ObjectiveTo observe the effects of modified Chaihu Shugansan on the calmodulin-dependent protein kinase Ⅱ（CaMKⅡ）/cAMP-response element binding protein （CREB） signaling pathway in the hippocampus and heart tissue of a rat model with myocardial ischemia and depression and explore the mechanism by which this formula prevents and treats coronary heart disease combined with depression. MethodsThe model of myocardial ischemia combined with depression was established by high-fat diet， intraperitoneal injection of isoproterenol （ISO）， and chronic unpredictable mild stress （CUMS）. A total of 108 SD male rats were randomly divided into normal group， model group， high （23.4 g·kg^-1）， medium （11.7 g·kg^-1）， and low （5.85 g·kg^-1） dose groups of modified Chaihu Shugansan， CaMKⅡ inhibitor （KN93） group， and KN93 + high， medium， and low dose groups of modified Chaihu Shugansan， with 12 rats in each group. From the first day of modeling to the end of modeling， drugs were administered once a day. In the seventh and eighth weeks， the KN93 group and the KN93 + high， medium， and low dose groups of modified Chaihu Shugansan were intraperitoneally injected with KN93 three times weekly. At the end of the eighth week， behavioral tests including sucrose preference， open field， and elevated plus maze were conducted. Electrocardiogram （ECG） lead Ⅱ changes were observed in each group of rats， and hematoxylin-eosin （HE） staining was performed to observe changes in heart tissue. Serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein （HDL）， low-density lipoprotein （LDL）， and lactate dehydrogenase （LDH） were measured by using an enzyme-labeled instrument. Creatine kinase （CK） and creatine kinase-MB （CK-MB） were detected by ultraviolet spectrophotometry， while serum monocyte chemoattractant protein-1 （MCP-1） was measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expression of CaMKⅡ and CREB in hippocampal and heart tissue， and Western blot was performed to assess protein expression of CaMKⅡ， phosphorylated （p）-CaMKⅡ， CREB， and p-CREB. ResultsCompared to the normal group， the model group showed significant reductions in sucrose preference rate， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）. The ECG showed ST-segment elevation， and HE staining showed serious degeneration of myocardial fibers， disordered arrangement， and infiltration of a large number of inflammatory cells. In addition， serum TC and LDL levels increased （P<0.01）， and HDL level decreased （P<0.01）. CK， CK-MB， LDH， and MCP-1 levels significantly increased （P<0.05， P<0.01）. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB decreased in the hippocampal tissue （P<0.05， P<0.01）， but those increased in the heart tissue （P<0.01）. Compared to the model group， the high， medium， and low dose groups of modified Chaihu Shugansan showed improvements in these abnormalities. The KN93 group had reduced sucrose preference， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）， as well as decreased serum CK， CK-MB， LDH， and MCP-1 levels （P<0.05， P<0.01）. KN93 also reduced ST-segment elevation， alleviated the degeneration degree of myocardial fibrosis， and lowered inflammatory cell infiltration. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB in both the hippocampal and heart tissue were reduced （P<0.05， P<0.01）. The KN93 + high， medium， and low dose groups of modified Chaihu Shugansan showed further improvements in these abnormalities compared to the KN93 group. ConclusionThe modified Chaihu Shugansan exerts antidepressant and myocardial protective effects in rats with myocardial ischemia and depression， possibly related to bidirectional regulation of the CaMKⅡ/CREB signaling pathway， with the high-dose modified Chaihu Shugansan showing the best effects.

Objective: To investigate the characteristics and risk factors of an outbreak of acute hemorrhagic conjunctivitis (AHC) in a boarding middle school in Guangdong Province, in order to provide a scientific evidence for effective prevention and control of campus AHC outbreaks. Methods: From September 1st to 28th 2023, case identification was conducted among 559 students and 60 faculty members using standardized definition. Descriptive analysis was conducted on the three distrubution patterns of the outbreak. Questionnaires were designed, and a case-control study was adopted to analyze the possible risk factors of the disease transmission. The propensity score matching (PSM) method was used to control the difference of baseline data. Results: A total of 269 cases of AHC were identified, with an attack rate of 43.46%. The pathogen was confirmed as Coxsackie virus A24 variant (CA24v). Among these, 264 cases were students (attack rate of 47.23%) and 5 were staff (attack rate of 8.33%). A total of 153 pairs of PSM were successfully matched. After PSM matching, there were no statistically significant differences in gender, grade and class between the case group and the control group ( χ 2=0.12, 5.41, 11.24, P >0.05). The results of multivariate Logistic regression analysis showed that middle school students whose towels contacted with others ( OR =1.81), and direct contact with other AHC cases recently ( OR =4.89) were more likely to have AHC; while wearing glasses ( OR =0.43) and frequent use of hand sanitizer ( OR = 0.37 ) were less likely to have AHC ( P <0.05). Conclusion The outbreak of AHC is caused by CA24v, demonstrating rapid spread and extensive impact within the school setting.

Objective To investigate and analyze epidemiological characteristics of patients with mycoplasma pneumoniae pneumonia (MPP) from 2020 to 2023, and the risk factors for plastic bronchitis (PB), To provide data support for developing preventive measures. Methods The medical records of 2 257 patients with respiratory tract infection treated at Huai'an Hospital Affiliated to Xuzhou Medical University from 2020 to 2023 were collected. Count the number of MPP patients and analyze the MP detection rate. Multivariate logistic regression analysis and ROC curve was used to screen the risk factors for PB. Results A total of 858 cases were positive for MP antibodies, and the detection rate was 38.02%. There are statistically significant differences in MP detection rates among different genders, age groups, and years (P<0.05). Among the 286 patients diagnosed with MPP and undergoing bronchoscopy, 68 (23.78%) patients had PB. According to univariate and multivariate logistic regression analysis, small age, higher N%, D-D, LDH and AST levels were independent risk factors for PB (P<0.05). ROC curve analysis shows that age and combined detection are the most effective indicators for PB prediction, with areas under the curve of 0.998 and 0.961, respectively. Conclusion MP is the main pathogen of respiratory tract infections in the area from 2020 to 2023. Women and children are more susceptible to MP infection. Small age, high N%, DD, LDH and AST levels are independent risk factors for PB in patients with MPP. Targeted preventive measures should be taken for MP susceptible population, and close attention should be paid to PB related risk factors to prevent disease progression and the occurrence of PB.

Objective To describe and analyze the epidemiological characteristics of scrub typhus in Huai'an, Jiangsu Province from 2006 to 2024 and explore the long-term incidence trend and distribution of high-risk areas, and to formulate targeted prevention and control strategies. Methods The scrub typhus case report data of Huai'an from 2006 to 2024 in the Chinese Disease Prevention and Control Information System were extracted for descriptive analysis. Results A total of 898 cases of scrub typhus were reported in Huai'an, with an average annual incidence rate of 0.96 per 100 000 from 2006 to 2024. There was a turning point in the incidence trend of scrub typhus in 2011. From 2006 to 2011, the annual percentage change (APC) was 47.09% (95% CI: 7.53 - 859.39), and the upward trend was statistically significant (P < 0.05). From 2012 to 2024, the APC was -2.12% (95% CI: -29.09 - 3.75), and the downward trend was not statistically significant. October and November were the high-incidence months, and the total concentration from 2006 to 2024 was 0.93, indicating that scrub typhus had strict seasonality. The circular distribution method estimated that the peak period of the epidemic was from October 11th to November 25th, and the peak day of incidence was November 3rd. Jinhu County was a high-incidence area. The ratio of male to female cases was 1.03. The age group with the highest reported incidence was 40 to < 80 years old. The occupation with the highest proportion was farmers, accounting for 78.03%. Conclusion From 2006 to 2024, scrub typhus in Huai'an shows a peak every 3 - 4 years. Middle-aged and elderly farmers are the key population at risk, and Jinhu County is a key area. In the future, targeted health education should be carried out to effectively control the prevalence of scrub typhus.

Immunotherapy is an important breakthrough in canc-er treatment.Unfortunately,low drug concentration in tumor sites almost ineffectively initiates immune responses and thereby severely limits immune therapy applications in clinics.Nanoma-terials are well-recognized drug delivery system in cancer thera-py.Nanographene oxide(NGO)have shown immense perti-nence for anti-cancer drug delivery owing to their ultra-high sur-face area,chemical stability,good biocompatibility and excel-lent photosensitivity.In addition,functionalized modifications on the surface of NGO increase tumor targeting and minimize cy-totoxicity.This study focuses on reviewing the literature and up-dates on NGO in drug delivery and discussing the possibilities and challenges of NGO in cancer synergetic therapy.

Objective To focus on the imaging features of liposclerosing myxofibrous tumor(LSMFT)and diagnostic chal-lenges to enhance clinical recognition and differential diagnosis accuracy.Methods Retrospective analysis was conducted on the imaging and pathological data from 21 cases diagnosed with LSMFT between January 2014 and November 2022,including 14 males and 7 females(aged from 21 to 73 years;the course of disease ranged from 4 to 48 months).Patient demographics,clinical presentations,and imaging modalities including X-ray,CT,and MRI were reviewed.Pathological findings were corre-lated with imaging features to delineate diagnostic criteria and identify causes of misdiagnosis.Results All 21 patients repre-sented primary lesions,located in 14 bilateral femurs[9 on the right and 5 on the left;12 proximal femurs(intertrochanteric and peripheral)and 2 distal femurs],2 proximal tibia,2 proximal humerus,1 proximal radius,and 1 ilium and 1 calcaneus.On X-ray and CT,all lesions showed cartographical or quasi-circular osteolytic destruction with distinct and sclerotic margins,continuous bone cortex,absence of periosteal reaction and surrounding soft tissue mass.Calcification,bone ridge and varying degrees of fat components were observed in 16 lesions,displaying mixed density;5 lesions showed ground-glass density with minimal bone ridge.On MRI,the signal intensity of the lesion was heterogeneous.T1-weighted imaging showed iso-to slightly high signal intensity,while T2-weighted imaging demonstrated unevenly high signal intensity.Fat-suppressed sequences de-picted significantly elevated signal intensity within lesions,with post-contrast enhancement showing uneven patterns.5 Cases were initially misdiagnosed as fibrous dysplasia.Conclusion LSMFT is an uncommon benign bone tumor,typically localized in the proximal femur but occasionally found in other skeletal sites.Understanding its distinct imaging characteristics is crucial for accurate diagnosis.Typical cases exhibit identifiable imaging patterns,whereas atypical presentations may lead to misdiagnosis as fibrous dysplasia.

Objective:To construct the nursing sensitive quality index system for interventional treatment of trigeminal neuralgia, so as to provide reference for the nursing quality evaluation and management of interventional treatment of trigeminal neuralgia.Methods:From June to December 2022, using the "Structure-Process-Results" quality evaluation model as the theoretical framework, an expert inquiry questionnaire was developed based on literature review. The indicator system was established using the Delphi method, and the weights of the indicators were determined using the analytic hierarchy process.Results:The recovery rates of the two rounds of expert correspondence questionnaires were 92.6% (25/27) and 100.0% (25/25), the expert authority coefficients were 0.860 and 0.888, the Kendall's coordination coefficients were 0.073 and 0.058 ( P<0.05), and the coefficient of variation were 0-0.330 and 0-0.191, respectively. Finally, the nursing sensitive quality index system for interventional treatment of trigeminal neuralgia was formed, which included three primary indexes, 14 secondary indexes and 54 tertiary indexes. Conclusions:The index system has strong scientific and clinical applicability, which can provide reference for nursing quality evaluation and management of interventional treatment of trigeminal neuralgia.

Objective:To investigate the impact of pumpkin polysaccharide(PP)on hypoxia/reoxygenation(H/R)-induced myocardial cell(H9C2)injury by regulating Nrf2/γ-GCS pathway.Methods:HR cell models were established,and the concentration of pumpkin polysaccharide(PP)was determined.H9C2 cells were grouped into Control group,H/R group,pumpkin polysaccharide group(PP group,2 mg/L PP),Nrf2 inhibitor group(ML385 group,2.0 μmol/L ML385),and PP+ML385 group(2.0 mg/L PP+2.0 μmol/L ML385),the apoptosis,mitochondrial membrane potential changes,oxidative stress(LDH,MDA,SOD,ROS),the lev-els of inflammatory factors(TNF-α,IL-6,IL-1β)and the protein expressions of Nrf2 and γ-GCS in H9C2 cells were detected,respec-tively.Results:Compared with Control group,H/R group had changes in cell morphology,the cell injury and mitochondrial membrane potential decreased,the H9C2 cell viability,SOD and protein expression levels of Nrf2 and γ-GCS were significantly decreased,while the apoptosis rate,LDH,MDA,ROS,and levels of TNF-α,IL-6 and IL-1β were significantly increased(P<0.05);compared with H/R group,the cell injury in PP group was reduced,the mitochondrial membrane potential was restored,the H9C2 cell viability,SOD and protein expression levels of Nrf2 and γ-GCS were significantly increased,and the apoptosis rate,LDH,MDA,ROS,and levels of TNF-α,IL-6 and IL-1β were significantly decreased(P<0.05),the effect of ML385 was opposite to that of PP,and ML385 could reverse the antioxidant and anti-inflammatory effects of PP.Conclusion:PP up-regulates the Nrf2/γ-GCS pathway to exert antiox-idant and anti-inflammatory effects,and reduces H/R-induced H9C2 cell injury.

Objective:To explore the application effect of nursing intervention based on the information-motivation-behavioral skills (IMB) model in perioperative nursing of children undergoing concealed penis phalloplasty.Methods:Using the convenient sampling method, a total of 86 children who were admitted to and underwent concealed penis phalloplasty in Jiaxing Maternity and Child Health Care Hospital were selected as the research objects from January 2022 to January 2023. They were randomly divided into the observation group and the control group, with 43 cases in each group. The control group was treated with routine nursing mode, and the observation group was treated with IMB model nursing intervention based on routine nursing. The heart rate (HR) and mean arterial pressure (MAP) levels of children in the two groups were recorded at five time points, such as after preoperative visit (T 0), when leaving the preparation room period (T 1), before anesthesia induction (T 2), when leaving the anesthesia recovery room (T 3) and 24 h postoperative follow-up (T 4). The children were evaluated using Children's Emotional Adjustment Scale Preschool Version (CEAS-P), Modified Yale Preoperative Anxiety Scale (m-YPAS), the Induction Compliance Checklist (ICC) and Pediatric Anesthesia Emergence Delirium (PAED) . Results:After intervention, the CEAS-P scores in the observation group were higher than those in the control group, while the m-YPAS, ICC and PAED scores were lower than those in the control group, and the differences were statistically significant (all P<0.01). There were statistically significant differences in HR and MAP levels of children undergoing concealed penis phalloplasty between the two groups at different time points ( P<0.01). HR and MAP levels at T 0, T 1, T 2, T 3 and T 4 in observation group were lower than those in control group, and the differences were statistically significant (all P<0.05). There was statistically significant differences in the interaction between nursing intervention and HR and MAP over time ( P<0.01) . Conclusions:Nursing intervention based on the IMB model can effectively relieve the psychological anxiety of children with concealed penis phalloplasty in perioperative period and improve surgical safety.

Objective:To assess the diagnostic performance of 68Ga-PSMA PET/CT and mpMRI in initial staging of prostate cancer. Methods:A retrospective analysis was conducted on patients with initial diagnosis of prostate cancer who underwent prostatectomy at Fudan University Shanghai Cancer Center from December 2021 to June 2023. All had biopsy-confirmed prostate cancer preoperatively and had not undergone any anti-tumor treatment. Prior to surgery, all patients underwent 68Ga-PSMA PET/CT and mpMRI scans. The surgical samples were processed by whole-mount slides pathology. Thirty patients were included, with a median age of 68 years (range 67-76 years). The preoperative median PSA level was 17.91 ng/ml (range 9.41-39.53 ng/ml). The median interval between the two examinations was 21.00 days (range 2.75-35.50 days). Based on the postoperative whole-mount slides pathology which was the gold standard, we compared the sensitivity and specificity of 68Ga-PSMA PET/CT and mpMRI in diagnosing extraprostatic extension, seminal vesicle invasion, and intraprostatic tumor lesion. Results:According to the postoperative pathology, among the 30 patients, 12 had extraprostatic extension (EPE), 8 had seminal vesicle invasion (SVI). Among the 50 lesions found before surgery, postoperative pathology showed that 38 of them were clinically significant prostate cancer lesions (76.0%, 38/50). Using whole-mount pathology, preoperative mpMRI, and 68Ga-PSMA PET/CT imaging for triple fusion comparison, the sensitivity and specificity of 68Ga-PSMA PET/CT in diagnosing EPE were 66.7% (8/12) and 88.9% (16/18), respectively. The sensitivity and specificity of mpMRI in diagnosing EPE were 50.0% (6/12) and 83.3% (15/18), respectively. In diagnosing SVI, the sensitivity and specificity of 68Ga-PSMA PET/CT were 50.0% (4/8) and 86.3% (19/22), respectively. The sensitivity and specificity of mpMRI were 75.0% (6/8) and 90.9% (20/22), respectively. When diagnosing clinically significant tumor lesions within the prostate, the sensitivity of 68Ga-PSMA PET/CT was 89.5% (34/38), which was significantly better than the mpMRI of 63.2% (24/38), with no significant difference in specificity. Conclusions:The sensitivity of 68Ga-PSMA PET/CT in diagnosing intraprostatic lesions was significantly higher than that of mpMRI, with no significant difference in specificity.