A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

Objective:To explore the developmental trajectory and influencing factors of kinesiophobia in patients undergoing percutaneous coronary intervention (PCI) .Methods:By convenient sampling, totally 217 patients undergoing PCI who enrolled from two tertiary hospitals in Guangdong Province from March 2022 to July 2023. The demographic data of the patients was collected , and kinesiophobia was measured using the Tampa scale for kinesiophobia heart(TSK-SV-Heart) at one day pre-discharge, 2 weeks, 1 month, and 4 months post-discharge. Data analysis was conducted using SPSS 25.0 and Mplus 8.7 softwares. Growth mixture modelling, chi-square test, and polynomial Logistic regression were used for data processing and analysis.Results:Three different kinesiophobia trajectory classes were identified in patients within 4 months after PCI: sustained high level of kinesiophobia group (C1 group, 22.6%(49/217)), moderate level of kinesiophobia with a rapid decrease group (C2 group, 47.4%(103/217)), and rapid decrease of kinesiophobia followed an increase group (C3 group, 30.0%(65/217)). Polynomial Logistic regression results showed that, females ( B=1.136, OR=3.113, 95% CI=1.155-8.389) , patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=1.135, OR=3.112, 95% CI=1.380-7.017) were more likely to develop into the C1 compared with the C2 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=3.322, OR=27.712, 95% CI=5.251-146.244), and patients with coronary heart disease(CHD) more than two years ( B=3.855, OR=47.250, 95% CI=2.146-1 040.535)were more likely to develop into the C1 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=-2.187, OR=0.112, 95% CI=0.022-0.565), patients with three or more comorbidities ( B=-2.711, OR=0.066, 95% CI=0.008-0.528), and patients with CHD more than two years ( B=-2.376, OR=0.093, 95% CI=0.011-0.783) were more likely to develop into the C2 group. Conclusion:Kinesiophobia level in patients undergoing PCI presents a curvilinear decrease within 4 months after PCI.Different kinesiophobia trajectory classes can be observed. Sex, NYHA/Killip class, course of CHD, and comorbidity affect the development trajectory of different subgroups.

Objective:To explore the developmental trajectory and influencing factors of kinesiophobia in patients undergoing percutaneous coronary intervention (PCI) .Methods:By convenient sampling, totally 217 patients undergoing PCI who enrolled from two tertiary hospitals in Guangdong Province from March 2022 to July 2023. The demographic data of the patients was collected , and kinesiophobia was measured using the Tampa scale for kinesiophobia heart(TSK-SV-Heart) at one day pre-discharge, 2 weeks, 1 month, and 4 months post-discharge. Data analysis was conducted using SPSS 25.0 and Mplus 8.7 softwares. Growth mixture modelling, chi-square test, and polynomial Logistic regression were used for data processing and analysis.Results:Three different kinesiophobia trajectory classes were identified in patients within 4 months after PCI: sustained high level of kinesiophobia group (C1 group, 22.6%(49/217)), moderate level of kinesiophobia with a rapid decrease group (C2 group, 47.4%(103/217)), and rapid decrease of kinesiophobia followed an increase group (C3 group, 30.0%(65/217)). Polynomial Logistic regression results showed that, females ( B=1.136, OR=3.113, 95% CI=1.155-8.389) , patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=1.135, OR=3.112, 95% CI=1.380-7.017) were more likely to develop into the C1 compared with the C2 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=3.322, OR=27.712, 95% CI=5.251-146.244), and patients with coronary heart disease(CHD) more than two years ( B=3.855, OR=47.250, 95% CI=2.146-1 040.535)were more likely to develop into the C1 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=-2.187, OR=0.112, 95% CI=0.022-0.565), patients with three or more comorbidities ( B=-2.711, OR=0.066, 95% CI=0.008-0.528), and patients with CHD more than two years ( B=-2.376, OR=0.093, 95% CI=0.011-0.783) were more likely to develop into the C2 group. Conclusion:Kinesiophobia level in patients undergoing PCI presents a curvilinear decrease within 4 months after PCI.Different kinesiophobia trajectory classes can be observed. Sex, NYHA/Killip class, course of CHD, and comorbidity affect the development trajectory of different subgroups.

A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

Hemorrhagic shock (HS) is one of the leading causes of death among young adults worldwide. Multiple organ dysfunction in HS is caused by an imbalance between tissue oxygen supply and demand, which is closely related to the poor prognosis of patient. Mitochondrial dysfunction is one of the key mechanisms contributing to multiple organ dysfunction in HS, while mitochondrial quality control regulates mitochondrial function through a series of processes, including mitochondrial biogenesis, mitochondrial dynamics, mitophagy, mitochondrial-derived vesicles, and mitochondrial protein homeostasis. Modulating mitochondrial quality control can improve organ dysfunction. This review aims to summarize the effects of mitochondrial dysfunction on organ function in HS and discuss the potential mechanisms of mitochondrial quality control, providing insights into the injury mechanisms underlying HS and guiding clinical management.

Objective To analyze the current situation and latent profiles of nurses'voice behavior in nurses,and explore the influencing factors of different types.Methods Through convenience sampling,812 nurses who worked in tertiary hospitals from 5 cities in Guangdong Province during April 2022 to June 2022 were recruited.The demographic questionnaire,the Voice Behavior Scale,the Humble Leadership Scale,and the Team Psychological Safety Climate Scale were used for investigation.Latent profile analysis was used to explore the latent profiles of nurses'voice behavior.The influencing factors of latent profiles were identified by multivariate Logistic regression.Results The total score of the voice behavior in 812 nurses is(37.04±5.88).Voice behaviors in nurses is divided into 3 latent classes,namely"conservation group"(27.83％),"balanced-risky group"(61.95％),and"the challenge group"(10.22％).The influencing factors include recruitment type,whether to assist in department management,humble leadership,team psychological safety climate(all P＜0.05).Conclusion The level of nurses'voice behavior is upper medium with heterogeneity,which can be divided into 3 latent profiles.Nurses managers should focus on nurses with conservation group and balanced-risky group and conduct early targeted prevention and care according to characteristics and influencing factors of different latent profile.

Objective: To understand the prevalence of Lying Flat behaviors and its association with depressive symptoms among Chinese college students, so as to provide a scientific basis for promoting the physical and mental health development of adolescents. Methods: From July to October 2023, three universities were selected through convenient sampling from Jiangxi Province, Liaoning Province and Beijing City, respectively. Selfdesigned questionnaire links were distributed on campus to collect basic information and Lying Flat behaviors among college students, and the Patient Health Questionnaire-9 (PHQ-9) was utilized to screen for students with depressive symptoms. Finally, a total of 4 225 valid questionnaires were obtained. Chisquare was used to compare of report rates of Lying Flat behaviors across different demographic characteristics. Ordered Logistic regression analysis was used to explore the association between Lying Flat behaviors and depressive symptoms, with Z test used to assess variations in the strength of associations. Results: The reporting rates of academic, life, and social Lying Flat were 32.7%, 17.8% and 17.5%, respectively. And 6.7% of the participants were found of all three Lying Flat behaviors simultaneously.Among college students with three Lying Flat behaviors, the constituent ratios of no, mild, moderate and above depressive symptoms were 9.9%, 30.5% and 59.6%, respectively. Additionally, college students who had three Lying Flat behaviors were more likely to show mild, moderate and above depressive symptoms [OR(95%CI)=2.49(1.60-3.87), 7.69(5.01-11.79), P<0.01]. Conclusions Academic Lying Flat behavior is most prevalent among college students. Academic, life and social Lying Flat behaviors are all significantly positively correlated with depressive symptoms. Attention should be paid to the Lying Flat behaviors and college students psychological health conditions to promote their physical and mental health development.

OBJECTIVE To explore the effect of Xuanbai Chengqi Decoction on respiratory and oxygenation functions and the ex-pression levels of serum aquaporin(AQP)1 and AQP5 in patients with severe pneumonia complicated with gastrointestinal dysfunction of lung heat and fu-organ repletion type.METHODS 60 patients with severe pneumonia complicated with gastrointestinal dysfunc-tion of lung heat and fu-organ repletion type were randomly divided into control group and treatment group,with 30 cases each.The control group received standardized Western medicine treatment,and the treatment group was treated with Xuanbai Chengqi Decoction in addition to the control group.Both groups were treated for 7 d.The respiratory rate and oxygenation index,mechanical ventilation u-tilization rate,the clinical score including CURB-65 and CPIS scores,TCM syndrome score,gastrointestinal function indicators inclu-ding intra-abdominal pressure,serum gastrin(GAS)and vasoactive intestinal peptide(VIP),AQP1 and AQP5 levels were compared between the two groups before and after treatment.Ventilation utilization and ICU hospitalization days during treatment were compared between the two groups.RESULTS After treatment,compared with the control group,the respiratory rate,TCM syndrome score and intra-abdominal pressure in the treatment group were decreased significantly(P<0.05,P<0.01);meanwhile,the oxygenation index and the levels of serum GAS,AQP1 and AQP5 were increased significantly(P<0.05,P<0.01).CONCLUSION Xuanbai Chengqi Decoction can significantly improve clinical symptoms such as respiratory and oxygenation functions in patients,and its mechanism may be related to the regulation of AQP1 and AQP5.

Acute and chronic wounds seriously threaten patients' life health and quality of life, therefore, wound repair has become a hot topic of research for scholars at home and abroad in recent years. With the development of material science and tissue engineering, more and more biomaterials prepared from natural ingredients were used in basic research and clinical treatment of wound repair. Such biomaterials can be used as templates for wound tissue regeneration to induce autologous cell adhesion and migration, and promote the deposition of extracellular matrix, which have broad clinical application prospects. This paper reviews the characteristics and application advance of natural biomaterials which are popular in the field of wound repair, aiming to provide ideas for the research and development of new wound dressing and tissue engineering skin.

Objective:Human leukocyte antigen(HLA)B27 is a susceptibility allele of ankylosing spondylitis(AS),and HLA-B27 antigen typing is an important indicator for clinical diagnosis of AS,but current typing methods such as sequence specific primer polymerase chain reaction(PCR-SSP)still possess limitation.Therefore,this study aims to analyze the correlation between B27 subtypes and susceptibility to AS in Hunan Province by applying high-resolution polymerase chain reaction-sequence-based typing(PCR-SBT). Methods:Peripheral blood of 116 patients with suspected AS(suspected AS group)and 121 healthy volunteers(control group)admitted to the Second Xiangya Hospital from January 2020 to December 2020 were collected for HLA-B genotyping by PCR-SBT.Among the patients in the suspected AS group,23 patients were finally diagnosed with AS(confirmed AS group),and the remaining 93 undiagnosed patients served as the non-confirmed AS group.PCR-SBT and PCR-SSP were used to detect HLA-B27 typing in 116 patients with suspected AS,and the results of the 2 methods were compared. Results:The HLA-B27 allele frequency in the suspected AS group was significantly higher than that in the control group[11.63%vs 2.48%;P<0.001,odds ratio(OR)=5.18,95%confidence interval(CI)2.097 to 12.795].B*27:04,B*27:05,B*27:06,and B*27:07 were detected in the suspected AS group and the control group.The frequency of the B*27:04 allele in the suspected AS group was significantly higher than that in the control group(9.48%vs 1.24%;P<0.001,OR=8.346,95%CI 2.463 to 28.282).The positive rate of B27 in the suspected AS group and the confirmed AS group(B27+/+ and B27+/-)was significantly higher than that in the control group(χ2=16.579,P<0.001;χ2=94.582,P<0.001,respectively).Among the confirmed AS group,21 were HLA-B27 carriers,and the B27 positive rate in the confirmed AS group was 91.3%.PCR-SBT could achieve high resolution typing of the HLA-B gene locus,with higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy than PCR-SSP. Conclusion:PCR-SBT typing analysis shows a strong correlation between HLA-B * 27:04 and AS in Hunan province.The PCR-SBT method can be used as the preferred option for the auxiliary diagnosis of clinical AS.