Developing and identifying effective medications and targets for treating hepatic fibrosis is an urgent priority. Our previous research demonstrated the efficacy of artesunate (ART) in alleviating liver fibrosis by eliminating activated hepatic stellate cells (HSCs). However, the underlying mechanism remains unclear despite these findings. Notably, endocytic adaptor protein (NUMB) has significant implications for treating hepatic diseases, but current research primarily focuses on liver regeneration and hepatocellular carcinoma. The precise function of NUMB in liver fibrosis, particularly its ability to regulate HSCs, requires further investigation. This study aims to elucidate the role of NUMB in the anti-hepatic fibrosis action of ART in HSCs. We observed that the expression level of NUMB significantly decreased in activated HSCs compared to quiescent HSCs, exhibiting a negative correlation with the progression of liver fibrosis. Additionally, ART induced senescence in activated HSCs through the NUMB/P53 tumor suppressor (P53) axis. We identified NUMB as a crucial regulator of senescence in activated HSCs and as a mediator of ART in determining cell fate. This research examines the specific target of ART in eliminating activated HSCs, providing both theoretical and experimental evidence for the treatment of liver fibrosis.
Hepatic Stellate Cells/cytology* ; Liver Cirrhosis/genetics* ; Artesunate/pharmacology* ; Cellular Senescence/drug effects* ; Membrane Proteins/genetics* ; Animals ; Humans ; Nerve Tissue Proteins/genetics* ; Tumor Suppressor Protein p53/genetics* ; Male ; Mice

Objective To construct,implement and evaluate the effectiveness of the virtual simulation technology-based prenatal health education course.Methods The curriculum included 4 parts:"warm delivery room and easy delivery","medicated analgesic delivery","non-medicated analgesic delivery"and"early maternal and infant health care".From May to September 2022,100 primiparas in an obstetrics and gynecology hospital in Zhejiang Province were investigated by convenient sampling method.Random number table method was used to divide the participants into an experimental group and a control group,with 50 participants per group.The control group received conventional health education,while the experimental group received an augmented virtual reality technology-based prenatal health education course during the late stages of pregnancy on this basis.We conducted a post-intervention comparative analysis of antenatal anxiety levels,fear of childbirth,and birth outcomes between the 2 groups.Furthermore,a post-intervention satisfaction survey was administered to the experimental group.Results After intervention,the antenatal anxiety of the experimental group was lower than that of the control group(x2=4.943,P=0.026),and the decrease in fear of childbirth scores was higher than that of the control group(t=3.200,P=0.002).The experimental group was highly satisfied with all of the 4 dimensions of the course,and the overall evaluation was(31.8±3.23)points.However,there were no significant differences in vaginal delivery rate,postpartum bleeding volume,postpartum hemorrhage incidence,perineal injury degree and duration of each labor stage between the 2 groups(P＞0.05).Conclusion The virtual reality technology-based prenatal health education course was effective in improving the antenatal anxiety and fear of childbirth of primipara,and the use satisfaction is high.

Senescence of activated hepatic stellate cells (aHSCs) is a stable growth arrest that is implicated in liver fibrosis regression. Senescent cells often accompanied by a multi-faceted senescence-associated secretory phenotype (SASP). But little is known about how alanine-serine-cysteine transporter type-2 (ASCT2), a high affinity glutamine transporter, affects HSC senescence and SASP during liver fibrosis. Here, we identified ASCT2 is mainly elevated in aHSCs and positively correlated with liver fibrosis in human and mouse fibrotic livers. We first discovered ASCT2 inhibition induced HSCs to senescence in vitro and in vivo. The proinflammatory SASP were restricted by ASCT2 inhibition at senescence initiation to prevent paracrine migration. Mechanically, ASCT2 was a direct target of glutaminolysis-dependent proinflammatory SASP, interfering IL-1α/NF-κB feedback loop via interacting with precursor IL-1α at Lys82. From a translational perspective, atractylenolide III is identified as ASCT2 inhibitor through directly bound to Asn230 of ASCT2. The presence of -OH group in atractylenolide III is suggested to be favorable for the inhibition of ASCT2. Importantly, atractylenolide III could be utilized to treat liver fibrosis mice. Taken together, ASCT2 controlled HSC senescence while modifying the proinflammatory SASP. Targeting ASCT2 by atractylenolide III could be a therapeutic candidate for liver fibrosis.

This research implements the "dual-element and three-step" education model based on the modern apprenticeship system for rural medical students, establishes a complete teacher management system through the joint enrollment of schools and teaching hospitals, and strengthens the professional cognition stage, professional learning stage and professional practice stage. It has certain effects on promoting students' good sense of professional identity and responsibility, enhancing learning initiative and professional vocational ability, and cultivating skilled and service-oriented medical talents with "six-in-one" post competences in rural areas.

Objective:To investigate the utilization of peripheral intravenous catheter (PIVC) in hospitalized children in Class Ⅲ specialized children's hospitals, aiming to discover existing issues of PIVC in order to provide reference for clinical nurses and nurse administer to improve the quality on intravenous therapy and to avoid potential risk.Methods:This study uses the field survey method. From July 23rd to 31st, 2018, 25 Class Ⅲ children's specialized hospitals were first sampled in 23 provinces, municipalities, and autonomous regions of the country by the convenient sampling method. The cluster sampling method was then used to select all the pediatric patients with PIVCs admitted to the hospital on the date of investigation. A self-designed 'Cross-sectional Questionnaire for Pediatric Patients with PIVC' was used for survey, and images and data were analyzed. SPSS 17.0 software was used to statistically analyze the data.Results:In this study, 8 635 cases of PICVs were investigated, and the utilization rate of PICVs accounted for 86.9% (8 635/9 942) of all venipuncture tools. Among these cases, 4 665 (54.0%) cases' puncture sites were at the dorsal side of the hand, and 1 234 (14.3%) were at the head. Among the PIVCs, 45.8% (3 954/8 635) were safety PIVCs. And 54.6% (4 712/8 635) of the PIVCs were di (2-ethylhexyl) phthalate (DEHP) free products. The incidence rate of PICV related complications was 7.9% (682/8 635) . Univariate analysis and multivariate logistic regression analysis showed that the PIVC time, IV site, dressing fixation problems, catheter maintenance problems, and patient age were risk factors for PIVC related complications ( P<0.05) . Conclusions:PIVC is the widely used among pediatric patients. The IV site is mainly at the dorsal side of the hand, followed by head and wrist. The selection of material and type of PIVC still require further improvement to ensure the safety of pediatric intravenous therapy. Nursing measures should be taken during the use of PIVC to identify the risk factors at early stage and intervene effectively, which can reduce the occurrence of complications.

Objective:To screen and identify autoantibody biomarker to diagnose patients with nasopharyngeal carcinoma (NPC).Methods:Candidate autoantibodies against tumor-associated antigens were identified from NPC CNE2 cells using serological proteome analysis. Levels of candidate autoantibody biomarkers were measured by enzyme-linked immunosorbent assay (ELISA) in 50 patients with NPC and 80 normal controls recruited from the Cancer Hospital of Shantou University Medical College between July 2014 and January 2015. Receiver operating characteristic curve (ROC) was employed to evaluate diagnostic efficacy.Results:Serological proteome analysis showed that sera from patients with NPC yielded a positive spot, of which was identified as enolase 1 (ENO1). ELISA results showed that the level of serum autoantibody against ENO1 in patients with NPC was significantly higher than that in normal controls [0.165 (0.088, 0.378) vs. 0.100 (0.054, 0.117), Z=4.077, P<0.001]. With the optimum diagnostic cutoff of 0.164, ROC curve showed the diagnostic sensitivity and specificity of autoantibodies against ENO1 were 52.0% and 90.0%, respectively. Measurement of autoantibody against ENO1 demonstrated a positive rate of 75.0% for early stage NPC. Conclusion:Autoantibody against ENO1 may be a potential diagnostic biomarker for NPC.

Objective To explore the application value of ultrasound-guided stellate ganglion block in patients with aneurysmal cerebral hemorrhage.Methods Eighty patients with subarachnoid hemorrhage caused by aneurysm from November 2017 to March 2019 in Hangzhou Hospital of Zhejiang Medical Health Group were selected.The patients were divided into observation group and control group by random digits table method with 40 cases in each group.All patients were treated with craniotomy hematoma removal.At the conclusion of the surgical procedure,the control group was treated with nimodipine,while the observation group was treated with ultrasound-guided right stellate ganglion block on the basis of nimodipine.The blood flow velocity of middle cerebral artery before operation and 6,24 h after operation by transcranial Doppler sonography were detected to reflect cerebral vasospasm status;the blood samples from the radial artery and internal jugular bulb 24 h after operation were used to detect and count cerebral oxygen metabolism indexes,including the blood oxygen saturation of internal jugular bulb,arteriovenous oxygen content difference and cerebral oxygen uptake rate;the IgG,IgA and IgM 24 h after operation were detected.The patients were followed up at 1 week after operation,and the complication was observed.Results There was no statistical difference in the blood flow velocity of middle cerebral artery before operation between 2 groups (P＞0.05);the blood flow velocity of middle cerebral artery 6 and 24 h after operation in observation group was significantly lower than that in control group:(100.8± 8.2) cm/s vs.(123.5 ± 9.9) cm/s and (89.7 ± 5.3) cm/s vs.(118.9 ± 7.1) cm/s,and there was statistical difference (P＜0.01).The blood oxygen saturation of internal jugular bulb,cerebral oxygen uptake rate,IgG,IgA and IgM 24 h after operation in observation group were significantly higher than those in control group:0.704 ± 0.035 vs.0.598 ± 0.058,(57.5 ± 6.5)％ vs.(49.7 ± 3.6)％,(12.5 ± 0.3) mg/L vs.(5.0 ± 0.1) mg/L,(5.5 ± 0.3) mg/L vs.(2.1 ± 0.1) mg/L and (4.3 ± 0.3) mg/L vs.(1.9 ± 0.2) rg/L,the arteriovenous oxygen content difference and incidence of complication were significantly lower than those in control group:(40.8 ± 3.2) ml/L vs.(58.3 ± 8.6) ml/L and 5.0％ (2/40) vs.25.0％ (10/40),and there were statistical differences (P＜0.01 or ＜0.05).Conclusions For patients with aneurysmal intracerebral hemorrhage,ultrasound-guided stellate ganglion block therapy can effectively improve cerebral blood flow,ensure cerebral oxygen supply,improve humoral immunity,reduce the incidence of postoperative complication,and achieve the purpose of improving clinical therapeutic effect.

Objective To compare the efficacy and adverse reactions of desloratadine citrate disodium tablets and loratadine dispersible tablets in treatment of patients with allergic rhinitis,and their influence on leukotriene B4(LTB4),interleukin-4 (IL-4),interleukin-10 (IL-10) and interferon gamma (INF-γ).Methods From June 2015 to June 2016,a total of 110 patients with allergic rhinitis in the Second People's Hospital of Cangnan County were selected and randomly divided into control group and observation group according to the digital table,with 55 cases in each group.The control group was given loratadine dispersible tablets,while the observation group was given desloratadine citrate disodium tablets.Both two groups were treated for 14 days.The clinical efficacy,adverse reactions and changes of LTB4,IL-4,IL-10,INF-γ levels before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 94.5 ％,which was significantly higher than 80.0％ of the control group(x2 =6.310,P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 16.4％,which was similar to 20.0％ in the control group.Before treatment,there were no statistically significant differences in LTB4,IL-4,IL-10,INF-γ levels between the two groups (all P ＞ 0.05).After 2 weeks of treatment,the levels of LTB4,IL-4,IL-10 and INF-γ in the observation group were (67.74 ±10.15) ng/L,(52.37 ± 5.12) μg/L,(81.26 ± 11.78) μg/L,(94.47 ± 7.87) μg/L,respectively,which in the control group were (80.32 ± 9.97) ng/L,(62.95 ± 5.45) μg/L,(96.32 ± 11.57) μg/L,(86.74 ± 7.63) μg/L,respectively,there were statistically significant differences between the two groups (t =7.124,5.262,4.654,3.718,all P ＜ 0.05).Conclusion Both desloratadine citrate disodium tablets and loratadine dispersible tablets can effectively treat patients with allergic rhinitis,improve the symptoms and physical signs,reduce the levels of LTB4,IL-4 and IL-10,increase the level of INF-γ,and the adverse reactions are less and slight,but the efficacy of desloratadine citrate disodium tablets is better than loratadine dispersible tablets.

In this study, apoptotic mechanism of resveratrol against human prostatic carcinoma DU145 cells was investigated. MTT was used to measure cell growth and proliferation. Reactive oxygen species(ROS)kit was used to analyze ROS level. Cell apoptosis and cell cycle analysis were observed by flow cytometry. Protein expression levels of apoptosis and pathway associated were analyzed by Western blot. The result shows that DU145 cells treated with different resveratrol concentrations suffered apoptosis, cycle arrest in G0/G1 phase, ROS increase in the cell and a decrease in mitochondrial membrane potential(MMP, ΔΨm), in a concentration-dependent manner. Resveratrol inhibited the expression of Bcl-2 protein via up-regulating Bax protein, thus increasing the ratio of Bax/Bcl-2, activating Caspase reaction and led apoptosis ultimately. Further investigation confirmed that resveratrol increased ROS level, decreased MMP and consequently induced apoptosis via michondrial-mediated pathway in DU145 cells. Therefore resveratrol may induce apoptosis via ROS-michondrial pathway in DU145 cells.

Objective To study the effect of Shengmai injection on the platelet parameters and CD4+CD25+cells in peripheral blood of patients with chronic lymphocytic leukemia,and to explore the optimal regimen for patients with chronic lymphocytic leukemia.Methods One hundred and twenty patients with chronic lymphocytic leukemia were enrolled in this study from January 2012 to December 2014.(D1),vincristine 4mg(d1),prednisone 60 mg/d(d1-5)were given to the CHOP regimen in the control group: cyclophosphamide 600 mg/m2(d1),doxorubicin 25 mg/m2(d12)28d a course of treatment,a total of 4 courses,the observation group of patients in the control group of patients treated on the basis of Shengmai injection,compared the two groups of patients with chemotherapy,platelet parameters and serum CD4+CD25+T cells and Th17 cells.Results After treatment,the PLT,MPV and PDW of the observation group were(215.4± 31.7),(9.5±2.5)and(16.9±2.4),respectively,which were significantly higher than those of the control group.The CD4+CD25+T cells in the observation group were(1.5±0.8)The total effective rate of the control group was 35.0％,the total effective rate was 35.0％,and the total effective rate of the control group was 35.0％.There were significant difference between the control group and the control group(P<0.05),The difference was statistically significant.Conclusion Shengmai injection combined with CHOP regimen in chronic lymphocytic leukemia patients can improve immune function,promote platelet growth,improve platelet clinical parameters,and help improve the efficiency of chemotherapy,compared with CHOP alone Program treatment is better,worthy of clinical application.