ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction （祛风通窍止咳方， QTCD） in the treatment of upper airway cough syndrome （UACS）. MethodsTwenty-four guinea pigs were randomly divided into blank group， model group， traditional Chinese medicine （TCM） group， and inhibitor group， with six guinea pigs in each group. Except for the blank group， guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection， followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling， the TCM group was administered QTCD 0.9 g/（100 g·d） by gavage， the inhibitor group received the transient receptor potential vanilloid receptor 4 （TRPV4） inhibitor GSK2193874 1 mmol/L， 5 min by nebulisation， and the blank group and model group were given 2 ml/（100 g·d） normal saline by gavage once daily. After 7 days of treatment， a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines， including interleukin-6 （IL-6）， interleukin-8 （IL-8） in serum， bronchoalveolar lavage fluid （BALF）， and nasal lavage fluid （NLF） were detected by enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the protein levels of TRPV4， substance P （SP）， and calcitonin gene-related peptide （CGRP） in lung and nasal mucosal tissues. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRPV4， SP， and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group， while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group， the model group showed increased cough frequency， serum IgE level， and IL-6 and IL-8 levels in serum， BALF， and NLF. The protein levels of TRPV4， SP， and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated （P＜0.05 or P＜0.01）. Compared with the model group， the TCM group and inhibitor group showed reduced cough frequency， serum IgE level， and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， reduced IL-6 in BALF， reduced IL-8 in NLF， and decreased TRPV4， SP， and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues （P＜0.05 or P＜0.01）. Compared with the TCM group， the inhibitor group had increased serum IgE， IL-6， and IL-8 levels， increased IL-6 level in BALF， and increased IL-8 levle in NLF， but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues （P＜0.01）. ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway， improving airway neurogenic inflammation， alleviating inflammatory responses， and reducing cough hypersensitivity.

Objective: To investigate the prevalence and influencing factors of depression among middle school students in Jiading District, Shanghai Municipality, so as to provide the evidence for developing mental health intervention strategies among middle school students. Methods: Students from 3 junior high schools and 3 senior high schools in Jiading District were selected from June 2022 to June 2023 using a stratified random cluster sampling method. Basic information including gender and educational stage was collected through questionnaire surveys. Depression, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction were assessed using the Children's Depression Inventory, the Mental Health Literacy Assessment Scale, the Chinese version of the Cognitive Emotion Regulation Questionnaire, the Family Adaptability and Cohesion Scale, the Perceived School Climate Scale, Depression-Anxiety-Stress Scale, and the Life Satisfaction Scale, respectively. Factors affecting depression among middle school students were analyzed using a multivariable logistic regression model. Results: There were 1 117 boys (53.94%) and 954 girls (46.06%), with a mean age of (15.20±1.77) years. There were 1 193 (57.61%) junior high school students and 878 (42.39%) senior high school students. Depression was detected in 577 students, with a prevalence of 27.86%. Multivariable logistic regression analysis identified gender (boy, OR=0.652, 95%CI: 0.512-0.832), educational stage (senior high school, OR=2.519, 95%CI: 1.584-4.008), mental health literacy (OR=0.958, 95%CI: 0.951-0.966), cognitive emotion regulation (adaptive cognitive emotion regulation strategies, OR=0.970, 95%CI: 0.958-0.982; maladaptive cognitive emotion regulation strategies, OR=1.103, 95%CI: 1.084-1.123), family cohesion (OR=0.910, 95%CI: 0.899-0.921), school climate (OR=0.720, 95%CI: 0.694-0.747), stress (OR=1.127, 95%CI: 1.104-1.150), life satisfaction (OR=0.817, 95%CI: 0.799-0.836) as factors affecting depression among middle school students. Conclusions Depression among middle school students in Jiading District is associated with gender, educational stage, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction. It is recommended that targeted measures be taken from the perspectives of individuals, families, schools, and society to promote the mental health of middle school students.

BACKGROUND: G protein-coupled receptor kinase 2 (GRK2) could participate in the regulation of diverse cells via interacting with non-G-protein-coupled receptors. In the present work, we explored how paroxetine, a GRK2 inhibitor, modulates the differentiation and activation of immune cells in rheumatoid arthritis (RA). METHODS: The blood samples of healthy individuals and RA patients were collected between July 2021 and March 2022 from the First Affiliated Hospital of Anhui Medical University. C57BL/6 mice were used to induce the collagen-induced arthritis (CIA) model. Flow cytometry analysis was used to characterize the differentiation and function of dendritic cells (DCs)/T cells. Co-immunoprecipitation was used to explore the specific molecular mechanism. RESULTS: In patients with RA, high expression of GRK2 in peripheral blood lymphocytes, accompanied by the increases of phosphatidylinositol 3 kinase (PI3K), protein kinase B (AKT), and mammalian target of rapamycin (mTOR). In animal model, a decrease in regulatory T cells (T regs ), an increase in the cluster of differentiation 8 positive (CD8 + ) T cells, and maturation of DCs were observed. Paroxetine, when used in vitro and in CIA mice, restrained the maturation of DCs and the differentiation of CD8 + T cells, and induced the proportion of T regs . Paroxetine inhibited the secretion of pro-inflammatory cytokines, the expression of C-C motif chemokine receptor 7 in DCs and T cells. Simultaneously, paroxetine upregulated the expression of programmed death ligand 1, and anti-inflammatory cytokines. Additionally, paroxetine inhibited the PI3K-AKT-mTOR metabolic pathway in both DCs and T cells. This was associated with a reduction in mitochondrial membrane potential and changes in the utilization of glucose and lipids, particularly in DCs. Paroxetine reversed PI3K-AKT pathway activation induced by 740 Y-P (a PI3K agonist) through inhibiting the interaction between GRK2 and PI3K in DCs and T cells. CONCLUSION Paroxetine exerts an immunosuppressive effect by targeting GRK2, which subsequently inhibits the metabolism-related PI3K-AKT-mTOR pathway of DCs and T cells in RA.
G-Protein-Coupled Receptor Kinase 2/metabolism* ; Arthritis, Rheumatoid/immunology* ; Animals ; Dendritic Cells/metabolism* ; Paroxetine/therapeutic use* ; Proto-Oncogene Proteins c-akt/metabolism* ; Mice ; Humans ; Mice, Inbred C57BL ; Signal Transduction/drug effects* ; Male ; Phosphatidylinositol 3-Kinases/metabolism* ; Lymphocyte Activation/drug effects* ; Female ; T-Lymphocytes/metabolism* ; Middle Aged

Neurodegenerative disorders (NDDs) are prevalent chronic conditions characterized by progressive synaptic loss and pathological protein alterations. Increasing evidence suggested that mitochondrial quality control (MQC) serves as the key cellular process responsible for clearing misfolded proteins and impaired mitochondria. Herein, we provided a comprehensive analysis of the mechanisms through which MQC mediates the onset and progression of NDDs, emphasizing mitochondrial dynamic stability, the clearance of damaged mitochondria, and the generation of new mitochondria. In addition, traditional Chinese medicines (TCMs) and their active monomers targeting MQC in NDD treatment have been demonstrated. Consequently, we compiled the TCMs that show great potential in the treatment of NDDs by targeting MQC, aiming to offer novel insights and a scientific foundation for the use of MQC stabilizers in NDD prevention and treatment.

Objective This essay excavates the contents of urinary diagnosis in the Four Tantras and visualize the invisible experience knowledge of urinary diagnosis of Jenesake disease(type II diabetes)based on clinical medical records.It also explores the digitization and visualization of original thinking of Tibetan medicine,clinical diagnosis and treatment and modern science and technology,and clinical invisible experience and knowledge.Methods The contents of urinary diagnosis in the Four Tantras were deeply explored by literature method.And 355 cases of Jenesake disease c were analyzed by Gephi,Spsspro,traditional Chinese medicine inheritance computing platform and other software.Results Urology in Tibetan medicine has a long history,with a development period of one thousand years and has a systematic and complete theoretical system.The three-times and nine-diagnosis method of urinary in Tibetan medicine recorded in the Four Tantras is unique and plays an important role in the diagnosis of clinical diseases.According to the analysis of 355 clinical cases of Jenesake disease,urine diagnosis was slightly different according to different syndrome types,the overall color was light yellow,cyan,yellow,relatively bright,close to normal urine color.Steam and smell are big;The foam is bluish and large or dissipates quickly;Few or hairy suspensions;The float is thin;Change time for the hot gas is not finished began to change;The pattern of change from the thin middle to the edge;Cyclotron condition from thin to thick and other characteristics.The frequency analysis of urinary diagnosis syndromes showed that 139 cases of Chiba type,91 cases of lung type,88 cases of bacon type and 34 cases of Pechi type.Conclusion Urology in Tibetan medicine has a complete theoretical system and rich experience in clinical practice.Through the method of combining literature mining and clinical medical cases,this paper expands the contents of the three-time and nine-time urine diagnosis of Jenesake disease in Tibetan medicine and combines the original thinking of Tibetan medicine with modern information technology to realize the visualization of the invisible experience knowledge of Jenesake disease urine diagnosis in Tibetan medicine.

Objective:To analyze the clinical characteristics, treatment methods, and efficacy of hemorrhagic supratentorial deep brain arteriovenous malformation(BAVM) in children.Methods:Clinical data of 12 pediatric patients with hemorrhagic supratentorial deep BAVM diagnosed and treated in the Department of Neurosurgery, Children′s Hospital of Nanjing Medical University from May 2020 to January 2023 were retrospectively analyzed.Among them, there were 7 males and 5 females, aged range from 4.8 to 14.1(9.6±3.2) years old.On the day of onset, the children underwent lateral external ventricular drainage, combined surgery, evacuation of intracranial hematoma, or medication to reduce intracranial pressure, based on the location of intracranial hemorrhage, degree of neurological dysfunction, and angioarchitecture of BAVM.Afterwards, the patients were given embolization with stable physical signs.The data of 12 patients were analyzed retrospectively, including clinical manifestations, imaging features, and treatment outcomes.Results:All 12 children started with intracranial hemorrhage.Digital subtraction angiography confirmed the diagnosis of deep BAVM, with 6 cases having the niduses in the splenium of the corpus callosum, 3 cases in the body of the corpus callosum, 2 cases in the basal ganglia area, and 1 case in the thalamus.Ten children had an intracranial hemorrhage in the lateral ventricle.Among them, 6 children underwent lateral external ventricular drainage on the day of onset and then were given BAVM embolization 7-14 days after onset; 1 patient experienced intraoperative bleeding, but showed no neurological dysfunction after surgery; 1 patient experienced temporary facial numbness; 1 patient with massive hemorrhages in the occipital lobe and lateral ventricle underwent combined surgery to embolize the BAVM and remove intracranial hematoma on the first day of onset; 1 patient suffered from basal ganglia hemorrhage with lateral intraventricular hemorrhage, and evacuation of intracranial hematoma was performed on the day of onset, and BAVM embolization was performed 7 days after surgery.Three months after combined surgery and embolization and 3 years after gamma knife treatment, the digital subtraction angiography was re-performed, and results showed that 5 cases, including 1 child undergoing combined surgery, was cured through a single interventional embolization, and 1 case was cured by a single embolization combined with gamma knife treatment.Conclusions:Intracranial hemorrhage caused by deep BAVM in children is mainly located in the lateral ventricle.In the acute phase, the main focus is on treating intracranial hypertension caused by obstructive hydrocephalus and intracranial parenchymal hematoma.Interventional embolization is safe and effective in the treatment of deep BAVM in children.

Objective:To compare the short-term efficacy of Kamikawa anastomosis and double-tract reconstruction (DTR) after proximal gastrectomy.Methods:This was a propensity score matched, retrospective, cohort study. Inclusion criteria comprised age 20–70 years, diagnosis of gastric cancer by pathological examination of preoperative endoscopic biopsies, tumor diameter ≤4 cm, and location in the upper 1/3 of the stomach (including the gastroesophageal junction), and TNM stage IA, IB, or IIA. The study cohort comprised 73 patients who had undergone laparoscopic proximal gastric cancer radical surgery in the Department of Gastroenterology, Tangdu Hospital, Air Force Medical University between June 2020 and February 2023, 19 of whom were in the Kamikawa group and 54 in the DTR group. After using R language to match the baseline characteristics of patients in a ratio of 1:2, there were 17 patients in the Kamikawa group and 34 in the DTR group. Surgery-related conditions, postoperative quality of life, and postoperative complications were compared between the two groups.Results:After propensity score matching, there were no statistically significant differences in baseline data between the two groups ( P>0.05). Compared with the DTR group, the Kamikawa group had longer operative times (321.5±15.7 minutes vs. 296.8±26.1 minutes, t=32.056, P<0.001), longer anastomosis times (93.0±6.8 minutes vs. 45.3±7.7 minutes, t=56.303, P<0.001), and less bleeding (76 [54~103] mL vs.112 [82~148) mL, Z=71.536, P<0.001); these differences are statistically significant. There were no statistically significant differences between the two groups in tumor size, time to first postoperative passage of gas, postoperative hospital stay, number of lymph nodes removed, duration of lymph node dissection, or total hospitalization cost (all P>0.05). The median follow-up time was 6.1 ± 1.8 months. As to postoperative quality of life, the Kamikawa group had a lower rate of upper gastrointestinal contrast reflux than did the DTR group (0 vs. 29.4% [10/34], χ 2=6.220, P=0.013); this difference is statistically significant. However, differences between the two groups in quality of life score on follow-up of 3 months and 6 months on the Gastroesophageal Reflux Disease (GERD) scale were not statistically significant (all P>0.05). The incidence of postoperative complications was 2/17 in the Kamikawa group, which is significantly lower than the 41.2% (14/34) in the DTR group (χ 2=4.554, P=0.033). Conclusion:Kamikawa anastomosis and DTR are equally safe and effective procedures for reconstructing the digestive tract after proximal gastric surgery. Although Kamikawa anastomosis takes slightly longer and places higher demands on the surgical team, it is more effective at preventing postoperative reflux.

The application of proximal gastrectomy for suitable upper gastric cancer and AEG patients is increasing along with the promotion of the concept and technology for function-preserving partial gastrectomy. The following problems such as postoperative reflux esophagitis and anastomotic stenosis naturally become the focus of academic field. Based on the understanding of the anti-reflux structure and function of the esophagogastric junction, scholars have successfully established some representative esophagogastric anastomosis methods with additional mechanical anti-reflux barrier, including gastric tube reconstruction, side overlap esophagogastrostomy, and double flap technique. Subsequently, a series of improved esophagogastric reconstruction methods have been derived. At present, the recognized ideal reconstruction method has not yet been established, and there are also misunderstandings in related concepts and cognition. Based on the literatures and the authors' own practical experience, this paper draws on the research results in the field of surgical treatment for reflux esophagitis, and discusses the theoretical basis, key details and anti-reflux effect of the above-mentioned digestive tract reconstruction methods after proximal gastrectomy, as well as the possible problems in the exploration of innovative surgical methods at home and abroad.

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

Objective:To establish the objective of zero inventory management of in vitro diagnostic reagents,to evaluate the quality of supply chain,and to improve the existing problems in the supply of reagents.Methods:The problems existing in the management of in vitro diagnostic reagents were analyzed from the aspects of inventory,supply efficiency and product quality,and the management system of hospital operation,management quality and patient benefit optimization was established,and the zero-inventory management path and quality evaluation model were constructed.85 models of 21 types of in vitro diagnostic reagents purchased by Jiangsu Subei People's Hospital from January 2020 to March 2023 were selected.According to different supply chain quality management methods,on-demand inventory management mode(referred to as mode 1)and zero inventory management mode(referred to as mode 2)were adopted respectively.The demand procurement,inventory management and clinical use effects of the two management modes were compared.Results:The reagent procurement demand compliance rate,supply capacity high-quality quality rate and clinical use matching rate of mode 2 were(93.35±3.62)%,(94.87±2.63)% and(96.08±2.31)%,respectively,which were higher than those of mode 1,the difference was statistically significant(Z=2.489,2.836,2.838,P<0.05).The number of cases of long-term overstocking of products,substandard environment and untimely information in mode 2 were(2.92±2.54)cases,(2.83±1.59)cases and(5.58±3.12)cases,respectively,which were lower than those in mode 1,the difference was statistically significant(Z=2.959,3.037,3.703,P<0.05).The satisfaction of clinical departments,medical technology departments and procurement center with the supply,distribution and information communication of in vitro diagnostic reagents in mode 2 were 97.8% and 93.3%,97.0% and 87.9%,100% and 84.6%,respectively,which were higher than those in mode 1,the difference was statistically significant(x2clinical departments=5.428,6.133,x2medical technology departments=3.958,3.937,x2procurement center=5.159,4.996,P<0.05).Conclusion:The zero inventory management model can improve the standardization of in vitro diagnostic reagent demand procurement,reduce the incidence of backlog failure in inventory management,and improve the quality of clinical supply services.