ObjectiveTo observe the effect of M1 bone marrow-derived macrophages （M1-BMDM） with Wnt5a knockdown on liver fibrosis and regeneration in a rat model of liver cirrhosis， and to investigate its gain-of-function effect compared with unmodified M1-BMDM. MethodsPrimary bone marrow-derived macrophages were isolated from rats and were polarized to M1 phenotype to construct M1-BMDM^Wnt5a-KD cells. A rat model of liver cirrhosis induced by CCl₄/2-AAF was established， and at the end of week 8， rats were randomly divided into model group， M1-BMDM group， M1-BMDM Wnt5a-knockdown empty vector group （M1-BMDM^KD-EV group）， and M1-BMDM Wnt5a-knockdown group （M1-BMDM^Wnt5a-KD group）， with 6 rats in each group. On the first day of week 9， the rats in each group were given a single injection of the corresponding cells via the caudal vein， along with an intraperitoneal injection of a CCR2 inhibitor. Six rats without any treatment were used as normal control group. Samples were collected at the end of week 12 to assess liver histopathology， serum liver function parameters， hepatic stellate cell activation， and the expression levels of mature hepatocyte markers. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the model group， all cell treatment groups had significant alleviation of liver inflammatory response and significant reductions in the activities of alanine aminotransferase and aspartate aminotransferase （AST） in serum （all P<0.01）， and the M1-BMDM^Wnt5a-KD group had a significantly lower serum level of AST than the M1-BMDM group （P<0.05）. The semi-quantitative analysis based on immunohistochemical staining showed that compared with the model group， all cell treatment groups had a significant reduction in the percentage of CD68-positive area （all P<0.05）， and compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had a significant reduction in the percentage of CD68-positive area and a significant increase in the percentage of CD163-positive area （both P<0.05）. Compared with the model group， all cell treatment groups had significant reductions in the mRNA expression levels of CD68 and tumor necrosis factor-α （all P<0.05） and the protein expression level of CD68 （all P<0.01）； compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significant increases in the protein and mRNA expression levels of CD163 （both P<0.05）， significant reductions in the protein and mRNA expression levels of CD68 （both P<0.05）， and a significant reduction in the protein expression level of tumor necrosis factor-α （P<0.01）. Sirius Red collagen staining and alpha-smooth muscle actin （α-SMA） immunohistochemical staining showed that compared with the model group， all cell treatment groups had significant alleviation of liver collagen deposition and α-SMA-positive area， with the most significant changes in the M1-BMDM^Wnt5a-KD group， and compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significantly smaller Sirius Red-positive area and α-SMA-positive area and a significantly lower content of hydroxyproline in liver tissue （all P<0.05）. Compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significant reductions in the protein and mRNA expression levels of α-SMA and the mRNA expression level of COL-I and TGF-β （all P<0.05）. Compared with the model group， all cell treatment groups had a significant increase in the protein expression level of HNF-4α in liver tissue （all P<0.05）， and the M1-BMDM^Wnt5a-KD group had significantly higher protein and mRNA expression levels of HNF-4α and hepatocyte specific antigen than the M1-BMDM^KD-EV group （both P<0.05）. The M1-BMDM^Wnt5a-KD group had a significantly higher serum level of albumin than the M1-BMDM^KD-EV group （P<0.01）. Immunofluorescence co-staining showed that compared with the model group， all cell treatment groups had a significant increase in the number of cells stained positive for HNF and HNF-4α and Ki67 （all P<0.01）， and the M1-BMDM^Wnt5a-KD group had a significantly higher number of such cells than the M1-BMDM^KD-EV group （P<0.05）. ConclusionInhibition of Wnt5a expression enhances the therapeutic effect of M1-BMDM on rats with liver cirrhosis induced by CCl₄/2-AAF， which provides new ideas for enhancing the anti-cirrhotic effect of M1-BMDM through genetic modification.

Objective To explore the correlation between pre-pregnancy body mass index (BMI) and the risk of difficult airway during labor and delivery through grading changes of Mallampati test (MT). Methods A total of 354 primiparous women who delivered at Obstetrics and Gynecology Hospital of Fudan University from October 2020 to April 2021 were enrolled and categorized into low BMI, normal BMI, and high BMI groups based on pre-pregnancy BMI. Changes in MT grading were analyzed during early labor, postpartum (20 minutes to 1 hour after placental delivery), and 48 hours postpartum. A multifactor logistic regression model was used to analyze the factors increased MT grading postpartum. Results Among the 354 participants, 97 (27.4%) exhibited increased MT grading postpartum, with the proportion of women classified as MT grade 3-4 rising from 39 (11.0%) during early labor to 77 (21.8%) postpartum. By 48 hours postpartum, the number of women with MT grade 3-4 decreased to 21 (5.9%). Multifactor logistic regression analysis showed that low pre-pregnancy BMI (vs high BMI: OR＝2.15, 95%CI 1.02-4.53, P＝0.045) and snoring history during pregnancy (OR＝2.32, 95% CI 1.38-3.90, P＝0.001) were independent risk factors for postpartum MT grading elevation. Conclusions MT grading might increase postpartum in parturients, with low pre-pregnancy BMI and prenatal snoring history identified as significant risk factors for elevated MT grading after delivery.

Objective To explore the application of graded nursing based on humanistic care in frail elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 138 patients with COPD treated in Qinhuai Branch,The General Hospital of Eastern Theater Command from October 2020 to April 2023 were randomly assigned into two groups by a random number table,with 69 patients in each group.The control group received routine nursing care based on humanistic care,and the observation group were given routine nursing and graded nursing care according to the frailty scale.Clinical indicators,self-efficacy,treatment compliance and quality of life were compared between the two groups.Results After intervention,the partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),blood oxygen saturation(SpO2),and the scores of self-decision-making,self-stress reduction and positive attitude of the two groups were improved,especially in the observation group(P<0.05).The compliance rate of observation group was higher than that of control group(97.10%vs.84.06%,P<0.05).The scores of vitality(VT),physical pain(BP),physiological function(RP),social function(SF),emotional function(RE),physiological function(PF),mental health(MH)and overall health(CH)in the observation group were higher than those in the control group(P<0.05).Conclusion The combined application of graded nursing based on frailty scale and humanistic care in COPD patients can effectively improve the quality of routine nursing,patient's self-efficacy,treatment compliance,illness status,and quality of life.

Objective:The aim of this study is to analyze the clinical characteristics and genetic variants of a late-onset auditory neuropathy pedigree caused by maternally inherited- mitochondrial mutation.Methods:A male proband who presented with bilateral sensorineural hearing loss at Henan Children′s Hospital in September 2023 was chosen, along with his family members (4 generations, 20 individuals) as the study subjects. Data from this pedigree were collected, organized, and analyzed for clinical genetic characteristics. Medical histories were obtained from family members, pedigree charts were drawn, audiological, imaging, and physical examinations were conducted. Pathogenic genes and mutations were screened using high-throughput sequencing. Sanger sequencing was employed for variant confirmation and segregation validation in the family.Results:In this family, a total of 12 members (10 members collected) had sensorineural hearing loss, characterized by late-onset hearing impairment with an onset age ranging from 9 to 30 years. The patients exhibited poor speech recognition rates, and audiometric examinations are consistent with auditory neuropathy. There was no history of ototoxic drug use. High-throughput sequencing identified the variant NC_012920.1:m.7471dup in the mitochondrial MT-TS1 gene as the pathogenic variant. Sanger sequencing results confirmed that the pathogenic gene mutation site perfectly co-segregated with the auditory neuropathy phenotype in this family. According to the classification criteria and guidelines for genetic variations by the American College of Medical Genetics and Genomics, the variant was classified as a pathogenic mutation. Conclusion:The mitochondrial MT-TS1 gene mutation m.7471dup is considered to be the pathogenic cause in this late-onset auditory neuropathy pedigree.

Objective:To study the surface characterization and bonding strength of zirconia ceramic following nonthermal argon plasma(NTAP)treatment for different times.Methods:Zirconia ceramics were cut into 2 sizes of specimens(Ⅰ:10 mm×10 mm ×2 mm,Ⅱ:3 mm3 mm×2 mm),which were respectively subdivided into 5 groups:blank control group(A),sandblasting group(B)and NTAP treatment for 60,90 and 120 s groups(C,D and E respectively).The changes in surface morphology,roughness,C and O elements and contact angle of the sample surfaces were tested with Type Ⅰ specimens.Type Ⅱ specimens were applied to the uniform surface treatments and were cemented to isolated teeth using the RelyX U200 cement,the samples were submitted to a shear bond strength(SBS)test.Results:SEM and AFM show that NTAP treatment does not alter the surface morphology and roughness of zirconia ceramics.C element decreased and O element increased,and the contact angle became smaller after NTAP treatment.Among the 5 groups,group D showed the most extensive changes.And the result of SBS was as follows of NTAP treat-ment time:0 s＜60 s＜90 s=120 s(among 0,60 and 90 s groups,P＜0.05).Conclusion:NTAP treatment can improve the bond strength of zirconia ceramic by increasing its surface energy and wettability,and NTAP treatment for 90 s may be a suitable surface treatment method for zirconia ceramics.

Objective:To explore the psychological vulnerability characteristics of patients after percutaneous coronary intervention (PCI) based on symptom network analysis, and to provide evidence for maintining their psychological health.Methods:Using a cross-sectional survey method, from October 2023 to March 2024, a convenience sampling approach was employed to conduct a questionnaire survey among patients who underwent percutaneous coronary intervention (PCI) in the general ward of the Cardiology Department at Peking University Third Hospital. The survey involved a general information questionnaire and Mental Vulnerability Questionnaire. The R language was used to construct a symptom network to describe the relationship between each symptom of patients′psychological vulnerability, and its centrality index was calculated.Results:A total of 260 post-PCI patients were enrolled, including191 males and 69 females, with a mean age of (62.38 ± 12.91) years and a total psychological vulnerability score of (47.25 ± 13.18). Multiple linear regression analysis showed that the level of mental vulnerability was higher in patients with female gender ( β = 0.207, P = 0.001) and higher number of comorbidities/past history ( β = 0.126, P = 0.039). In the symptom network analysis, the symptoms with the highest node strength, tight centrality, and mediator centrality were "You often feeling unwell" ( rs = 1.25, rc = 0.003 45, rb = 2.61), "You always in a bad mood" ( rs = 1.15) and "You often have anxiety attacks" ( rs = 1.13) were second only to "You often feeling unwell" in the center of intensity. Conclusions:The core symptom of psychological vulnerability in post-PCI patients is "You often feeling unwell", and mental symptoms are in a more central position. Nursing staff should take mental symptoms as the target of intervention, and strengthen the holistic care for patients′physical-psychological-mental symptoms, so as to effectively reduce the level of psychological vulnerability of the patients, and to maintain their psychological health.

Objective:To study the surface characterization and bonding strength of zirconia ceramic following nonthermal argon plasma(NTAP)treatment for different times.Methods:Zirconia ceramics were cut into 2 sizes of specimens(Ⅰ:10 mm×10 mm ×2 mm,Ⅱ:3 mm3 mm×2 mm),which were respectively subdivided into 5 groups:blank control group(A),sandblasting group(B)and NTAP treatment for 60,90 and 120 s groups(C,D and E respectively).The changes in surface morphology,roughness,C and O elements and contact angle of the sample surfaces were tested with Type Ⅰ specimens.Type Ⅱ specimens were applied to the uniform surface treatments and were cemented to isolated teeth using the RelyX U200 cement,the samples were submitted to a shear bond strength(SBS)test.Results:SEM and AFM show that NTAP treatment does not alter the surface morphology and roughness of zirconia ceramics.C element decreased and O element increased,and the contact angle became smaller after NTAP treatment.Among the 5 groups,group D showed the most extensive changes.And the result of SBS was as follows of NTAP treat-ment time:0 s＜60 s＜90 s=120 s(among 0,60 and 90 s groups,P＜0.05).Conclusion:NTAP treatment can improve the bond strength of zirconia ceramic by increasing its surface energy and wettability,and NTAP treatment for 90 s may be a suitable surface treatment method for zirconia ceramics.

Objective:To explore the psychological vulnerability characteristics of patients after percutaneous coronary intervention (PCI) based on symptom network analysis, and to provide evidence for maintining their psychological health.Methods:Using a cross-sectional survey method, from October 2023 to March 2024, a convenience sampling approach was employed to conduct a questionnaire survey among patients who underwent percutaneous coronary intervention (PCI) in the general ward of the Cardiology Department at Peking University Third Hospital. The survey involved a general information questionnaire and Mental Vulnerability Questionnaire. The R language was used to construct a symptom network to describe the relationship between each symptom of patients′psychological vulnerability, and its centrality index was calculated.Results:A total of 260 post-PCI patients were enrolled, including191 males and 69 females, with a mean age of (62.38 ± 12.91) years and a total psychological vulnerability score of (47.25 ± 13.18). Multiple linear regression analysis showed that the level of mental vulnerability was higher in patients with female gender ( β = 0.207, P = 0.001) and higher number of comorbidities/past history ( β = 0.126, P = 0.039). In the symptom network analysis, the symptoms with the highest node strength, tight centrality, and mediator centrality were "You often feeling unwell" ( rs = 1.25, rc = 0.003 45, rb = 2.61), "You always in a bad mood" ( rs = 1.15) and "You often have anxiety attacks" ( rs = 1.13) were second only to "You often feeling unwell" in the center of intensity. Conclusions:The core symptom of psychological vulnerability in post-PCI patients is "You often feeling unwell", and mental symptoms are in a more central position. Nursing staff should take mental symptoms as the target of intervention, and strengthen the holistic care for patients′physical-psychological-mental symptoms, so as to effectively reduce the level of psychological vulnerability of the patients, and to maintain their psychological health.

Objective:The aim of this study is to analyze the clinical characteristics and genetic variants of a late-onset auditory neuropathy pedigree caused by maternally inherited- mitochondrial mutation.Methods:A male proband who presented with bilateral sensorineural hearing loss at Henan Children′s Hospital in September 2023 was chosen, along with his family members (4 generations, 20 individuals) as the study subjects. Data from this pedigree were collected, organized, and analyzed for clinical genetic characteristics. Medical histories were obtained from family members, pedigree charts were drawn, audiological, imaging, and physical examinations were conducted. Pathogenic genes and mutations were screened using high-throughput sequencing. Sanger sequencing was employed for variant confirmation and segregation validation in the family.Results:In this family, a total of 12 members (10 members collected) had sensorineural hearing loss, characterized by late-onset hearing impairment with an onset age ranging from 9 to 30 years. The patients exhibited poor speech recognition rates, and audiometric examinations are consistent with auditory neuropathy. There was no history of ototoxic drug use. High-throughput sequencing identified the variant NC_012920.1:m.7471dup in the mitochondrial MT-TS1 gene as the pathogenic variant. Sanger sequencing results confirmed that the pathogenic gene mutation site perfectly co-segregated with the auditory neuropathy phenotype in this family. According to the classification criteria and guidelines for genetic variations by the American College of Medical Genetics and Genomics, the variant was classified as a pathogenic mutation. Conclusion:The mitochondrial MT-TS1 gene mutation m.7471dup is considered to be the pathogenic cause in this late-onset auditory neuropathy pedigree.

Objective:To investigate the practicality of TrueFidelity deep learning reconstruction algorithm in low-dose abdominal and pelvic CT angiography (CTA).Methods:The patients who required abdominal and pelvic CTA were prospectively included at the First Affiliated Hospital of Xi′an Jiaotong University from June 2020 to March 2021. All patients underwent low-dose CTA with a tube voltage of 80 kV and smart tube current modulation (100-720 mA). Images were reconstructed using the traditional FBP, adaptive statistical iterative reconstruction with a strength of 50% (ASIR-V 50%), TrueFidelity with medium (TF-M) and high (TF-H) strength. The CT value and standard deviation (SD value) of the abdominal aorta, psoas major muscle and subcutaneous fat in the same layer were measured, signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated. We also introduced the measurement of skewness of CT value in psoas major muscle with uniform density. The above indexes of the four groups of reconstructed images were compared. A 5-point scoring method was used to evaluate the granularity, fuzziness and beam-hardening artifacts of all images. Objective measurement indicators, such as CT values, were tested by repeated measure ANOVA with the Bonferroni post hoc test.Results:There were forty-six patients in the study. The volume CT dose index of the scan was low at (1.09±0.31)mGy. There was no significant difference in CT values of vessels and muscles between the four groups ( P>0.05), but there was a significant difference in SD value( P<0.001). The SD value of the FBP group was the largest and that of the TF-H group was the smallest. The difference between SNR and CNR was statistically significant ( P<0.001), and the overall trend was opposite to that of the SD value. There was no significant difference in the skewness between the four groups. The granularity score of the FBP group was the largest, that of the TF-H group was the smallest, and there was a significant difference among the four groups. The score of fuzziness in the TF-H group was slightly higher than that in the other three groups, but there was no significant difference. The beam-hardening artifact score of FBP and ASIR-V 50% group was the worst, and the TF-H group was the best ( P<0.001). Conclusions:Compared with FBP and ASIR-V, TrueFidelity reconstruction algorithm provides better image quality (comprehensively considering image noise, fuzziness, uniformity, and hardening artifacts) in low-dose CT scanning of abdominal and pelvic vessels, and TF-H has the best image quality.