[Objective]To explore the protective effect of glucocorticoid-induced transcription factor 1(GLCCI1)on cognitive dysfunction in diabetic mice and its mechanism.[Methods]Twenty-four C57BL/6J mice were randomly divided into 4 groups,namely Control,DM,DM+AAV-Glcci1,and DM+AAV-NC.The Control group was intraperitoneally injected with saline,while the other groups were all injected with streptozotocin(STZ).Two weeks after successful modeling,the DM+AAV-Glcci1 group was brain stereotactic injected with Glcci1 overexpressing adeno-associated virus,and the DM+AAV-NC group was stereoscopically injected with the control virus.After 12 weeks,the Morris water maze test was used to evaluate the learning and memory abilities of mice in each group.Subsequently,the localized expression of GLCCI1 in the hippocampus were determined by immunofluorescence and immunohistochemistry experiments.The myelin morphology in the hippocampus was observed by LFB staining,the neuronal morphology was observed by Nissl staining,and the myelin-related proteins MBP and CNPase were stained by immunohistochemistry.Molecular docking was used to predict the interaction between GLCCI1 and HSPA5.The expression of endoplasmic reticulum stress-related proteins was detected by Western blot.[Results]The results of the behavioral experiment showed that compared with the mice in the Control group,DM mice exhibited obvious cognitive dysfunction behaviors(P＜0.000 1),and the learning and memory abilities of mice improved after overexpression of Glcci1(P=0.000 7).The results of immunofluorescence and immunohistochemistry showed that GLCCI1 was expressed in hippocampal neuron cells.Compared with Control mice,the expression level of GLCCI1 in DM mice was significantly downregulated(P＜0.000 1).The molecular docking results revealed that GLCCI1 interacts with HSPA5.The Western blot results indicated that,compared with the Control group,the expression levels of endoplasmic reticulum stress-related proteins HSPA5(P＜0.000 1),ATF4(P＜0.000 1),ATF6(P=0.001 1),and p-ELF2α/elF2α(P=0.000 1)in the DM group were significantly increased;Compared with the DM group,the expression of the corresponding protein HSPA5(P＜0.000 1),ATF4(P＜0.000 1),ATF6(P=0.000 2),and p-ELF2α/elF2α(P=0.000 1)was significantly down-regulated after overexpression of Glcci1.LFB staining showed that compared with the Control group,the myelin integrity of DM mice decreased significantly(P=0.010 3),the expressions of myelin-related proteins MBP and CNPase decreased significantly(P=0.000 4,P=0.000 2),and Nissl staining observed disordered neuronal arrangement.Compared with the mice in the DM group,the myelin integrity in the hippocampal region significantly increased after overexpression of Glcci1(P=0.000 3),the expressions of myelin-related proteins MBP and CNPase significantly increased(P=0.001 4,P=0.000 1),and the ordered arrangement of neurons was observed by Nissl staining.[Conclusion]The down-regulation of GLCCI1 expression in hippocampal neurons promotes demyelination of hippocampal neurons and thereby induces diabetic cognitive dysfunction.The specific mechanism may be related to endoplasmic reticulum stress.

Objective To build a whole-course nursing quality evaluation system for liver transplanta-tion in children,so as to provide a basis for nursing quality evaluation and management.Methods With Donabedian's"structure-process-outcome"model as the theoretical framework,we employed literature analysis,Delphi method,and hierarchical analysis to determine the contents and weights of indexes in the whole-course nursing quality evaluation system for liver transplantation in children.Results The three rounds of survey based on questionnaires showed the questionnaire recovery rate of 100% ,the expert authority coefficients of 0.95,0.96,and 0.98,and the Kendall's coefficients of concordance of 0.165,0.209,and 0.220,respectively(all P<0.001).The established nursing quality evaluation system included 3 first-level indexes,15 second-level inde-xes,and 67 third-level indexes.Conclusion The whole-course nursing quality evaluation system for liver trans-plantation in children that was built in this study can provide a basis for the evaluation of the nursing quality.

Objective To investigate the efficacy of Amplatzer duct occluder-Ⅱ device(ADO-Ⅱ)in treating ventricular septal detect(VSD)with aortic sinus prolapse(ASP)in child patients.Methods The clinical data of 94 child patients with VSD complicated by ASP,who were admitted to the Hunan Provincial Children's Hospital of China between January 2018 and September 2022,were retrospectively collected.The child patients included 60 males and 34 females with a mean age of(4.7±3.1)years.Mild-moderate ASP was seen in 83 child patients,with a mean(4.12±0.97)mm-sized VSD.Severe ASP was seen in 11 child patients,with a mean(4.95±0.51)mm-sized VSD.Perimembrane VSD was observed in 54 child patients and intracristal VSD in 40 child patients.The relationship of VSD size and degree of ASP to the selection of ADO-Ⅱ,postoperative middle period aortic valve regurgitation and residual leakage was analyzed,so as to clarify the applicability of ADO-Ⅱ to such child patients.Results In the postoperative middle period,6 child patients had mild aortic valve regurgitation,most seen in the child patients who received 4-4 mm or 5-4 mm ADO-occluder;and 10 child patients had residual leakage,mainly seen in the child patients who received 5-4 mm or 6-4 mm occluder.Conclusion In the condition when the ADO-Ⅱ occluder shows satisfactory placement pattern,this treatment is suitable for the child patient having＜6 mm VSD with ASP.Although there are some residual leakage and aortic valve regurgitation after surgery,this interventional therapy still meets the clinical requirements.(J Intervent Radiol,2024,32:17-21)

Objective To observe the efficacy and safety of sacubitril valsartan in the treatment of dilated cardiomyopathy (DCM) in children. Methods A total of 19 hospitalized children with DCM were retrospectively selected as study subjects. All patients received captopril combined with conventional anti-heart failure therapy for 1 to 4 weeks, but due to ineffective treatment, they were switched to treatment of sacubitril valsartan. Clinical data, biochemical indicators, and echocardiographic findings were collected to assess changes in clinical symptoms and related indicators after 1-, 3-, 6-, and 12-month sacubitril valsartan treatment. Information on the dosage and administration of sacubitril valsartan, as well as the occurrence of adverse reactions was collected. Results Among 19 patients, there were 8 males and 11 females, with a median age of 3 years. Heart function was classified as grade Ⅱ in 2 patients, grade Ⅲ in 10 patients, and grade Ⅳ in 7 patients. At the final follow-up, the efficacy assessment showed significant improvement in 8 patients, effective improvement in 6 patients, and no improvement in 5 patients, with a total effective rate of 73.7%. After 1-, 3-, 6-, and 12-month sacubitril valsartan treatment, the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) were lower, left ventricular ejection fraction (LVEF) was higher, and left ventricular diastolic diameter (LVDd)-Z value was smaller compared with those before treatment (P < 0.05). The initial single dose of sacubitril valsartan was 0.8 mg/kg, and the average maintenance dose was 1.7 mg/kg, administered twice daily. After treatment, 1 patient developed hypotension, and 5 patients exhibited mild abnormalities in renal function indicators (of which 4 recovered to normal levels after tolerance). Conclusion Sacubitril valsartan can effectively improve heart failure symptoms and cardiac function indicators in children with DCM, but close monitoring of blood pressure and renal function changes is required during treatment.

Colorectal surgery originated in early civilizations, since then, its evolution follows a certain pattern. Most surgical techniques have their historical basis and have never been separated from social, technological, and conceptual progress. Given that the development of colorectal surgery and the development of surgical platforms and surgical concepts have mutually reinforced each other, this article collects historical information related to colorectal surgery and provides its historical review from the ancient Egyptian culture to modern civilization, taking into account the development of surgical platforms and concepts. The evolution of colorectal surgery is described as "for an understanding of the future, look to the past". For colorectal surgeons, in particular, a proper understanding of the evolution of colorectal surgery is the best way to understand its direction.

Objective:To analyze the research hotspots of foreign liver transplantation nursing, and explore the current research trends in this field.Methods:The subject words of liver transplantation nursing literature included in Web of Science were used as the research object, the retrieval time was from the establishment of the database to November 24, 2021, and Bicomb software was used for word frequency analysis, and SPSS software was used carry out systematic clustering analysis on high-frequency keywords.Results:Two hundred and ninety-four articles were finally included and published in 169 journals. Thirty high-frequency subject words were extracted, accounting for 47.60% of the total frequency. Through co-word cluster analysis, it is found that research hotspots include 7 categories: pediatric liver transplantation and family, quality of life and transitional care, postoperative complications and psychology, organ donation and ethics, treatment compliance, intensive care and psychiatry, nutrition and symptoms management.Conclusions:It is suggested that the future nursing research of liver transplantation in China should focus on pediatric living donor liver transplantation and family management, symptom management of liver transplantation recipients, nutrition management of pediatric liver transplantation recipients, psychiatric complications after transplantation in ICU, nursing ethics of liver transplantation, etc. So as to improve the nursing development level of liver transplantation in China.

Objective:To evaluate the inflammatory factors effects of early endoscopic therapy for elderly patients with acute biliary pancreatitis (ABP) and its clinical efficacys.Methods:206 elderly patients with ABP admitted from Jan. 2010 to Dec. 2019 were divided into observation group (102 cases) and the control group (104 cases) according to treatment method. The observation group received endoscopic retrograde cholangiopancreatography (ERCP) , endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) , while the control group received conventional treatment. Clinical symptoms, changes of inflammatory factors, complications and prognosis were observed in each group.Results:CRP, SAA, IL-6, IL-8 and TNF-a after treatment were significantly lowered than those before treatment ( P<0.05) . In addition, the levels of CRP, SAA, IL-6, IL-8 and TNF-a in the observation group were significantly lower than those in the control group ( P<0.05) . The time to abdominal pain extinction, time to fever cessation, hospital stay in observation group were (3.92±1.54) , (3.63±1.41) , and (14.35±2.46) d, significantly less than those in the control group [ (5.81±1.72) , (5.45±2.13) , (19.37±3.12) d, P<0.05]. APACHE Ⅱ score of the observation group was (10.02±2.67) point after treatment, significantly lower than that in the control group [ (12.35±3.62) point, t=4.42, P<0.05]. The incidence of complications in the observation group was 10.78% after treatment, significantly lower than that in the control group [ (24.03%) , χ2=6.27, P< 0.05]. The mortality in the observation group was 1.96%, lower than 4.81% in the control group, with no statistical significance. Conclusion:Early endoscopic therapy is safe and highly effective for elderly patients with ABP, with the advantages of shorter hospital stay, quicker subsided inflammation, and lower incidence of complications.

Objective:To investigate the clinical effect of hyperbaric oxygen (HBO) combined with platelet-rich plasma (PRP) in the reconstruction of anterior cruciate ligament injury (ACLI).Methods:A total of 100 ACLI patients who were treated in the Department of Joint Trauma Surgery of Qingdao Jiaozhou Central Hospital from January 2018 to May 2019 were randomly divided into two groups according to the random number table: observation group and control group. Each group had 50 cases. The patients in the control group were only treated with PRP, while the patients in the observation group were treated with hyperbaric oxygen combined with PRP. Then the curative effect of the two groups, Lysholm, Tegner, and IDKC scores of knee joint, serum insulin-like growth factor-1 (IGF-1), bone gla protein (BGP), and matrix metalloproteinase-1 (MMP-1) were observed after 3 consecutive courses of treatment.Results:After 3 consecutive courses of treatment, the total effective rate of the observation group (90.0%) was significantly higher than that of the control group (68.0%) ( P<0.05); the difference was statistically significant. The scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group and the control group were significantly higher than those before treatment, and the scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group were significantly higher than those in the control group ( P<0.05). The contents of IGF-1, BGP, and MMP-1 in the two groups were significantly lower than those before treatment, and those contents of observation group were significantly lower than those of the control group ( P<0.05). Conclusion:HBO combined with platelet-rich plasma can effectively improve the therapeutic effect of ACLI reconstruction, improve the serum contents of IGF-1, BGP, and MMP-1. This treatment, therefore, is worthy of popularization and application in clinic.

Objective:To investigate the clinical effect of hyperbaric oxygen (HBO) combined with platelet-rich plasma (PRP) in the reconstruction of anterior cruciate ligament injury (ACLI).Methods:A total of 100 ACLI patients who were treated in the Department of Joint Trauma Surgery of Qingdao Jiaozhou Central Hospital from January 2018 to May 2019 were randomly divided into two groups according to the random number table: observation group and control group. Each group had 50 cases. The patients in the control group were only treated with PRP, while the patients in the observation group were treated with hyperbaric oxygen combined with PRP. Then the curative effect of the two groups, Lysholm, Tegner, and IDKC scores of knee joint, serum insulin-like growth factor-1 (IGF-1), bone gla protein (BGP), and matrix metalloproteinase-1 (MMP-1) were observed after 3 consecutive courses of treatment.Results:After 3 consecutive courses of treatment, the total effective rate of the observation group (90.0%) was significantly higher than that of the control group (68.0%) ( P<0.05); the difference was statistically significant. The scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group and the control group were significantly higher than those before treatment, and the scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group were significantly higher than those in the control group ( P<0.05). The contents of IGF-1, BGP, and MMP-1 in the two groups were significantly lower than those before treatment, and those contents of observation group were significantly lower than those of the control group ( P<0.05). Conclusion:HBO combined with platelet-rich plasma can effectively improve the therapeutic effect of ACLI reconstruction, improve the serum contents of IGF-1, BGP, and MMP-1. This treatment, therefore, is worthy of popularization and application in clinic.

Objective To evaluate the efficacy and safety of single flexible ureteroscope vs.flexible ureteroscope combined with intraoperative ultrasonography guided in the endogenous renal cyst incision and drainage.Methods Retrospective analysis of case data of 64 patients with endogenous renal cysts admitted from January 2015 to December 2017.All the patients undrwent contrast-enhanced CT,urinary tract imaging,ultrasound B to confirm bosniak classification Ⅰ and Ⅱ renal cyst.The patients (38 males,26 females) were divided into single flexible ureteroscope group [group A,32 cases of patients,average age (54.2 ±6.6) years,unilateral or bilateral cystic patients:19 cases/ 13cases,simple cyst of kidney or polycystic kidney:24 cases/8 cases,average maximum diameter of the renal cyst (5.4 ± 1.3) cm,combined with renal calculus:8 cases,combined with hydronephrosis:7 cases,1 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture] and flexible ureteroscope group combined with intraoperative ultrasonography guided [group B,32 cases of patients,average age (52.3 ± 9.3) years,unilateral or bilateral cystic patients:21 cases/11 cases,simple cyst of kidney or polycystic kidney:25 cases/7 cases.Average maximum diameter of the renal cyst (5.3 ±1.2) cm,combined with renal calculus:9 cases,combined with hydronephrosis:8 cases,2 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture].The double J stent was placed two weeks before the surgery into the body of patients.During the operation,the surgical procedure were used by the electronic flexible ureteroscope and holmium laser (0.8 J,20 Hz),combined with ultrasound B in the monitoring,to find the suitable incision position.It would be defined as the successful result if we could put the head of flexible ureteroscope into the inside of renal cyst and see the image of mist in the screen of ultrasound B.According to the standard,the result of operation wound be defined compared to before operation (success:shrink more than 80％ or maximum diameter was smaller than 1 cm;improvement:shrink about 50％-79％;ordinary result:shrink about 30％-49％;failure:shrink smaller than 30％).Effective rate =(success cases + improvement cases)/total cases.We compared the differences of two groups in the time,efficacy,safety and complication of surgery.Results Compared the results of single flexible ureteroscope groups vs flexible ureteroscope group combined with intraoperative ultrasonography guided in the success cases of surgery,after 8-30 months following-up,total operative complication rate was [8 cases(25％)vs.1 case(3.1％)],success rate of operation in 6 month later [(20 cases (62.5％) vs.28 cases (87.5％)].Flexible ureteroscope group combined with intraoperative ultrasonography guided had advantages statistically (P ＜ 0.05).However,there was no statistical difference for the two groups in the time of operation [(33.4 ± 6.7) min vs.(35.1 ± 8.6) min],single operative complication (intraoperative wounding bleeding:3 cases vs.1 case,postoperative urinary infection:3 cases vs.0 case,perinephric space effusion:2 cases vs.0 case,renal function impairment:1 case vs.0 case)(P ＞0.05).Conclusions Flexible ureteroscope combined with intraoperative ultrasonography guided can help the urologist can improve the success rate of surgery and reduce the chance of surgical injury intraoperatively.