This study aims to evaluate the preventive effect of the exogenous protein chIFN-γ-chCD154 against Salmonella typhimurium(S.typhimurium)infection in White Leghorn chick-ens,and the potential mechanism.In this study,Escherichia coli was used to express the proteins chIFN-γ,chCD154 and chIFN-γ-chCD154.Before S.typhimurium infection,the White Leghorn chickens were pre-immunized via drinking water for three consecutive days,and infected with S.typhimurium by gavage.The results from Western blot,quantitative real-time PCR(qRT-PCR)analysis and histopathology analysis showed that compared to chIFN-γ and chCD154,chIFN-γ-chCD154 pre-treatment could synergistically increase the survival rate of infected chickens,reduce the bacterial load in the liver and cecum,and attenuate the pathological damage of liver and cecum.Moreover,chIFN-γ-chCD154 significantly decreased the mRNA expression of Toll-like receptor-4(TLR-4)and myeloid differentiation primary response gene 88(MyD88)in the cecum,and then inhibited the mRNA expression of NF-κB and pro-inflammatory cytokines(TNF-α and IL-6),and maintained the integrity of the intestinal tight junction proteins(zo-1,claudin-1,occlu-din).Compared with single protein pretreatment,chIFN-γ-chCD154 pretreatment significantly up-regulated the mRNA expression of the genes related to the vitamin D(VD)pathway(cyp27b1,VD receptor VDR,antimicrobial peptide AvBD7 and cathelicidin-b1)in S.typhimurium-infected peripheral blood mononuclear cells(PBMCs).The results of colony counting showed that the num-ber of S.typhimurium in the chIFN-γ-chCD154 group were the lowest.Also,chIFN-γ-chCD154 could up-regulate the relative abundance of beneficial bacteria such as Blautia,Ruminococcus,En-terococcus and Faecalibacterium,while down-regulate the relative abundance of harmful bacteria such as Staphylococcaceae in the cecum and improve the intestinal dysbiosis.In conclusion,chIFN-γ-chCD154 could activate the VD-antimicrobial peptide pathway and inhibit the TLR-4/MyD88/NF-κB inflammatory signaling pathway in S.typhimurium-infected chickens,which significantly improve the intestinal barrier function,reduce the inflammatory damage of liver and cecum,im-prove the structure of cecum microbial,promote the health of intestinal tract,and provide theoreti-cal basis for the development of chIFN-γ-chCD154 as a safe and effective alternative antibiotic.

Objective To explore the effect of artificial pleural effusion combined with radiofrequency ablation in patients with phrenic top liver cancer.Methods A total of 92 patients with liver tumors at top of the diaphragm were prospectively selected and divided into the control group(46 cases,radiofrequency ablation)and the observation group(46 cases,radiofrequency ablation+artificial pleural effusion)by the random number table method.Clinical outcomes one month after treatment,time to first surgical ablation,serum alpha-fetoprotein(AFP)levels and complications before treatment and one month after treatment were compared.Both groups were followed up for 2 years after the operation,and survival conditions of patients were compared.Results Enhanced MRI or enhanced CT at 1 month after surgery in the 2 groups showed that the complete tumor ablation rate was lower in the control group than that in the observation group(76.09%vs.93.48%,P＜0.05).The surgical ablation time of the observation group was shorter than that of the control group[(9.64±1.22)min vs.(11.15±1.47)min,P＜0.05].The survival rates were higher in the observation group than those in the control group at 1 year(82.61%vs.58.70%)and 2 years(71.74%vs.47.83%)after treatment(P＜0.05).Serum AFP levels decreased in both groups after treatment,and those were lower in the observation group than those in the control group(P＜0.05).The total complication rate of the observation group was lower than that of the control group(8.70%vs.23.91%,P＜0.05).The follow-up period of 92 patients ranged from 7 to 29 months,with a mean of(20.17±4.61)months.The local tumor progression rate was higher in the control group than that in the observation group during the follow-up period(36.96%vs.10.87%,P＜0.05).Conclusion Artificial pleural effusion combined with radiofrequency ablation can effectively improve the clinical efficacy and survival rate of patients with liver cancer,reduce the level of serum AFP and decrease the occurrence of complications.

Objective To explore the effect of artificial pleural effusion combined with radiofrequency ablation in patients with phrenic top liver cancer.Methods A total of 92 patients with liver tumors at top of the diaphragm were prospectively selected and divided into the control group(46 cases,radiofrequency ablation)and the observation group(46 cases,radiofrequency ablation+artificial pleural effusion)by the random number table method.Clinical outcomes one month after treatment,time to first surgical ablation,serum alpha-fetoprotein(AFP)levels and complications before treatment and one month after treatment were compared.Both groups were followed up for 2 years after the operation,and survival conditions of patients were compared.Results Enhanced MRI or enhanced CT at 1 month after surgery in the 2 groups showed that the complete tumor ablation rate was lower in the control group than that in the observation group(76.09%vs.93.48%,P＜0.05).The surgical ablation time of the observation group was shorter than that of the control group[(9.64±1.22)min vs.(11.15±1.47)min,P＜0.05].The survival rates were higher in the observation group than those in the control group at 1 year(82.61%vs.58.70%)and 2 years(71.74%vs.47.83%)after treatment(P＜0.05).Serum AFP levels decreased in both groups after treatment,and those were lower in the observation group than those in the control group(P＜0.05).The total complication rate of the observation group was lower than that of the control group(8.70%vs.23.91%,P＜0.05).The follow-up period of 92 patients ranged from 7 to 29 months,with a mean of(20.17±4.61)months.The local tumor progression rate was higher in the control group than that in the observation group during the follow-up period(36.96%vs.10.87%,P＜0.05).Conclusion Artificial pleural effusion combined with radiofrequency ablation can effectively improve the clinical efficacy and survival rate of patients with liver cancer,reduce the level of serum AFP and decrease the occurrence of complications.

This study aims to evaluate the preventive effect of the exogenous protein chIFN-γ-chCD154 against Salmonella typhimurium(S.typhimurium)infection in White Leghorn chick-ens,and the potential mechanism.In this study,Escherichia coli was used to express the proteins chIFN-γ,chCD154 and chIFN-γ-chCD154.Before S.typhimurium infection,the White Leghorn chickens were pre-immunized via drinking water for three consecutive days,and infected with S.typhimurium by gavage.The results from Western blot,quantitative real-time PCR(qRT-PCR)analysis and histopathology analysis showed that compared to chIFN-γ and chCD154,chIFN-γ-chCD154 pre-treatment could synergistically increase the survival rate of infected chickens,reduce the bacterial load in the liver and cecum,and attenuate the pathological damage of liver and cecum.Moreover,chIFN-γ-chCD154 significantly decreased the mRNA expression of Toll-like receptor-4(TLR-4)and myeloid differentiation primary response gene 88(MyD88)in the cecum,and then inhibited the mRNA expression of NF-κB and pro-inflammatory cytokines(TNF-α and IL-6),and maintained the integrity of the intestinal tight junction proteins(zo-1,claudin-1,occlu-din).Compared with single protein pretreatment,chIFN-γ-chCD154 pretreatment significantly up-regulated the mRNA expression of the genes related to the vitamin D(VD)pathway(cyp27b1,VD receptor VDR,antimicrobial peptide AvBD7 and cathelicidin-b1)in S.typhimurium-infected peripheral blood mononuclear cells(PBMCs).The results of colony counting showed that the num-ber of S.typhimurium in the chIFN-γ-chCD154 group were the lowest.Also,chIFN-γ-chCD154 could up-regulate the relative abundance of beneficial bacteria such as Blautia,Ruminococcus,En-terococcus and Faecalibacterium,while down-regulate the relative abundance of harmful bacteria such as Staphylococcaceae in the cecum and improve the intestinal dysbiosis.In conclusion,chIFN-γ-chCD154 could activate the VD-antimicrobial peptide pathway and inhibit the TLR-4/MyD88/NF-κB inflammatory signaling pathway in S.typhimurium-infected chickens,which significantly improve the intestinal barrier function,reduce the inflammatory damage of liver and cecum,im-prove the structure of cecum microbial,promote the health of intestinal tract,and provide theoreti-cal basis for the development of chIFN-γ-chCD154 as a safe and effective alternative antibiotic.

Objective To investigate the efficacy of electromagnetic guidance and bedside ultrasound in the placement of nasointestinal feeding tubes in neurocritical care patients,providing a reference for nurses to accurately and efficiently place tubes at the bedside. Methods A tatal of 85 patients were selected as the study subjects,who required nasoenteric tube placement and treated in the department of neurocritical care unit of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2023. Patients were randomly divided into an experimental group (43 cases) and a control group (42 cases) using a random number table. The experimental group used electromagnetic guidance-assisted nasointestinal tube placement,while the control group utilized bedside ultrasound technology. The differences in the success rate of one-time tube placement,placement time,and complications between the two groups were compared. Results The success rate of one-time tube placement in the experimental group was higher than that in the control group[97.67％ (42/43) vs. 95.24％ (40/42)],but the difference was not statistically significant (P>0.05). The placement time in the experimental group was significantly reduced compared to the control group (minutes:16.23±3.06 vs. 25.07±3.26,P<0.05),and the number of positioning attempts was significantly fewer[attempts:1 (1,3) vs. 3 (3,4),P<0.05]. Scores for theoretical knowledge,operational practice,placement preparation,catheter position visualization,and catheter position interpretation in the experimental group were significantly lower than those in the control group[theoretical knowledge score:2.67±0.52 vs. 4.67±0.52,operational practice score:2.50±0.55 vs. 5.00±0.00,placement preparation score:2.33 (2.00,3.00) vs. 3.00 (2.00,4.00),catheter position visualization score:1.83±0.41 vs. 4.83±0.41,catheter position interpretation score:1.83±0.41 vs. 3.83±0.41,all P<0.05]. The technical difficulty score was significantly lower in the experimental group than in the control group (11.17±0.75 vs. 21.33±0.82,P<0.05). The incidence of nasal bleeding complications in the experimental group was significantly lower than that in the control group[6.98％ (3/43) vs. 23.81％ (10/42),P<0.05]. No other placement complications occurred in either group. Conclusions The success rates of one-time tube placement using electromagnetic navigation and bedside ultrasound for bedside placement of nasointestinal feeding tubes were comparable,but electromagnetic guidance offered higher efficiency and safety. It is suggested that bedside ultrasound be used for gastrointestinal evaluation before electromagnetic guidance-assisted tube placement to assist nurses in implementing personalized pre-placement preparations,thereby further increasing the success rate of tube placement.

Objective:The aim of this study was to investigate the clinical characteristics and analyze the risk factors of patients with acute dichlorvos poisoning combined with shock.Methods:The clinical data of patients with acute dichlorvos poisoning admitted to the Peking University Third Hospital and the Fifth Medical Center of the PLA General Hospital between January 2019 and September 2020 were retrospectively analyzed, and demographic data, poisoning, clinical manifestations, laboratory tests, therapeutic measures and clinical outcomes were collected to establish a clinical database. The patients were divided into two groups: the shock group and the non-shock group, and the clinical data were compared between the two groups to analyze the clinical characteristics and prognosis of shock in acute dichlorvos poisoning, and the risk factors of shock in acute dichlorvos poisoning were analyzed by logistic regression.Results:A total of 134 patients who met the criteria for acute dichlorvos poisoning were included in this study; the incidence of shock within 24 hours of admission was 39.6% (53/134), and 11 patients (8.21%) died in hospital; the in-hospital morbidity and mortality rate of patients in the shock group was higher than that in the non-shock group (20.8% vs. 0.0%, P<0.001). Symptoms of sphincter relaxation, coma, hypothermia, and organ function damage were more common in the shock group than in the non-shock group; and shock patients had longer hospitalization, ICU stay, and invasive ventilator use. Binary logistic regression analysis showed that the presence of sphincter relaxation manifestations ( OR=10.888, 95% CI: 1.677-70.684, P=0.012) was an independent risk factor for comorbid shock in patients with acute dichlorvos poisoning, and the use of cholinesterase reanimators ( OR=0.246, 95% CI: 0.072-0.846, P=0.026) was a protective factor for combined shock in patients with acute dichlorvos poisoning. Conclusions:The incidence of shock in patients with acute dichlorvos poisoning is high and affects the clinical prognosis, and the presence of sphincter relaxation and the absence of cholinesterase reenergizers are independent risk factors for combined shock in patients with acute dichlorvos poisoning.

BACKGROUND:Studies have found that nicotine can activate the dopamine system,slowing the progression of Parkinson's disease,but the specific mechanism is still unclear.Research on the neuroprotective mechanism of nicotine in animal models of Parkinson's disease is lacking. OBJECTIVE:To investigate the neuroprotective effect of nicotine on rotenone-induced Parkinson's disease in mice. METHODS:Twenty-eight C57BL/6 mice were randomly divided into vehicle group,rotenone group,autophagy agonist group and nicotine group,with seven mice in each group.Dopaminergic nerve damage was induced by rotenone in C57BL/6 mice,and the autophagy agonist(rapamycin)or nicotine was given before modeling.The spatial exploration function of the mice was observed by open field test.Western blot and Q-PCR were used to detect the expression of α-synuclein,autophagy related factors Beclin-1 and P62,and apoptosis-related factors Bax,Bcl-2 and Cleaved-caspase3 in the nigra of each group.The deposition of mitochondria,autophagosomes and lipofuscin in nigra cells were observed by transmission electron microscopy.The survival of neurons was observed by Nissl staining.The expression of tyrosine hydroxylase was observed by immunofluorescence and immunohistochemical staining. RESULTS AND CONCLUSION:The open field test showed that the distance,average speed and time of movement were reduced in the rotenone group compared with the solvent group.Compared with the rotenone group,the exercise distance,average speed and exercise time of mice were increased in the nicotine group and autophagy agonist group(P＜0.05).The results of immunofluorescence and immunohistochemistry showed that the mean fluorescence intensity and mean absorbance value of tyrosine hydroxylase in the rotenone group decreased compared with that in the solvent group.Compared with the rotenone group,the mean fluorescence intensity and mean absorbance value of tyrosine hydroxylase were increased in the nicotine group and autophagy agonist group.Western blot and Q-PCR results showed that compared with the solvent group,the expressions of α-synuclein and P62 in the rotenone group were increased,while Beclin-1 expression was decreased(P＜0.05);compared with the rotenone group,the expression of α-synuclein and P62 decreased in the nicotine group and autophagy agonist group,and the expression of Beclin-1 increased(P＜0.05).Compared with the solvent group,the expressions of Bax and Cleaved caspase3 were increased and Bcl-2 expression was decreased in the rotenone group(P＜0.05);compared with the rothenone group,the expressions of Bax and Cleaved-caspase3 were decreased and the expression of Bcl-2 was increased in the nicotine and autophagy agonist groups(P＜0.05).To conclude,nicotine may have a dopaminergic neuroprotective effect on rotenone-induced Parkinson's disease mouse models by improving autophagy dysfunction and reducing apoptosis.

Objective To investigate the efficacy of electromagnetic guidance and bedside ultrasound in the placement of nasointestinal feeding tubes in neurocritical care patients,providing a reference for nurses to accurately and efficiently place tubes at the bedside. Methods A tatal of 85 patients were selected as the study subjects,who required nasoenteric tube placement and treated in the department of neurocritical care unit of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2023. Patients were randomly divided into an experimental group (43 cases) and a control group (42 cases) using a random number table. The experimental group used electromagnetic guidance-assisted nasointestinal tube placement,while the control group utilized bedside ultrasound technology. The differences in the success rate of one-time tube placement,placement time,and complications between the two groups were compared. Results The success rate of one-time tube placement in the experimental group was higher than that in the control group[97.67％ (42/43) vs. 95.24％ (40/42)],but the difference was not statistically significant (P>0.05). The placement time in the experimental group was significantly reduced compared to the control group (minutes:16.23±3.06 vs. 25.07±3.26,P<0.05),and the number of positioning attempts was significantly fewer[attempts:1 (1,3) vs. 3 (3,4),P<0.05]. Scores for theoretical knowledge,operational practice,placement preparation,catheter position visualization,and catheter position interpretation in the experimental group were significantly lower than those in the control group[theoretical knowledge score:2.67±0.52 vs. 4.67±0.52,operational practice score:2.50±0.55 vs. 5.00±0.00,placement preparation score:2.33 (2.00,3.00) vs. 3.00 (2.00,4.00),catheter position visualization score:1.83±0.41 vs. 4.83±0.41,catheter position interpretation score:1.83±0.41 vs. 3.83±0.41,all P<0.05]. The technical difficulty score was significantly lower in the experimental group than in the control group (11.17±0.75 vs. 21.33±0.82,P<0.05). The incidence of nasal bleeding complications in the experimental group was significantly lower than that in the control group[6.98％ (3/43) vs. 23.81％ (10/42),P<0.05]. No other placement complications occurred in either group. Conclusions The success rates of one-time tube placement using electromagnetic navigation and bedside ultrasound for bedside placement of nasointestinal feeding tubes were comparable,but electromagnetic guidance offered higher efficiency and safety. It is suggested that bedside ultrasound be used for gastrointestinal evaluation before electromagnetic guidance-assisted tube placement to assist nurses in implementing personalized pre-placement preparations,thereby further increasing the success rate of tube placement.

Objective:This study investigated the changes of cortical thickness in patients with Parkinson's cognitive dysfunction.Methods:In this cross-sectional study, general clinical data and head magnetic resonance imaging data were collected from Parkinson's disease(PD)patients and healthy controls who were hospitalized or outpatient in the Department of Geriatric Neurology of the First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020.We observed the changes of cortical thickness in each group, and analyzed the correlation between cortical thickness and cognitive dysfunction in PD.Results:Compared with PD normal cognitive group, the cortical thickness of the left superiortemporal gyrus[(2.7±0.1)mm, (2.4±0.1)mm, t=-4.194], left supramarginal[(2.4±0.1)mm, (2.2±0.1)mm, t=-4.845], right insula[(3.0±0.1)mm, (2.7±0.1)mm, t=-4.170], left parahippocampal[(2.8±0.3)mm, (2.4±0.3)mm, t=-4.164]decreased in PD cognitive impairment group(all P<0.05), and cortical thickness of the right parsorbitalis[(2.5±0.2)mm, (2.4±0.2)mm, t=-4.226], left entorhinal[(3.5±0.3)mm, (3.1±0.4)mm, t=-4.583], left inferiortemporal[(2.7±0.2)mm, (2.5±0.1)mm, t=-6.229], left supramarginal[(2.4±0.1)mm, (2.1±0.1)mm, t=-3.236], right fusiform[(2.8±0.1)mm, (2.5±0.1)mm, t=-5.364], right lingual[(2.0±0.1)mm, (1.9±0.1)mm, t=-3.887], right insula[(3.0±0.1)mm, (2.7±0.2)mm, t=-5.326], right isthmuscingulate[(2.6±0.2)mm, (2.3±0.2)mm, t=-3.743]decreased in PD severe cognitive impairment group, the statistical difference was significant(all P<0.05). The cerebral cortex thickness was positively correlated with Mini-Mental State Examination and different cognitive areas, and negatively correlated with Hoehn-Yahrr grading. Conclusions:Local cortical thinning was observed in PD patients with cognitive impairment, whereas cortical involvement was more extensive in PD patients with severe cognitive impairment.

Objective:To investigate the relationship between rapid eye movement sleep behavior disorder(RBD)and neurofilament light chain(NfL)levels in patients with Parkinson's disease(PD).Methods:General clinical data of 121 PD patients and 38 healthy controls(HC)who visited the Department of Geriatric Neurology of the First Affiliated Hospital of Kunming Medical University from June 2019 to January 2021 were collected in a prospective study.According to the Rapid Eye Movement Sleep Behavior Disorder Questionnaire(RBDSQ), PD patients were divided into a PD with RBD group(PD-RBD, RBDSQ≥6)and a PD without RBD group(PD-NRBD, RBDSQ<6). General clinical data and plasma NfL levels of patients in the groups were compared.In addition, symptoms during exercise, during non-exercise, and sleep quality in the groups were also compared.Results:Plasma NfL levels were higher in the PD group than in the HC group(19.39 ng/L, 12.58-31.78; 14.85 ng/L, 9.78-22.15; Z=-2.492, P<0.05); plasma NfL levels were significantly higher in the PD-RBD group than in the PD-NRBD group and in the HC group(25.29 ng/L, 19.09-34.75; 17.14 ng/L, 11.70-26.67; 14.85 ng/L, 9.78-22.15; Z=-3.434, P<0.01); there was no significant difference in plasma NfL levels between the HC group and the PD-NRBD group( P>0.05). Receiver operating characteristic(ROC)curve analysis showed that, when the plasma NfL cutoff was set at 17.86 ng/L, PD-RBD and PD-NRBD could be distinguished( AUC=0.70, 95% CI=0.60-0.80, sensitivity 82%, specificity 54%). Binary logistic regression identified NfL level as an independent predictor of PD-RBD( β=0.068, OR=1.103, P=0.003). Conclusions:PD-RBD patients have increased plasma NfL levels, which can potentially serve as a biomarker for PD with RBD.