Dehong Prefecture， especially those aged ≥ 30 years and with a history of intravenous drug use in Myanmar. Therefore， early detection of HIV infection should be strengthened for timely intervention and treatment management among Burmese.

Objective:To construct an evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room and provide a reference for objectively assessing the nursing quality in ophthalmological Daytime Operation Room.Methods:From January to August 2020, the evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room was constructed by literature retrieval, semi-structured interviews, Delphi's expert correspondence inquiries, and hierarchical analysis based on Donabedian's structure-process-outcome model.Results:The effective response rates of the questionnaires for the two rounds of expert correspondence inquiries were 100.0%; the expert authority coefficients were 0.851 and 0.858; and the expert coordination coefficients were 0.098-0.264. The evaluation indicator system of nursing quality in ophthalmological daytime operation room finally constructed included 3 primary indicators, 11 secondary indicators, and 57 tertiary indicators.Conclusions:The evaluation indicator system of nursing quality in Ophthalmological Daytime Operation Room constructed in this study is highly scientific and reliable, which can comprehensively and objectively assess and continuously improve the nursing quality of Ophthalmological Daytime Operation Room.