Objective To explore the mechanism of action of Neiyi Soft Extract in the treatment of endometriosis(EMS)based on network pharmacology and transcriptomics.Methods A model of SD rat with EMS was replicated by autotransplantation method.After successful modeling,the rats were randomly divided into model group,Neiyi Soft Extract low-,medium-and high-dose groups and dienogest group,with 10 rats in each group.Another sham-operated group(10 rats)was set up.After four consecutive weeks of intervention,the volume size of the endometriotic lesions was measured,and its pathological changes were detected by hematoxylin-eosin(HE)staining.RNA was extracted from the rat lesions for transcriptomic sequencing,and Gene Ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)functional enrichment analysis were performed on the differential genes among various groups.The main active ingredients and their targets of Neiyi Soft Extract were collected and screened in databases such as TCMSP,the disease targets of EMS were collected through databases such as OMIM,the intersection targets between the drug ingredient targets and the diseases were obtained by using Venn diagrams,GO enrichment analysis and KEGG pathway enrichment analysis of genes in the intersection targets of the drug ingredients and the diseases were performed by using gene enrichment analysis online tool(Metascape).The network pharmacology enrichment pathway and transcriptomics enrichment pathway were taken for intersection,the mRNA and protein expression levels of the key targets on the intersection pathway were correspondingly detected by real-time quantitative polymerase chain reaction(qPCR)and Western Blot,respectively.Results The volume of lesions in the model group was significantly increased compared with that of the sham-operated group(P<0.01);the volume of lesions in rats in the drug-administered groups was significantly reduced compared with that of the model group(P<0.05).A total of 341 active ingredients were obtained from Neiyi Soft Extract,and there were 2 178 disease-related targets of EMS,and 278 intersections between drug targets and disease targets;189 differential genes were screened in the sham-operated group and the model group;255 differential genes were screened in the model group and Neiyi Soft Extract high-dose group;and 740 differential genes were screened in the sham-operated group and the Neiyi Soft Extract high-dose group,including 390 up-regulated genes and 350 down-regulated genes.The result of intersection of KEGG enrichment pathways between the network pharmacology and transcriptomics showed that the distriution mainly included P53 signaling pathway,FOXO signaling pathway,cell cycle,etc.The qPCR and Western Blot validation results showed that Neiyi Soft Extract could inhibit the proliferation of endometrial stromal cells and up-regulated the mRNA and protein expression levels of BAX,Caspase3 in EMS rats(P<0.05 or P<0.01),and down-regulated BCL-2 mRNA and protein expression levels(P<0.05 or P<0.01).Conclusion Neiyi Soft Extract may play a therapeutic role in the treatment of EMS by regulating the P53 signaling pathway.

Background With economic development and globalization, shift work has become prevalent across industries. Its relationship with type 2 diabetes mellitus (T2DM) attracts increasing attention. Objective To thoroughly explore the relationship between shift work and T2DM, and analyze the impacts of specific shift patterns on T2DM, so as to provide a basis for formulating reasonable shift schedules. Methods We conducted a 1:2 matched case-control study among adults (20-60 years) who ordered occupational health examinations at the Wuxi No.8 People's Hospital from November to December 2023. The case group comprised 200 T2DM patients, while the controls were 400 age-stratified matched non-diabetic individuals. General demographic characteristics, behavioral habits, medical history, and shift work exposure data (including shift patterns, frequency, and length of service) 5 years prior to diagnosis were collected through standardized questionnaires. Logistic regression adjusted for selected confounders was employed to evaluate the association between shift work and T2DM. Results The logistic regression analysis demonstrated that shift work was associated with an increased risk of T2DM. After adjusting for confounding factors, shift workers had a 3.55 times higher risk of being diagnosed T2DM compared to non-shift workers (OR=3.55, 95%CI: 1.026, 12.263). The risk varied across different shift patterns, and the three-shift two-rotation system showed the highest risk (OR=4.17, 95%CI: 1.921, 9.035), followed by the two-shift system (OR=2.94, 95%CI: 2.016, 4.281) and four-shift three-rotation system (OR=2.66, 95%CI: 1.611, 6.093). Workers with more than 3 monthly shift days had a 2.74-fold increased risk (95%CI: 1.658, 4.512) compared to non-shift workers. Additionally, working more than 8 h daily (OR=1.74, 95%CI: 1.185, 2.562) and having more than 20 years of service (OR=2.51, 95%CI: 1.581, 3.976) were both significantly associated with a higher T2DM risk. The trend tests revealed that each incremental increase in monthly shift days and length of service elevated T2DM risk by 2.61 times (95%CI: 1.813, 3.765) and 1.49 times (95%CI: 1.147, 1.931), respectively (P<0.05). Conclusion Shift work is an independent risk factor for T2DM, with three-shift two-rotation system posing the highest risk. Shift frequency, daily working hours, and length of service are all significant factors affecting the risk of T2DM. These findings support industry-specific shift policy reform and targeted glucose monitoring and health interventions are recommended for workers engaged in high-risk shift patterns (e.g., three-shift two-rotation system, frequent shifts) and those with prolonged shift work history (>20 years).

Objective: To establish a bacterial endotoxin detection method for vidarabine monophosphate for injection and conduct methodological validation for harmanizing the quality control standard of this product.
Methods: According to the Chinese Pharmacopoeia 2020 volume Ⅳ general chapter 1143“Bacterial endotoxin test”, the limit of bacterial endotoxin was determined,interference test and endotoxin testing were performed.
Results: The bacterial endotoxin test were performed on 25 batches of test samples provided by 15 manufacturers according to the experienced experimented limitation which is the amount of endotoxin in 1 mg of adenosine monophosphate should be less than 0.06 EU. All results were found to be in compliance with the specified standards.
Conclusion: The established bacterial endotoxin method can be used for quality control of vidarabine monophosphate for injection.

Objective:To establish a micro kinetic-chromogenic method and verify its feasibility for bacterial endo-toxin testing.Methods:Establish an addition system for micro kinetic-chromogenic lysate reagent with 25 μL and 25 μL sample,respectively.Methodological validation was conducted by examining accuracy and precision,linear-ity and range,minimum detection limit,and reagent durability.Two methods,kinetic-chromogenic method and micro kinetic-chromogenic method,were used to compare the applicability of the method to 39 different varieties.Results:The recovery rates of three doses of 0.03,0.3,and 3.0 EU·mL-1 in six repeated experiments were(96.19±16.68)％,(92.53±10.17)％,and(89.54±25.84)％,respectively.The absolute value of the correlation coefficient(r)for the six standard curves is(0.997 7±0.002 3).When the minimum sensitivity concentration of lysate reagent is 0.01 EU·mL-1,the reaction time is(3 896.0±279.6)s,which is lower than the reaction time of the negative control.The durability test results meet the requirements by two micro kinetic-chromogenic lysate reagents from different manufacturers.The research results on variety adaptability show that the recovery rates of 39 varieties are between 50％and 200％,the effectiveness of the two methods is the same.Conclusion:The accuracy and precision,linearity and range,minimum detection limit,and reagent durability of micro kinetic-chromogenic method all meet the requirements of method validation.The variety applicability is equivalent to that of the traditional kinetic-chromogenic method,so this method can be used for bacterial endotoxin detection of routine samples.

Objective:To explore the genetic etiology of pediatric intensive care unit (PICU) mortality cases and summarize their clinical characteristics.Methods:This was a retrospective cohort study. The study population consisted of 234 children who died within 7 d after admitted to the PICU of Children′s Hospital of Fudan University from January 2017 to December 2021. The clinical diagnoses, laboratory test results, and genetic testing results were collected. These patients were divided into the pathogenic gene variation positive (PGVP) group and the pathogenic gene variation negative (PGVN) group according to the results of genetic testing. The Mann-Whitney U test and Pearson′s chi-square test or Fisher′s exact probability method were used to compare the clinical characteristics between the groups. Results:A total of 234 cases were enrolled, including 139 (59.4%) males and 95 (40.6%) females. The age at death was 1.0 (0.4, 3.7) years old and the length of PICU stay was 16 (6, 33) days. There were 62 cases (26.5%) PGVP, and the mutated pathogenic genes included immune genes (23 cases (37.1%)), metabolic genes (11 cases (17.7%)), neuromuscular genes (11 cases (17.7%)), cardiovascular genes (4 cases (6.5%)), and genes of other systems (13 cases (21.0%)). The age at death in PGVP cases was significantly lower than in PGVN cases (0.6 (0.3, 1.4) vs. 1.3(0.5, 4.3) years old, Z=3.85, P<0.001). Compared with the PGVN group, the PGVP group had a higher incidence of family history and chronic complex conditions (CCC) than the PGVN group (6.5% (4/62) vs. 0.6% (1/172) and 93.5% (58/62) vs. 76.2% (131/172), χ2=8.87, P=0.018 and 0.003, respectively). Children in the PGVP group were admitted with higher incidence of severe infection, decreased consciousness or coma, moderate-to-severe anemia, thrombocytopenia, protracted diarrhea, and abnormalities in muscle strength or tone than those in the PGVN group (74.2%(46/62) vs. 45.9%(79/172), 50.0%(31/62) vs. 35.5%(61/172), 32.3%(20/62) vs. 18.0%(31/172), 21.0%(13/62) vs. 10.5%(18/172), 25.8%(16/62) vs. 4.1%(7/172), 16.1%(10/62) vs. 5.2%(9/172), χ2=14.63, 4.04, 5.41, 4.37, 24.30, 7.25, all P<0.05). Pathogenic genes that occurred more than twice included IL2RG (5 cases), SMN1 (4 cases), and SH2D1A (3 cases, including 2 single gene varients and 1 copy number varient). Conclusions:Among the deceased cases in the PICU, the main genetic causes are immune-related, metabolic, and neuromuscular genetic disorders. Critically ill children with a family history, CCC, and early features such as severe infections, decreased consciousness or coma, moderate to severe anemia, thrombocytopenia, protracted diarrhea, or abnormalities in muscle strength or tone should be closely monitored and undergo early genetic testing.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective:To establish a micro kinetic-chromogenic method and verify its feasibility for bacterial endo-toxin testing.Methods:Establish an addition system for micro kinetic-chromogenic lysate reagent with 25 μL and 25 μL sample,respectively.Methodological validation was conducted by examining accuracy and precision,linear-ity and range,minimum detection limit,and reagent durability.Two methods,kinetic-chromogenic method and micro kinetic-chromogenic method,were used to compare the applicability of the method to 39 different varieties.Results:The recovery rates of three doses of 0.03,0.3,and 3.0 EU·mL-1 in six repeated experiments were(96.19±16.68)％,(92.53±10.17)％,and(89.54±25.84)％,respectively.The absolute value of the correlation coefficient(r)for the six standard curves is(0.997 7±0.002 3).When the minimum sensitivity concentration of lysate reagent is 0.01 EU·mL-1,the reaction time is(3 896.0±279.6)s,which is lower than the reaction time of the negative control.The durability test results meet the requirements by two micro kinetic-chromogenic lysate reagents from different manufacturers.The research results on variety adaptability show that the recovery rates of 39 varieties are between 50％and 200％,the effectiveness of the two methods is the same.Conclusion:The accuracy and precision,linearity and range,minimum detection limit,and reagent durability of micro kinetic-chromogenic method all meet the requirements of method validation.The variety applicability is equivalent to that of the traditional kinetic-chromogenic method,so this method can be used for bacterial endotoxin detection of routine samples.

Objective: To investigate the influencing factors of depressive symptoms among rural elderly patients with chronic diseases in China, so as to provide insights into depression prevention and control among the rural elderly patients with chronic diseases. Methods: The basic demographics, health status, and lifestyle of rural residents at ages of 65 years and older who had at least one chronic disease were retrieved from The Chinese Longitudinal Healthy Longevity Survey (CLHLS) database in 2018, and participants' depressive symptoms were assessed with The Center for Epidemiological Studies Depression-10 (CES-D-10) scale. Factors affecting the depressive symptoms were identified with a multivariable logistic regression model. Results: Totally 5 146 rural elderly patients with chronic diseases were enrolled, including 2 373 men (46.11%) and 2 773 women (53.89%). The prevalence of depressive symptoms was 27.13%. Multivariable logistic regression analysis identified having two and more children (OR=0.614, 95%CI: 0.387-0.975), living alone (OR=1.450, 95%CI: 1.192-1.764), life satisfaction (general, OR=1.933, 95%CI: 1.651-2.264; low, OR=5.366, 95%CI: 3.488-8.254), self-assessed health status (general, OR=2.697, 95%CI: 2.284-3.185; poor, OR=5.338, 95%CI: 4.262-6.685), disability in instrumental activities of daily living (OR=1.592, 95%CI: 1.328-1.908), sleep duration (normal, OR=0.502, 95%CI: 0.429-0.586; too long, OR=0.494, 95%CI: 0.405-0.603), exercise (OR=0.721, 95%CI: 0.607-0.856), watching TV (OR=0.787, 95%CI: 0.664-0.933), and gardening activities (OR=0.781, 95%CI: 0.626-0.975) as factors affecting depressive symptoms among rural elderly patients with chronic diseases. Conclusions The prevalence of depressive symptoms was 27.13% among rural elderly patients with chronic diseases. Number of children, living style, life satisfaction, health status, sleep duration, exercise, watching TV, and gardening activities are associated with the development of depressive symptoms among rural elderly patients with chronic diseases.

Duodenal neuroendocrine neoplasms (D-NEN) is a kind of heterogeneous tumor originated from neuroendocrine cells. With the continuous progress of diagnostic technology, more and more examination methods and treatment methods are applied. This article reviews the characteristics, classification, imaging applications, biochemical markers' monitoring and treatment of D-NEN.

ObjectiveTo observe the effect of Kinesio taping on salivation after stroke. MethodsFrom October, 2019 to January, 2021, 40 patients with salivation after stroke were randomly divided into control group (n = 20) and experimental group (n = 20). Both groups received routine medicine, routine rehabilitation for dysphagia and rehabilitation nursing, while the experimental group received Kinesio taping in addition, for three weeks. They were assessed with Functional Oral Intake Scale (FOIS), Water Swallow Test (WST) and Teacher Drooling Scale (TDS) before and after treatment. ResultsOne case dropped in the experimental group. The scores of FOIS, TDS and WST improved in both groups after treatment (|Z| > 2.000, P < 0.05), and improved more in the experimental group than in the control group (|Z| > 3.045, P < 0.01). ConclusionKinesio taping may relieve the salivation of patients with dysphagia after stroke.