Anti-neutrophil cytoplasmic antibody-associated small-vessel vasculitis（ANCA-AAV） is an autoimmune disease that can involve multiple systems throughout the body， and approximately 15% of patients with AAV have central nervous system involvement. Hypertrophic spinal pachymeningitis （HSP） is a rare clinical form with nervous system involvement characterized by thickening of the dura mater， inflammatory response，and fibrosis. This article reports a case of HSP associated with myeloperoxidase antibody and ANCA and summarizes its clinical features and imaging characteristics with reference to the latest literature，so as to enhance the understanding of HSP among clinicians and reduce missed diagnosis or misdiagnosis.

Objective: To evaluate the effects of a multidisciplinary weight management intervention, so as to provide a reference for the formulation of overweight and obesity intervention measures. Methods: From April to September 2025, overweight and obese residents aged 18-60 years who participated in a weight loss competition at the Health Management Center of Beilun People's Hospital in Ningbo City were selected as study subjects. They were divided into a control group and an intervention group. The control group received conventional weight management, while the intervention group received the multidisciplinary integrated weight management in addition to the conventional weight management, for a total intervention period of 8 weeks. Weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood pressure were collected before and after the intervention through physical examinations and laboratory tests. The generalized estimating equations (GEE) method was employed to analyze the differences in indicators between the two groups before and after the intervention. Results: The control group comprised 241 participants, including 161 females (66.80%), with a mean age of (35.66±7.80) years. The intervention group consisted of 127 participants, including 86 females (67.72%), with a mean age of (36.80±7.05) years. No statistically significant differences were observed between the two groups at baseline in terms of age, gender, weight, BMI, or waist-to-hip ratio (all P>0.05). Results from the GEE analysis indicated significant interactions between group and time for weight, BMI, waist circumference, and hip circumference (all P<0.05) with greater reductions in these parameters observed in the intervention group compared to the control group before and after the intervention. Similarly, significant interactions between group and time were observed for FBG, TG, TC, and LDL-C (all P<0.05), with the intervention group demonstrating larger decreases in these markers compared to the control group. However, no statistically significant interactions between group and time were observed for waist-to-hip ratio, HDL-C, systolic blood pressure, and diastolic blood pressure (all P>0.05). Following the intervention, a weight loss exceeding 10% was achieved by 13 participants (5.39%) in the control group and 62 participants (48.82%) in the intervention group. The proportion of individuals with a weight loss exceeding 10% was significantly higher in the intervention group compared to the control group (P<0.05). Conclusion Compared to conventional weight management, multidisciplinary integrated weight management demonstrated greater efficacy in improving weight-related indicators and blood glucose, blood lipids, and enhancing weight loss outcomes among overweight and obese residents.

Although small in size, the eyeballs are extremely important in function, and are delicate and complex in structure. With the wide application of acupuncture for eye diseases and the high frequency of use of intra-orbital points, the incidence of acupuncture accidents increases accordingly in treatment. We reported two recent accident cases, retinal tear and ciliochoroidal detachment that occurred during the regular operation of acupuncture and acupoint injection at intra-orbital points, in order to strengthen people's awareness of acupuncture accidents caused by acupuncture at the points in the orbital region, and enhance the sound development and comprehensive promotion of acupuncture in treatment of eye diseases.
Humans ; Acupuncture Therapy/adverse effects* ; Acupuncture Points ; Male ; Adult ; Female ; Middle Aged ; Orbit ; Retinal Perforations/therapy*

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

Objective:To investigate the effect of Yiqi Shengqing Formula on neuronal damage in ischemic stroke(IS)rats by regulating brain-derived neurotrophic factor(BDNF)-extracellular regulated protein kinase(ERK)-cyclic adenosine monophosphate-responsive element binding protein(CREB)signal pathway.Methods:IS rat model was prepared by modified thread suppository method,and randomly divided into model group,low dose Yiqi Shengqing Formula(3 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)+empty load group,high dose Yiqi Shengqing Formula(6 g/kg)+BDNF knockdown group,with 10 rats in each group,another 10 healthy rats were set as sham operation group.After intervention with Yiqi Shengqing Formula and plasmid,neural function of rats in each group was scored with Longa scoring method;Morris water maze test was used to detect cognitive impairment of rats in each group;Nissl staining was used to detect the number of neurons in ischemic peripheral brain tissue and hippocampus of rats in each group;synaptic morphology of ischemic peripheral brain tissue was detected by silver staining;levels of TNF-α and IL-8 in brain tissue and serum of rats in each group were measured by ELISA;expressions of BDNF-ERK-CREB signal pathway related proteins in rat brain were detected by Western blot.Results:Compared with sham operation group,synaptic morphology of ischemic peripheral brain tissue in model group was severely damaged,retention time in target quad-rant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased significantly(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased significantly(P<0.05).Compared with model group,synaptic morphological damage of ischemic peripheral brain tissue in rats in low dose Yiqi Shengqing Formula group and high dose Yiqi Shengqing Formula group was alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were decreased(P<0.05).Compared with low dose Yiqi Shengqing Formula group,damage of synaptic morphology in ischemic peripheral brain tissue of rats in high dose Yiqi Shengqing Formula group was further alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were further increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were further reduced(P<0.05).Compared with high dose Yiqi Shengqing Formula group,synaptic morphological damage of ischemic peripheral brain tissue in high dose Yiqi Shengqing Formula+BDNF knockdown group was aggravated,retention time in target quadrant,times of crossing the platform,number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased(P<0.05);there was no significant changes in each index of rats in high dose Yiqi Shengqing Formula+empty load group(P>0.05).Conclusion:Yiqi Shengqing Formula can inhibit the neuroinflammation of IS rats by activating BDNF-ERK-CREB signal,thereby reducing the damage of its neurons and improving its neural function.

Objective To investigate the effects of asperuloside(ASP)on airway inflammation and the interleukin-6/Janus kinase 2/signal transducer and activator of transcription 3(IL-6/JAK2/STAT3)signaling pathway in juvenile rats with bronchial asthma.Methods A juvenile rat model of bronchial asthma was constructed and randomly separated into a Model group,low,medium,and high dose asperuloside groups(ASP-L,ASP-M,ASP-H groups),and high-dose asperuloside+pathway activator group(ASP-H+CA1 group),with 12 rats in each group.An additional 12 healthy rats were included as Control group.All rats were evaluated for lung function.The number of inflammatory cells in bronchoalveolar lavage fluid(BALF),and the levels of inflammatory factors in BALF and serum were detected.HE staining was applied to observe the pathological morphology of lung tissue.Western blot was applied to detect the expression of proteins related to the IL-6/JAK2/STAT3 signaling pathway.Results Compared with Control group,the lung tissue of rats in the Model group showed severe damage and higher levels of inflammatory cell infiltration,the PEF,Cdyn,and FEV/FVC indexes were greatly decreased,the numbers of inflammatory cells(WBC,EOS,NEU,LYM),levels of inflammatory factors(IL-1β,TNF-α,and IL-6)in BALF and serum,and the expression levels of signaling pathway proteins(IL-6,p-JAK2/JAK2,p-STAT3/STAT3)were obviously increased(P＜0.05).Compared with the Model group,with the increase of ASP dosage,the degree of lung tissue damage and inflammatory cell infiltration of rats in the ASP-L,ASP-M,and ASP-H groups were significantly reduced,the PEF,Cdyn,and FEV/FVC indexes were gradually increased,the numbers of inflammatory cells(WBC,EOS,NEU,LYM),levels of inflammatory factors(IL-1β,TNF-α,and IL-6)in BALF and serum,and the expression levels of signaling pathway proteins(IL-6,p-JAK2/JAK2,p-STAT3/STAT3)were gradually decreased(P＜0.05).Compared with the ASP-H group,the lung tissue of rats in the ASP-H+CA1 group showed severe damage,the infiltration of inflammatory cells increased,the PEF,Cdyn,and FEV/FVC indexes were decreased,the numbers of inflammatory cells(WBC,EOS,NEU,LYM),levels of inflammatory factors(IL-1β,TNF-α,and IL-6)in BALF and serum,and the expression levels of signaling pathway proteins(IL-6,p-JAK2/JAK2,p-STAT3/STAT3)were greatly increased(P＜0.05).Conclusion Asperuloside can improve lung tissue damage,reduce inflammation levels,and improve lung ventilation function in rats with bronchial asthma.Its effect may be related to the regulation of the IL-6/JAK2/STAT3 signaling pathway.

Objective:To evaluate the role of microglial hypoxia-inducible factor-3α (HIF-3α) in cognitive impairment after hemorrhagic shock and resuscitation(HSR) and the relationship with neuronal ferroptosis in mice.Methods:Twenty-four specific pathogen-free healthy male C57BL/6 mice, aged 10 weeks, weighing 25-30 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (Sham group), HSR group, and HSR+ ferroptosis inhibitor (ferrostatin-1) group (HSR+ Fer-1 group). Sixteen C57BL/6 mice and 16 HIF-3α flox/flox: Cx3crl Cre (HIF-3α CKO) mice were selected and assigned to 2 groups ( n=8 each) using a random number table method: sham operation group (WT-Sham group, HIF-3α CKO-Sham group) and HSR group (WT-HSR group, HIF-3α CKO-HSR group). To establish the HSR model, 40% of the total blood volume was withdrawn at a steady rate via the right carotid artery within 30 min and 1 h later reinfused through the jugular vein over a period of 30 min. Ferrostatin-1 10 mg/kg was nasally administered once mice recovered after HSR in HSR+ Fer-1 group. The cognitive function was evaluated by the novel object recognition test at 72 h after developing the model. The hippocampal tissues were collected under deep anesthesia after evaluation for determination of the expression of glutathione peroxidase 4 (GPX4) and ferritin heavy chain 1 (FTH1) in the ipsilateral hippocampi (by Western blot) and expression of microglial HIF-3α and GPX4 and FTH1 in neurons in the hippocampal CA3 region (by immunofluorescence staining) and for examination of the ultrastructure of mitochondria in hippocampal neurons (with a transmission electron microscope). Results:Compared to Sham group, the cognitive and discrimination indexes were significantly decreased, and the expression of GPX4 and FTH1 was down-regulated in HSR group ( P<0.05). Compared to HSR group, the cognitive and discrimination indexes were significantly increased, and the expression of GPX4 and FTH1 in the hippocampi was up-regulated in HSR+ Fer-1 group ( P<0.05). Compared to WT-Sham group, the cognitive and discrimination indexes were significantly decreased, and the expression of microglial HIF-3α in the hippocampal CA3 region was up-regulated, and the expression of neuronal GPX4 and FTH1 was down-regulated in WT-HSR group ( P<0.05), and no statistically significant change was found in the aforementioned parameters in HIF-3α CKO-Sham group ( P>0.05). Compared to WT-HSR group, the cognitive and discrimination indexes were significantly increased, and the expression of microglial HIF-3α in the hippocampal CA3 region was down-regulated, the expression of GPX4 and FTH1 was up-regulated ( P<0.05), and mitochondrial damage in the neurons was significantly attenuated in HIF-3α CKO-HSR group. Conclusions:Microglial HIF-3α-mediated ferroptosis in hippocampal neurons is involved in cognitive impairment following HSR in mice.

Objective:To investigate the effect of Yiqi Shengqing Formula on neuronal damage in ischemic stroke(IS)rats by regulating brain-derived neurotrophic factor(BDNF)-extracellular regulated protein kinase(ERK)-cyclic adenosine monophosphate-responsive element binding protein(CREB)signal pathway.Methods:IS rat model was prepared by modified thread suppository method,and randomly divided into model group,low dose Yiqi Shengqing Formula(3 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)+empty load group,high dose Yiqi Shengqing Formula(6 g/kg)+BDNF knockdown group,with 10 rats in each group,another 10 healthy rats were set as sham operation group.After intervention with Yiqi Shengqing Formula and plasmid,neural function of rats in each group was scored with Longa scoring method;Morris water maze test was used to detect cognitive impairment of rats in each group;Nissl staining was used to detect the number of neurons in ischemic peripheral brain tissue and hippocampus of rats in each group;synaptic morphology of ischemic peripheral brain tissue was detected by silver staining;levels of TNF-α and IL-8 in brain tissue and serum of rats in each group were measured by ELISA;expressions of BDNF-ERK-CREB signal pathway related proteins in rat brain were detected by Western blot.Results:Compared with sham operation group,synaptic morphology of ischemic peripheral brain tissue in model group was severely damaged,retention time in target quad-rant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased significantly(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased significantly(P<0.05).Compared with model group,synaptic morphological damage of ischemic peripheral brain tissue in rats in low dose Yiqi Shengqing Formula group and high dose Yiqi Shengqing Formula group was alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were decreased(P<0.05).Compared with low dose Yiqi Shengqing Formula group,damage of synaptic morphology in ischemic peripheral brain tissue of rats in high dose Yiqi Shengqing Formula group was further alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were further increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were further reduced(P<0.05).Compared with high dose Yiqi Shengqing Formula group,synaptic morphological damage of ischemic peripheral brain tissue in high dose Yiqi Shengqing Formula+BDNF knockdown group was aggravated,retention time in target quadrant,times of crossing the platform,number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased(P<0.05);there was no significant changes in each index of rats in high dose Yiqi Shengqing Formula+empty load group(P>0.05).Conclusion:Yiqi Shengqing Formula can inhibit the neuroinflammation of IS rats by activating BDNF-ERK-CREB signal,thereby reducing the damage of its neurons and improving its neural function.

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

[Objective] To investigate the implementation of emergency transfusion strategy of uncrossmatched type O suspended RBCs based on the single-center clinical practice, which is "emergency transfusion is initiated by the authorized doctor of the emergency department, and no more than 4 U of type O uncrossmatched suspended RBCs are issued within 15 minutes in the transfusion department"(referred as the Practice), so as to provide reference for blood management. [Methods] A retrospective analysis of the information of patients who received uncrossmatched type O suspended RBCs in West China Hospital of Sichuan University from August 2019 to April 2024 was conducted. The analysis included reasons for emergency blood transfusion, time of receiving transfusion application and blood distribution, total bilirubin, indirect bilirubin, lactate dehydrogenase before and after transfusion, blood group of patients, and disease outcome. [Results] From August 2019 to April 2024, 39 cases applied for emergency transfusion of type O suspended RBCs, and a total of 90 U uncrossmatched suspended RBCs were transfused. All patients were Rh(D) positive, including 14 cases of blood group A, 6 cases of blood group B, 16 cases of blood group O, 2 cases of blood group AB, one case of undetermined blood group, and 2 cases with positive antibody screening. The main cause of emergency transfusion of type O suspended RBCs was traffic accident, accounting for 46% (18/39), with a mortality rate at 51.28% (20/39). The cause of death was primary injury, and no adverse reactions were reported. There was no significant difference in total bilirubin (TBIL), indirect bilirubin (IBIL) and lactate dehydrogenase (LDH) before and after blood transfusion (P>0.05). The median duration from admission to receiving transfusion application was 30.20 minutes, and 5.30 minutes from receipt of the application to blood distribution. [Conclusion] The single-center based Practice is safe, but there is room for optimization before the link of blood transfusion application sent to the transfusion department when applying for emergency transfusion of type O suspended RBCs.