OBJECTIVE: To investigate the effects of Huayu Tongluo (transforming stasis and unblocking collaterals) moxibustion on cognitive function and insulin resistance in patients with type 2 diabetes mellitus (T2DM) and cognitive decline. METHODS: Ninety patients with T2DM and cognitive decline were randomly divided into a moxibustion group (n=45, 3 cases dropped out, 2 cases were eliminated) and a waiting moxibustion group (n=45, 2 cases dropped out). Both groups received routine hypoglycemic treatment for 12 weeks. The moxibustion group additionally received Huayu Tongluo moxibustion at Baihui (GV20), Shenting (GV24), and Dazhui (GV14). Pressing moxibustion was applied to Baihui (GV20) for 20 min, while suspended moxibustion was applied to Shenting (GV24) and Dazhui (GV14) for 20 min each. Treatments of moxibustion were administered every other day (three times per week) for 12 weeks. All patients were followed up for 12 weeks, during which their original hypoglycemic medication regimen was maintained. Before treatment, after 12 weeks of treatment, and at the 12-week follow-up, the scores of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Addenbrooke's cognitive examination Ⅲ (ACE-Ⅲ), symbol digit modalities test (SDMT), and Athens insomnia scale (AIS) and the insulin resistance index (HOMA-IR) were observed in the two groups. RESULTS: Compared with before treatment, the MoCA scores, MMSE scores, ACE-Ⅲ subscale scores (attention, memory, language fluency, language, visuospatial ability) and total scores, and SDMT scores were increased (P<0.01), while the AIS scores were decreased (P<0.05) in the moxibustion group after treatment and at follow-up. Compared with before treatment, the MMSE score, ACE-Ⅲ subscale scores (memory, attention) and total score after treatment, as well as the ACE-Ⅲ subscale scores (language, memory, attention) and total score, and SDMT score at follow-up were increased (P<0.05, P<0.01) in the waiting moxibustion group. Compared with before treatment, HOMA-IR was decreased in both groups after treatment and at follow-up (P<0.01). At follow-up, ACE-Ⅲ subscale scores (attention, memory), and the total score in the moxibustion group were lower than those after treatment (P<0.05, P<0.01), and the ACE-Ⅲ language subscale score, total ACE-Ⅲ score, and SDMT score in the waiting moxibustion group were higher than those after treatment (P<0.01, P<0.05). After treatment and at follow-up, compared with the waiting moxibustion group, the moxibustion group had higher MoCA scores, MMSE scores, SDMT scores, ACE-Ⅲ subscale scores (attention, memory, language fluency) and total scores (P<0.05, P<0.01), and lower HOMA-IR (P<0.05). CONCLUSION Huayu Tongluo moxibustion can effectively improve cognitive function in patients with T2DM and cognitive decline. This improvement may be associated with the reduction in insulin resistance.
Humans ; Insulin Resistance ; Diabetes Mellitus, Type 2/complications* ; Male ; Female ; Moxibustion ; Middle Aged ; Aged ; Cognition ; Acupuncture Points ; Adult ; Cognitive Dysfunction/therapy*

To clarify the causal factors of a case with severe Chlamydia psittaci pneumonia in Jiujiang District， Jiangxi Province and provide a scientific basis for effective prevention and control. Basic information and epidemiological data of the case were collected by epidemiological survey， and the samples from the close contacts and environment were collected for pathogen detection. A 37-year-old female patient was admitted to the hospital due to "fever with cough for five days and worsening dyspnea". The results of targeted next-generation sequencing （tNGS） of pathogenic microorganisms in the bronchoalveolar lavage fluid of the case indicated that the patient was infected with Chlamydia psittaci. Our epidemiological investigation revealed a clear history of chicken and duck exposure. Four throat swab samples of close contacts and one spleen， liver and lung sample of sick chicken and duck were collected for testing. One of the duck tissue samples tested positive， while the other samples were negative. The severe pneumonia was likely caused by exposure to the external environment contaminated by Chlamydia psittaci. Poultry farming should be regulated to prevent the transmission infection from poultry to humans．Additionally， awareness among medical staff should be increased to prevent severe outcomes．

Sesquiterpenoids are natural compounds composed of 15 carbon atoms， which can be divided into sesquiterpene alcohols， ketones， lactones， aldehydes， and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature， and their physiological activities are diverse. For example， many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects， including cytotoxicity， antioxidant， immune regulation， cell proliferation， and so on. In addition， some sesquiterpenoids have good application prospects in antibacterial， anti-inflammatory， and anti-cardiovascular diseases. Malignant tumors， inflammation， bacterial diseases， and cardiovascular diseases are the main diseases that cause human death， and natural products have unique advantages in the treatment of these diseases. Therefore， the development of new drugs that are easy to promote has become a new research hotspot. In this paper， the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor， anti-inflammatory， antibacterial， and anti-cardiovascular activities， such as Xanthium， Atractylodes， Convolvulus， Acanthium， Ligularia， Artemisia， Ligularia， Ligularia， Labiaceae Mint， Acanthophyllum， Turmeria， Ginger， and other Chinese herbs and plants， were discussed. The biological activities and related mechanisms of this compound were reviewed， which provided a reference for further research and clinical application of sesquiterpenes.

In order to understand nurses’ willingness to participate in humanistic nursing training and its influencing factors, and provide reference for managers to understand the current situation and improve nurses’ enthusiasm for humanistic nursing training. The convenience sampling method was used to investigate 23 707 nurses in 28 provinces (autonomous regions and municipalities directly under the central government) through a self-designed questionnaire distributed on the Internet. The results showed that 98.1% of nurses thought that participating in humanistic nursing related training was helpful to clinical work, but only 88.6% of the respondents were willing to participate in humanistic nursing training. Thirty factors were analyzed from four aspects of basic characteristics of individuals, cognitive relevant experience and organizational atmosphere. Fifteen factors had significant significance in binary Logistic regression analysis (P<0.05). Among them, the factors that had a positive impact on training willingness were: marriage, education, professional title, post establishment, agree with humanistic care is the basic duty of a nurse praised, experience of being praised at work, family support, rapport with patients, passion of colleagues to participate in training, sustained high-quality care demonstration activities, join the humanistic care related organization, hospital reimbursement of training expenses (OR value of 6.559~1.113, P<0.001). The OR value of humanistic nursing as a nurse’s responsibility was 6.559 and the 95%CI was 5.585~7.702. The factors that hindered nurses from participating in training were: work occupied most of time and energy, think humanistic nursing is abstract and difficult to understand, think the mastered humanistic knowledge and skills meet the needs of work (OR value of 0.657~0.722, P<0.001). Through the analysis, it is considered that nurses have a extremely consistent high recognition of the significance of humanistic nursing training, but their willingness to receive training is affected by many factors such as individual experience, cognitive attitude and organizational atmosphere. In order to realize nurses’ high recognition of humanistic nursing training to high enthusiasm of behavior, the aspects of individual cognition and organizational atmosphere must be discussed.

Objective:To study the diagnostic value of artificial intelligence B-ultrasound image computer-aided diagnosis system (hereinafter referred to as intelligent ultrasound system) in adult goiter.Methods:In June 2022 and March 2023, two phases of thyroid disease survey were carried out in 4 cities in Anhui Province. One village was selected in each city, and 250 adults were selected as survey subjects in each village. Adult bilateral thyroid area was scanned by both intelligent ultrasound system and conventional ultrasound scanning equipment, and the effectiveness of intelligent ultrasound system in the diagnosis of goiter was analyzed based on the results of conventional ultrasound examination. Receiver operating characteristic (ROC) curve was drawn, and Kappa test was used to analyze the consistency between intelligent ultrasound system and conventional ultrasound examination in the diagnosis of goiter. At the same time, Spearman correlation analysis and Bland-Altman method were used to evaluate the consistency of the two methods in measuring thyroid volume.Results:After screening and removing outliers and missing values, a total of 910 adults were included, including 253 males (27.80%) and 657 females (72.20%). The age was (45.92 ± 10.20) years old, ranging from 18 to 60 years old. The sensitivity, specificity, and accuracy of the intelligent ultrasound system for diagnosing adult goiter were 80.00%, 99.67%, and 99.56%, respectively. The area under the ROC curve (AUC) was 0.996, which was consistent with the results of conventional ultrasound examination for diagnosing goiter ( κ = 0.67, P < 0.001). After controlling for variables such as gender, thyroid function, and thyroid nodules, the intelligent ultrasound system showed good consistency with conventional ultrasound examination in the diagnosis of goiter in females, adults with thyroid dysfunction, and adults without thyroid nodules ( κ = 0.66, 0.80, 0.80, P < 0.001). The consistency in the diagnosis of goiter in adults with thyroid nodules was moderate ( κ = 0.56, P < 0.001). Spearman correlation analysis showed a highly positive correlation between the measurement results of adult thyroid volume by intelligent ultrasound system and conventional ultrasound examination ( r = 0.88, P < 0.001). The Bland-Altman method results showed that only 4.62% (42/910) of points in adults were outside the 95% consistency limit, indicating good consistency between intelligent ultrasound system and conventional ultrasound examination in measuring thyroid volume (< 5%). The proportion of points outside the 95% consistency limit in males, adults with thyroid dysfunction, and adults with thyroid nodules was 6.72% (17/253), 5.83% (12/206), and 6.45% (12/186), respectively. Conclusions:The intelligent ultrasound system has certain diagnostic value for adult goiter and has good consistency with conventional ultrasound examination for thyroid volume measurement. However, the accuracy of diagnosis for males and adults with thyroid nodules still needs to be improved.

Objective To study the protective effect of Wedelolactone(WEL)against inflammatory injury in human umbilical vein endothelial cells(HUVECs)and its molecular mechanism by inducing PI3K/Akt/mTOR.Methods The model of atherosclerosis(AS)oxidative stress injury in HUVECs was induced with 200 μmol·L-1 of hydrogen peroxide for 24 h.The experimental groups were as follows:normal control group,DMSO(dimethyl sulfoxide)group,H2O2 group,and WEL group.MTT was used to measure the cell survival rate of each group;flow cytometry was used to assess intracellular ROS levels;fluorescence microscopy was used to detect the expression of p62 protein;immunoblotting assay was used to determine the protein expression levels for apoptosis-related proteins associated with PI3K/Akt/mTOR signaling pathway and autophagy-related proteins.Results Compared with the H2 O2 group,the HUVEC cell survival rate was significantly inhibited in the WEL group(P＜0.05).ROS production was significantly lower,and the protein expressions of SOD1 and p62 were significantly increased in the WEL group as compared to the hydrogen peroxide group.The protein expression of p-mTOR,p-Akt,and p-PI3K was significantly decreased in hydrogen peroxide(P＜0.01);In the WEL experiment,p-mTOR,p-Akt,and p-PI3K were increased significantly in the post-injury HUVECs(P＜0.01).Conclusion Wedelolactone inhibits HUVECs'autophagy by suppressing H2O2-induced inflammatory damage in HUVECs,which may be related to the fact that WEL promotes the phosphorylation of PI3K,Akt,and mTOR proteins,inhibits autophagy and thus resists oxidative stress damage in HUVECs cells.

Goiter is a kind of non-inflammatory and non-neoplastic hyperplasia and enlargement. Many studies have shown that substances such as thiocyanates and isothiocyanates can prevent the development of a variety of tumors. However, some studies have also found that such substances can lead to goiter. In this article, relevant information on common goitrogen in food are collected to explore their mechanism of action, laying a foundation for guiding residents to maintain a healthy and balanced diet.

Objective: To construct a nonsuicidal selfinjury (NSSI) risk prediction model for middle school students using different machine learning algorithms and evaluate the models effectiveness, so as to provide guidance for the prevention and control of NSSI in campus. Methods: In March 2023, a total of 3 372 middle and high school students from schools in Nanchang, Fuzhou and Shangrao cities in Jiangxi Province were selected by combining stratified random cluster sampling and convenient sampling methods. Questionnaire surveys were conducted using various instruments including general information questionnaire, Selfesteem Scale, Ottawa Selfinjury Scale, Social Support Assessment Scale, Chinese Version of the Olweus Bullying Questionnaire, Event Attribution Style Scale, Adolescent Resilience Scale, and Adolescent Life Events Scale. Data were divided into training set (n=2 361) and test set (n=1 011) at a ratio of 7∶3, and variables were selected based on univariate and LASSO regression results. Four machine learning algorithms including namely random forest, support vector machine, Logistic regression and XGBoost, were used to construct NSSI risk prediction models, and the models performance was evaluated and compared using metrics including area under curve (AUC), sensitivity, specificity, positive predictive value, negative predictive value and F1 score. Results: The detection rate of NSSI among middle school students was 34.4%. Univariate analysis showed that there were statistically significant differences in NSSI detection rates among middle school students of different grades, genders, registered residence locations, whether they were class cadres and four types of bullying (physical, verbal, relational bullying and cyberbullying) (χ2=27.17, 15.81, 11.54, 4.63；68.22, 140.63, 77.81, 13.95, P<0.05). NSSI was included as the dependent variable in the LASSO regression model for variable screening, and the results regression identified 10 predictive variables including grade level, selfesteem, subjective support, support utilization, verbal bullying, emotional control, interpersonal relationships, punishment, loss of relatives and property, and health and adaptation issues. The AUC values of random forest, support vector machine, Logistic regression, and XGBoost algorithms were 0.76, 0.76, 0.76 and 0.77, respectively, with no statistically significant differences between pairwise comparisons (Z=-0.59-0.82, P>0.05). Sensitivity values were 0.62, 0.61, 0.62 and 0.61, respectively. Specificity values were 0.74, 0.78, 0.78 and 0.78, respectively. Positive predictive values were 0.56, 0.59, 0.60 and 0.59, respectively. Negative predictive values were 0.79, 0.79, 0.80 and 0.79, respectively. F1 scores were 0.59, 0.60, 0.61 and 0.60, respectively. Conclusions All four nonsuicidal selfinjury risk prediction models perform well, with the Logistic regression model slightly outperforming the others. Schools and parents should pay attention to the predictive factors corresponding to NSSI, so as to reduce the occurrence of NSSI among middle school students.

Objective:To design a health state holographic perceptual intelligence operation and maintenance system,and to explore the application effect in medical equipment management of infectious disease department.Methods:The holographic perception intelligent operation and maintenance system of health status of medical equipment in the infectious disease department was built by the perception layer,transmission layer and application layer to realize the automatic alarm,active protection and real-time monitoring functions of equipment management.A total of 119 medical devices in clinical use in the Department of Infectious Diseases of The Second Affiliated Hospital of Air Force Medical University from 2021 to 2022 were selected,according to different management methods,during the equipment operation and maintenance period in 2021,the conventional medical equipment(referred to as the conventional management mode)management mode was adopted;during the equipment operation and maintenance period in 2022,the holographic perception intelligent operation and maintenance system of medical equipment health status(referred to as the intelligent operation and maintenance management mode)was adopted.The differences in the safety score,maintenance status,and ability score of equipment users between the two management modes were compared.Results:The average scores of electrical safety,biological safety,radiation safety,damage safety,diagnosis and treatment safety of medical equipment using the intelligent operation and maintenance management mode were(0.47±0.21),(0.63±0.15),(1.38±0.11),(0.83±0.34)and(0.94±0.27),respectively,which were lower than those of the conventional management mode,and the difference was statistically significant(Department of Infectious Diseases;Medical equipment;Health status;Holographic sensing;Intelligent operation and maintenance=20.609,24.003,27.127,25.135,30.762,P＜0.05).The equipment failure maintenance rate,maintenance processing time and arrival time of equipment accessories using the intelligent operation and maintenance management mode were(85.41±3.37)%,(0.77±0.14)h and(3.29±0.58)d,respectively,which were lower than those of the conventional management mode,while the average score of equipment maintenance service quality was(95.36±5.13)points,which was higher than that of the equipment score of the conventional management mode,and the differences were statistically significant(t=16.638,25.569,29.333,18.499,P＜0.05).The average scores of equipment users with respect to the sense of responsibility for using the equipment,the ability to correctly operate the equipment,the effect of responding to equipment,the ability to give an accurate and timely alarm and other operating abilities with the intelligent operation and maintenance management mode were(97.48±5.66),(91.53±4.28),(93.37±5.12)and(95.62±4.93),respectively,which were higher than the scores of conventional management mode,and the difference was statistically significant(t=10.948,17.171,6.058,7.276,P＜0.05).Conclusion:The holographic perception intelligent operation and maintenance system of medical equipment health status in the Department of Infectious Diseases can improve the quality of medical equipment management,prevent equipment failures,reduce equipment maintenance,and improve the quality of equipment services.

Objective:To investigate effect of neferine(NeF)on myocarditis in heart failure(HF)rats by regulating CC-che-mokine ligand 2/CC chemokine receptor 2(CCL2-CCR2)signaling axis.Methods:HF rat model was constructed by ligating left ante-rior descending branch,and randomly separated into HF group,different doses of NeF groups(5 mg/kg,10 mg/kg,20 mg/kg),20 mg/kg NeF+CCL2 group,another 10 rats without ligating left anterior descending branch were regarded as sham surgery group.After treatment,cardiac function[left ventricular end systolic diameter(LVESD),ejection fraction(EF),left ventricular ejection fraction(LVEF)]were evaluated.Serum indicators[brain natriuretic peptide(BNP),IL-1β,N-terminal B-type natriuretic peptide(NT-pro BNP),TNF-α]were detected.Myocardial tissue was isolated and expressions of TNF-α and IL-1β,pathological damage,collagen deposition,expressions of CCL2 and CCR2 proteins were detected.Results:Compared with sham surgery group,HF group showed a decrease in myocardial cells,infiltration of inflammatory cells,and severe deposition of collagen fibers,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly increased,LVEF and EF were greatly decreased(P<0.05).Compared with HF group,central muscle tissue damage and collagen fiber deposition were reduced in different doses of NeF groups,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly decreased,LVEF and EF were greatly increased,with differences between groups(P<0.05).After CCL2 intervention,compared with 20 mg/kg NeF group,myocardial tissue damage and collagen fiber deposition were worsened,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly increased,LVEF and EF were greatly decreased(P<0.05).Conclusion:NeF regulates CCL2-CCR2 signaling axis,inhibits myocar-ditis in HF rats,and improves cardiac function.