OBJECTIVES: To investigate the role of a neural pathway from oxytocin (OXT) neurons in the paraventricular hypothalamic nucleus (PVN) to γ-aminobutyric acid (GABA) neurons (GABAergic neurons) in the trigeminal nucleus caudalis (TNC) in regulating pain sensitization in a mouse model of chronic migraine and to explore the underlying mechanisms. METHODS: A chronic migraine mouse model was established by intraperitoneal injection of nitroglycerin (NTG, 1 mg/mL, 10 mg/kg) on days 1, 3, 5, 7, and 9. The study consisted of four parts: PartⅠ: 24 male wild-type C57BL/6J mice were divided into four groups (n=6 in each), receiving single or repeated injection of NTG or saline, respectively. Immunofluorescence was used to detect c-Fos and OXT expression in the PVN. Part Ⅱ: 6 male OXT-Cre transgenic C57BL/6J mice were used for anterograde monosynaptic tracing combined with RNAscope and immunofluorescence to identify neural projections from PVN OXT neurons to TNC GABAergic neurons. Part Ⅲ: 30 male OXT-Cre transgenic C57BL/6J mice were bilaterally injected Cre-dependent chemogenetic activation virus into the PVN. These mice were randomly divided into five groups, with six mice in each group. Mice in the clozapine N-oxide (CNO) group and the control group were intra-peritoneally injected with 0.1 mg/mL of CNO solution (1 mg/kg) and the same volume of isotonic normal saline, respectively. 3 hours after the injection, the brain tissues were harvest and c-Fos immunofluorescence staining was performed to verify the efficiency of chemogenetic activation virus. Mice in the model control group and the CNO activated model group were subjected to chronic migraine modeling, with bilateral TNC injection of isotonic normal saline and CNO, respectively, on day 10. The mice in the negative control group were bilaterally intra-TNC injected with isotonic normal saline. After 30 minutes, the Von-Frey filament and acetone tests were used to assess the mechanical pain threshold and cold pain response time in the periorbital region of the mice in these three groups. Part Ⅳ: 24 male OXT-Cre transgenic C57BL/6J mice were bilaterally injected with the Cre-dependent chemogenetic activation virus into the PVN. These mice were randomly divided into four groups, with six mice in each group. Mice in the model control group, the CNO activated model group and the atosiban group were subjected to chronic migraine modeling. On day 10, mice in the negative control group and the model control group were intraperitoneally injected with isotonic normal saline, while mice in the CNO activated model group and the atosiban group were intraperitoneally injected with CNO. After 15 minutes, mice in the atosiban group were bilaterally intra-TNC injected with atosiban, while mice in other three groups were bilaterally intra-TNC injected with isotonic normal saline containing 1% dimethyl sulfoxide. After 15 minutes, the Von-Frey filament and acetone tests were used to assess the mechanical pain threshold and cold pain response time in the periorbital region of the mice. The GABA content in the bilateral TNC was detected by high-performance liquid chromatography (HPLC). RESULTS: Mice with chronic migraine models exhibited reduced periorbital mechanical pain thresholds and increased periorbital cold pain reaction time, accompanied by an increase in both the number of c-Fos⁺ neurons and the percentage of c-Fos⁺ OXT neurons in the PVN (all P<0.05). The anterograde tracing virus and RNAscope combined with immunofluorescence staining showed that PVN OXT neurons projected to TNC GABAergic neurons. Immuno-fluorescence staining demonstrated that compared with the control group, the percentage of c-Fos⁺ OXT neurons in the PVN of CNO group increased (P<0.05). In bilateral intra-TNC drug administration experiments, compared with the model control group, the periorbital mechanical pain threshold increased, and the periorbital cold pain reaction time decreased in the CNO activated model group (both P<0.05). In intraperitoneal drug administration experiments, compared with the CNO activate model group, the periorbital mechanical pain threshold decreased, and the periorbital cold pain reaction time increased in the atosiban group (both P<0.05). HPLC analysis showed that, compared with the negative control group, the model control group and the atosiban group, GABA level of TNC in the CNO activated model group increased (all P<0.05). CONCLUSIONS PVN OXT neurons exert a descending facilitatory effect on GABAergic neurons in the TNC via OXT release, thereby ameliorating pain sensitization in chronic migraine.
Animals ; Paraventricular Hypothalamic Nucleus/physiopathology* ; Male ; Mice, Inbred C57BL ; Migraine Disorders/physiopathology* ; Mice ; GABAergic Neurons/physiology* ; Oxytocin/physiology* ; Disease Models, Animal ; Neurons/physiology* ; Mice, Transgenic ; Neural Pathways ; Chronic Disease

Human infection with Orf virus is a rare zoonotic disease in clinical practice,mainly caused by human contact with infected sheep or its pollutants.It is commonly seen in shepherds and slaughterhouse workers.The le-sion mainly involves the skin.Since it is rare in clinic and difficult to diagnose and treat,it is easy to be misdiag-nosed and underdiagnosed.This paper reports a case of human infection with Orf virus,with locally dense skin le-sions.The clinical diagnosis and treatment processes of this case are analyzed,and relevant literatures are reviewed retrospectively,so as to improve clinical understanding on this disease.

[Objective]To explore the pathogenesis of prostate cancer and the prevention and treatment with moxibustion based on the theory of"excessive fire dispersing Qi,and mild fire generating Qi".[Methods]Based on the original text of The Inner Canon of Huangdi,the theoretical connotation of"excessive fire dispersing Qi,and mild fire generating Qi",and its relationship with the pathogenesis of prostate cancer and the reinforcing and reducing of moxibustion were investigated.The application of moxibustion reinforcing and reducing,guided by classical theory,is established in the prevention and treatment of prostate cancer,and illustrated with typical medical cases to substantiate the argument.[Results]The concept of"excessive fire dispersing Qi,and mild fire generating Qi"describes the impact of physiological and pathological fire on the body's genuine Qi.Mild fire is gentle in nature and helps to generate the body's genuine Qi,while excessive fire is intense and can consume the body's genuine Qi.Dampness,heat,blood stasis,and toxins,which are factors that induce prostate cancer,cancer toxins and western medical treatments such as surgery,radiotherapy and chemotherapy can all manifest as"excessive fire"pattern,consume the body's genuine Qi,which cause the course of prostate cancer to present in different stages,such as the initial formation of cancer toxins,deficiency of genuine Qi with toxin accumulation and Yang deficiency with cold stagnation.The moxibustion of reinforcing technique is relatively gentle and suitable in temperature,embodying the momentum of"mild fire",while the moxibustion of reducing technique is relatively intense and high in temperature to expel pathogens,similar to the fierce momentum of"excessive fire".Guiding the treatment of prostate cancer with moxibustion based on"excessive fire dispersing Qi",and"mild fire generating Qi"should focus on nourishing the mild fire and suppressing the excessive fire,using moxibustion of reinforcing to nourish the deficiency with"mild fire generating Qi",and using moxibustion of reducing to suppress cancer toxins and reduce the consumption of Qi dynamics,highlighting the therapeutic effect in disease prevention and treatment,as well as in improving the adverse reactions of western medical treatment.In the medical case mentioned,the patient suffered from urinary incontinence due to the damage to genuine Qi caused by surgery and the failure to consolidate and control it properly.The patient was comprehensively diagnosed with a deficiency of both the spleen and kidney.In the treatment,mild moxibustion was used to strengthen the spleen,warm the kidney,and replenish and consolidate Qi.Emphasis was also placed on the combination of moxibustion and herbal medicine.After two months of treatment,the symptoms were brought under stable control.[Conclusion]Under the guidance of the theory that"excessive fire dispersing Qi,while mild fire generating Qi",moxibustion techniques are flexibly selected in order to drain excess to suppress"excessive fire"and tonify deficiency to enhance"mild fire",which is well-suited to the complex pathogenesis of prostate cancer,which is characterized by a combination of deficiency and excess.This method provides an important reference for the prevention and treatment of the disease.

[Objective]To explore the pathogenesis of prostate cancer and the prevention and treatment with moxibustion based on the theory of"excessive fire dispersing Qi,and mild fire generating Qi".[Methods]Based on the original text of The Inner Canon of Huangdi,the theoretical connotation of"excessive fire dispersing Qi,and mild fire generating Qi",and its relationship with the pathogenesis of prostate cancer and the reinforcing and reducing of moxibustion were investigated.The application of moxibustion reinforcing and reducing,guided by classical theory,is established in the prevention and treatment of prostate cancer,and illustrated with typical medical cases to substantiate the argument.[Results]The concept of"excessive fire dispersing Qi,and mild fire generating Qi"describes the impact of physiological and pathological fire on the body's genuine Qi.Mild fire is gentle in nature and helps to generate the body's genuine Qi,while excessive fire is intense and can consume the body's genuine Qi.Dampness,heat,blood stasis,and toxins,which are factors that induce prostate cancer,cancer toxins and western medical treatments such as surgery,radiotherapy and chemotherapy can all manifest as"excessive fire"pattern,consume the body's genuine Qi,which cause the course of prostate cancer to present in different stages,such as the initial formation of cancer toxins,deficiency of genuine Qi with toxin accumulation and Yang deficiency with cold stagnation.The moxibustion of reinforcing technique is relatively gentle and suitable in temperature,embodying the momentum of"mild fire",while the moxibustion of reducing technique is relatively intense and high in temperature to expel pathogens,similar to the fierce momentum of"excessive fire".Guiding the treatment of prostate cancer with moxibustion based on"excessive fire dispersing Qi",and"mild fire generating Qi"should focus on nourishing the mild fire and suppressing the excessive fire,using moxibustion of reinforcing to nourish the deficiency with"mild fire generating Qi",and using moxibustion of reducing to suppress cancer toxins and reduce the consumption of Qi dynamics,highlighting the therapeutic effect in disease prevention and treatment,as well as in improving the adverse reactions of western medical treatment.In the medical case mentioned,the patient suffered from urinary incontinence due to the damage to genuine Qi caused by surgery and the failure to consolidate and control it properly.The patient was comprehensively diagnosed with a deficiency of both the spleen and kidney.In the treatment,mild moxibustion was used to strengthen the spleen,warm the kidney,and replenish and consolidate Qi.Emphasis was also placed on the combination of moxibustion and herbal medicine.After two months of treatment,the symptoms were brought under stable control.[Conclusion]Under the guidance of the theory that"excessive fire dispersing Qi,while mild fire generating Qi",moxibustion techniques are flexibly selected in order to drain excess to suppress"excessive fire"and tonify deficiency to enhance"mild fire",which is well-suited to the complex pathogenesis of prostate cancer,which is characterized by a combination of deficiency and excess.This method provides an important reference for the prevention and treatment of the disease.

Objective:The association between air pollutants and the risk of sudden cardiac death (SCD) remains controversial. This study aimed to investigate the relationship between five air pollutants—PM 2.5, PM 2.5–10, PM 10, NO 2, and NO?—and the risk of SCD. Methods:We analyzed data from 460 862 participants in the UK Biobank cohort, all enrolled between 2006 and 2010, with no baseline SCD. Follow-up continued until the study endpoint. Annual average concentrations of the five pollutants were assessed. Associations between pollutants and SCD were evaluated using Cox proportional hazards models, followed by Mendelian randomization (MR) to assess causality.Results:Over a mean follow-up of 12.4 years, 2 662 SCD cases were recorded. After adjusting for confounders, no significant associations were found between air pollutants and SCD risk: PM 2.5 ( HR 1.03, 95% CI 0.99–1.07, P = 0.14), PM 2.5–10 ( HR 1.04, 95% CI 1.00–1.08, P = 0.08), PM 10 ( HR 1.01, 95% CI 0.99–1.03, P = 0.26), NO? ( HR 1.00, 95% CI 0.99–1.00, P = 0.26), and NO x ( HR 1.00, 95% CI 1.00–1.01, P = 0.19). MR analysis further supported the absence of causal relationships: PM 2.5 ( β = -0.149, P = 0.90), PM 2.5–10 ( β = 0.387, P = 0.62), PM 10 ( β = -0.994, P = 0.62), NO? ( β = –0.005, P = 0.99), and NO 2 ( β = –0.827, P = 0.25). Conclusions:This study found no evidence linking PM 2.5, PM 2.5–10, PM 10, NO?, or NO 2 to an increased risk of SCD. Mendelian randomization confirmed the lack of causal associations between these pollutants and SCD.

Human infection with Orf virus is a rare zoonotic disease in clinical practice,mainly caused by human contact with infected sheep or its pollutants.It is commonly seen in shepherds and slaughterhouse workers.The le-sion mainly involves the skin.Since it is rare in clinic and difficult to diagnose and treat,it is easy to be misdiag-nosed and underdiagnosed.This paper reports a case of human infection with Orf virus,with locally dense skin le-sions.The clinical diagnosis and treatment processes of this case are analyzed,and relevant literatures are reviewed retrospectively,so as to improve clinical understanding on this disease.

Objective:To carry out a systematic review of the development, introduction or validation of drug literacy assessment tools for adults at home and abroad, and to summarize and analyze the characteristics of the assessment tools.Methods:The research framework of the scoping review was used to systematically search 8 Chinese and English databases, such as China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Web of Science, and Embase. The search period was from database establishment to October 31, 2023. Studies on adult drug literacy assessment tools were screened and included, tool characteristics were extracted and analyzed, and ultimately the extracts were standardized for reporting.Results:A total of 31 articles that met the criteria were included, of which 26 were on the development and validation of assessment tools, three were on the localization and application of assessment tools, and two were on the revision of assessment tools, covering 33 assessment tools.Conclusions:It is needed to recognize the importance of drug literacy assessment, actively explore the diversity of drug literacy assessment tools, clarify the limitations of existing drug literacy assessment tools, further improve the reliability and validity of existing tools, continue to develop and introduce assessment tools suitable for China's national conditions, so as to increase the accuracy of drug literacy assessment.

Objective:To carry out a systematic review of the development, introduction or validation of drug literacy assessment tools for adults at home and abroad, and to summarize and analyze the characteristics of the assessment tools.Methods:The research framework of the scoping review was used to systematically search 8 Chinese and English databases, such as China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Web of Science, and Embase. The search period was from database establishment to October 31, 2023. Studies on adult drug literacy assessment tools were screened and included, tool characteristics were extracted and analyzed, and ultimately the extracts were standardized for reporting.Results:A total of 31 articles that met the criteria were included, of which 26 were on the development and validation of assessment tools, three were on the localization and application of assessment tools, and two were on the revision of assessment tools, covering 33 assessment tools.Conclusions:It is needed to recognize the importance of drug literacy assessment, actively explore the diversity of drug literacy assessment tools, clarify the limitations of existing drug literacy assessment tools, further improve the reliability and validity of existing tools, continue to develop and introduce assessment tools suitable for China's national conditions, so as to increase the accuracy of drug literacy assessment.

Objective:To investigate the effect of Early infarct growth rate(EIGR) on the prognosis of patients with acute large vessel occlusive ischemic stroke.Methods:A total of 164 patients with acute large vessel occlusive ischemic stroke were enrolled in the emergency department of the First Affiliated Hospital of Nanjing Medical University from January 1, 2020 to December 31, 2022.According to the change of the National Institutes of Health Stroke Scale (NIHSS) score at admission and 72 h after treatment, the patients were divided into good prognosis group and poor prognosis group. The basic clinical data of the two groups were observed and compared. The risk factors of poor prognosis were analyzed by univariate regression. The effect of EIGR on prognosis after age stratification was further analyzed.Results:Comparing the clinical data of the two groups, there was no difference in EIGR (mL/h) (7.67 vs. 8.24, P=0.211) between the two groups. The product between EIGR and age was included as the interaction term, and the result of the interaction term in the model was statistically significant ( OR=1.002, 95% CI: 1.000-1.003, P=0.032) .Moreover, the result was still statistically significant after adjusting for relevant variables (gender, history of hypertension, history of atrial fibrillation, history of diabetes, history of coronary heart disease, and history of stroke) ( OR=1.002, 95% CI:1.000-1.003, P=0.027). Subgroup analysis was performed according to the median age (71 years). In the elderly group, the proportion of poor prognosis was higher with fast core infarction growth rate defined by 25 mL/h and 15 mL/h ( P < 0.05).In the younger age group, there was no significant difference in the proportion of poor prognosis in the fast core infarction growth rate compared with the slow type ( P > 0.05). Conclusions:EIGR can predict the early clinical outcome early in elderly patients with large vessel occlusive ischemic stroke.

Objective:To study the standardization path of medical ultrasound equipment management based on total quality management,and to improve the service level of medical ultrasound equipment in clinical diagnosis and treatment activities.Methods:According to the process of medical ultrasound equipment use,the risk nodes were determined,the formation path and damage probability of equipment use risk were analyzed by probabilistic graphical model,and the standardized path of medical ultrasound equipment use was formulated based on time control and standardized use mode.35 medical ultrasound equipment in clinical use in The People's Hospital of Jianyang from 2022 to 2023 were selected,the use and management of 33 medical ultrasound equipment in 2022 were managed in the conventional management mode(33 units),and the use and management of 35 medical ultrasound equipment in 2023(2 new units)were adopted in the total quality management mode.The difference in equipment operation quality,risk ratio and service effect under different modes were compared.Results:The failure rates of medical ultrasound diagnostic equipment,medical ultrasound treatment equipment and other medical ultrasound equipment using the total quality management model were(0.763±0.68)%,(0.833±0.65)%and(0.969±0.64)%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(t=3.331,5.348,5.940,P<0.05).The proportion of risk problems such as component damage,delayed diagnosis and treatment,resource waste and social impact of medical ultrasound equipment using total quality management mode were(2.023±0.99)‰,(1.569±0.89)‰,(2.541±1.05)‰ and(1.238±0.63)‰,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(t=3.935,3.676,5.699,3.189,P<0.05).The scores of clinicians,nurses,operating technicians,equipment engineers and management personnel involved in the use and management of medical ultrasound equipment were for the service effect of the total quality management model were(95.797±2.13)points,(93.880±2.12)points,(94.605±1.91)points,(91.387±3.20)points and(96.275±1.82)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=4.536,5.477,6.869,2.943,4.673,P<0.05).Conclusion:The standardized path of medical ultrasound equipment management based on total quality management can improve the operation quality of equipment,reduce the incidence of clinical use risk,and enhance the level of clinical service.