Alcoholic steatohepatitis (ASH) is a liver disease characterized by steatosis, inflammation, and necrosis of the liver tissue as a result of excessive alcohol consumption. Pregnane X receptor (PXR) is a xenobiotic nuclear receptor best known for its function in the transcriptional regulation of drug metabolism and disposition. Clinical reports suggested that the antibiotic rifampicin, a potent human PXR activator, is a contraindication in alcoholics, but the mechanism was unclear. In this study, we showed that the hepatic expression of fatty acid binding protein 4 (FABP4) was uniquely elevated in ASH patients and a mouse model of ASH. Pharmacological inhibiting FABP4 attenuated ASH in mice. Furthermore, treatment of mice with the mouse PXR agonist pregnenolon-16α-carbonitrile (PCN) induced the hepatic and circulating levels of FABP4 and exacerbated ASH in a PXR-dependent manner. Our mechanism study established FABP4 as a transcriptional target of PXR. Treatment with andrographolide, a natural compound and dual inhibitor of PXR and FABP4, alleviated mice from ASH. In summary, our results showed that the PXR-FABP4 gene regulatory axis plays an important role in the progression of ASH, which may have accounted for the contraindication of rifampicin in patients of alcoholic liver disease. Pharmacological inhibition of PXR and/or FABP4 may have its promise in the clinical management of ASH.

Objective:To retrieve the relevant guidelines and expert consensus on self-management of patients with high-risk foot diabetes, and analyze the content of high-quality guidelines and expert consensus recommendations, so as to provide a reference for the construction of a guidance program for self-management of patients with high-risk foot diabetes.Methods:Computer-retrieved clinical practice guidelines and expert consensus for self-management of patients with high-risk foot for diabetes from databases, guideline networks, and related professional websites. The search period was from January 1, 2012 to June 5, 2022. The quality of the included literature was evaluated and the evidence was extracted and integrated by 2 researchers. Experts were invited to evaluate the summarized evidence.Results:According to the quality of literature, a total of 12 guidelines (10 at level A and 2 at level B) and 3 expert consensus (expert discussion and decision) were included, and 8 themes were defined as regular follow-up, self-assessment, foot and decompression management, exercise management, nutrition management, indicator management, psychological management, and health education, a total of 28 recommendations. Among them, there were 23 A-level recommendations and 5 B-level recommendations.Conclusions:The quality of the guidelines and expert consensus included in this study is high,the recommended level of the summarized evidence is high. This study provides the reference and basis for the clinical staff to construct and guide the clinical practice of self-management of high-risk diabetic foot patients.

OBJECTIVE Parkinson's disease(PD)is a progressive neurodegenerative disease clinically char-acterized by dyskinesia,tremor,rigidity,abnormal gait,whereas 90%of patients with PD suffer from defects of the sense of smell before the appearance of the motor dysfunctions.However,the mechanism of olfactory disor-der is still not clear.METHODS We utilized olfaction based delayed paired association task in head-fixed mice.We focused on functional role of neural circuit using opto-genetic techniques.In addition,we viewed the synaptic transmission by slice physiological recording and count-ed the cell number of targeted circuits.RESULTS AND CONCLUSION In our experiments,olfactory working memory impairments were found in the PD mice,and the working memory impairment appeared before motor dys-functions.Furthermore,we also investigated the functional role of neural circuit for olfactory working memory in PD mice.Meanwhile,the excitatory post synaptic currents were decreased as a result of presynaptic release proba-bility suppression in PD mice.However cell loss wasn't found in working memory related circuit recently.These will provide a new idea of clinic diagnosis for PD.

Objective:To investigate the effect and mechanism of circular RNA (cirRNA) on the radiosensitivity of rectal cancer.Methods:The differential circRNAs in radiosensitive and radioresistant rectal cancer tissues (biopsy tissue before radiotherapy and chemotherapy) were detected by gene sequencing, and the effect of circRNAs on the radiosensitivity of colorectal cancer cells was further confirmed in vitro. Results:Through gene sequencing of rectal cancer tissue samples, 64 circRNAs were found to be highly expressed in radiosensitive rectal cancer tissues, and 36 circRNAs were lowly expressed in radiosensitive tissues. Ten differential circRNAs were selected and verified by qRT-PCR, and it was found that circATL2 was highly expressed in radiosensitive rectal cancer tissues. In vitro cell experiment indicated that up-regulation of circATL2 expression could significantly improve the radiosensitivity of rectal cancer. Subsequently, 8 miRNAs lowly expressed in radiosensitive rectal cancer tissues were analyzed. The direct binding relationship between miR-205 and circATL2 was confirmed by dual luciferase reporter assay. The rescue experiment confirmed that circATL2 in rectal cancer regulated the radiosensitivity of rectal cancer through miR-205. Conclusion:circATL2 regulates the radiosensitivity of rectal cancer by binding to miR-205.

Hyperglycemia and hyperosmolar state (HHS) is an acute complication of diabetes with a higher mortality rate. Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) , among which fatal PTE is one of the main causes of sudden death in hospitalized patients. There are relatively few clinical reports about the simultaneous occurrence of HHS and VTE. This article introduces the successful treatment of an elderly patient with HHS combined with VTE and gastrointestinal bleeding to improve clinicians’ understanding of the disease.

Objective:To investigate the status quo of knowledge, attitude and practice of enterostomal therapists (ET) in chronic wound pain management and analyze its influencing factors, so as to provide references and suggestions for continuous improvement of wound pain management.Methods:The convenient sampling method was used to investigate 260 ET objects. The survey tools were a self-designed General Information Questionnaire and questionnaires on knowledge, attitude and practice of ET on chronic wound pain.Results:A total of 260 questionnaires were distributed and 238 were valid. The score of ET on chronic wound pain knowledge questionnaire was (5.90±1.49) , the score of ET on chronic wound pain attitude questionnaire was (25.74±3.57) and the score of ET on chronic wound pain management practice questionnaire was (53.28±12.52) . The results of multiple linear regression showed that professional title, working years in wound care and working experience in relevant departments of oncology were the influencing factors of knowledge, attitude and practice of ET in chronic wound pain management ( P<0.05) . Conclusions:ET lacks knowledge of chronic wound pain and has acceptable attitudes, and his practical behaviors need to be strengthened urgently.Hospital administrators vigorously develop full-time ET and implement multidisciplinary collaboration to manage wound pain. When selecting ET training personnel, it is recommended that nurses at or above the intermediate level be the target of training. For ET, it is necessary to continuously improve professional titles and re-learn, and continuously accumulate experience in practice. For ET schools, a wound pain training knowledge system based on job competence should be established, and corresponding training should be carried out for wound specialist nurses.

SOCS3, a feedback inhibitor of the JAK/STAT signal pathway, negatively regulates axonal regrowth and inflammation in the central nervous system (CNS). Here, we demonstrated a distinct role of SOCS3 in the injured spinal cord of the gecko following tail amputation. Severing the gecko spinal cord did not evoke an inflammatory cascade except for an injury-stimulated elevation of the granulocyte/macrophage colony-stimulating factor (GM-CSF) and interferon gamma (IFN-γ) cytokines. Simultaneously, the expression of SOCS3 was upregulated in microglia, and unexpectedly not in neurons. Enforced expression of SOCS3 was sufficient to suppress the GM-CSF/IFN-γ-driven inflammatory responses through its KIR domain by attenuating the activities of JAK1 and JAK2. SOCS3 was also linked to GM-CSF/IFN-γ-induced cross-tolerance. Transfection of adenovirus overexpressing SOCS3 in the injured cord resulted in a significant decrease of inflammatory cytokines. These results reveal a distinct role of SOCS3 in the regenerating spinal cord, and provide new hints for CNS repair in mammals.

Objective To investigate the clinical efficacy of plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach in the treatment of type C2 and C3 humeral intercondylar fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 23 patients with humeral intercondylar fractures admitted to the Affiliated Hospital of Hangzhou Normal University from June 2014 to January 2017.There were 17 males and six females,aged 19-56 years,with an average of 41.2 years.According to AO classification,there were 15 patients with type C2 and eight with type C3.All patients were treated with plate internal fixation by olecranon osteotomy approach.The patients were divided into anterior group (11 patients) which was treated with ulnar nerve release anterior transposition and in situ reinforcing group (12 patients) which was treated with ulnar nerve release in situ.The operation time,intraoperative blood loss,fracture healing time,elbow flexion and extension range,elbow joint Mayo score,and excellent and good rate were compared between the two groups.Postoperative complications were recorded.Results All patients were followed up for 15-43 months,with an average of 26.7 months.All patients had no need of blood transfusion.There were no significant differences between anterior group and in situ reinforcing group in operation time [(219.1 15.1) minutes vs.(211.2 ± 17.1) minutes],intraoperative blood loss [(263.6 ± 35.3) ml vs.(237.5 ±25.6)ml] and fracture healing time [(18.2±2.4)weeksvs.(18.9±1.7)weeks] (P＞0.05).Nosignificant differences were found between the two groups in elbow flexion [(120.3 ±7.1) ° vs.(120.3 ±4.1)°],straightness [(3.7±2.7)° vs.(4.1 2.4)°],Mayo score [(89.09 ±9.17)points vs.(86.67 ±10.29)points] and excellent and good rate [91％ (10/12) vs.83％ (10/12)] (P ＞0.05).After operation,no complications such as infection,heterotopic ossification,ulnar neuritis,elbow valgus deformity,or internal fixation failure occurred.Conclusions For humeral intercondylar fracture,the plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach both have advantages such as small surgical trauma,strong fixation,fewer complications,satisfactory recovery of elbow function.Ulnar nerve anterior transposition or not does not affect the occurrence of ulnar neuritis,and both can obtain satisfactory clinical efficacy.

Objective: To investigate the clinical efficacy of colchicine tablets in the treatment of patients with gouty arthritis, and to observe the effect of colchicine tablets on erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and uric acid (UA). Methods: From March 2016 to March 2017, 70 patients with gouty arthritis in our hospital were randomly divided into control group and observation group according to the random number table method.The control group was treated with celecoxib capsules 0.2g, 2 times a day.The observation group was treated with colchicine tablets 0.5mg three times daily, celecoxib capsules 0.2g, 2 times a day.The visual analogue scale (VAS) was used to evaluate the degree of joint pain in two groups.The Likert scale was used to evaluate the swelling of the two groups before and after treatment.The pain relief time was recorded in both two groups.The ESR, CRP and UA were measured before and after treatment.The clinical effects and adverse reactions in the two groups were analyzed. Results: After treatment, the VAS score of the observation group was (2.04±0.52)points, which was significantly lower than (3.53±1.22)points of the control group(t=6.64, P=0.00). The joint swelling score of observation group after treatment was (0.62±0.24) points, which was significantly lower than (1.21±0.33)points of the control group(t=8.55, P=0.00). After treatment, the VAS score and joint swelling score in the two groups were significantly lower than those before treatment (all P<0.05). The pain relief time of the observation group was significantly shorter than that of the control group [(1.36±0.47)d vs.(1.79±0.63)d, t=3.23, P=0.00]. After treatment, the ESR, CRP and UA levels of the observation group were (12.65±3.17)mm/h, (12.14±2.27)mg/L, (417.82±55.88)μmol/L, respectively, which were significantly lower than those of the control group [(14.77±4.22)mm/h, (14.69±3.16)mg/L, (458.93±62.74)μmol/L, t=2.37, 3.87, 2.37, P=0.02, 0.00, 0.00]. After treatment, the ESR, CRP and UA levels of the two groups were significantly lower than those before treatment (all P<0.05). The total effective rate of the observation group was 80.00%, which was obviously higher than 57.14% of the control group(χ²=7.55, P=0.02). The incidence rate of adverse reaction of the observation group was 8.57%, which of the control group was 5.71%, the difference was not statistically significant (χ²=0.21, P=0.64). Conclusion Colchicine tablets combined with celecoxib capsules in the treatment of patients with gouty arthritis can reduce ESR, CRP and UA levels, improve the degree of pain and joint swelling, and will not increase the adverse reactions.

Objective To explore the psychological status of the patients with breast cancer and its influencing factors.Methods The psychological health status in 896 patients with breast cancer and 1 419 patients with benign breast diseases were surveyed and analyzed by adopting the Self-reporting Inventory(SCL-90).At the same time,SCL-90 was also used to analyze the differences of psychological health status among breast cancer patients with different occupations,degrees of education and family support attitudes.Results The each factor scores in breast cancer patients were higher than those in benign breast disease patients(P＜0.05).The scores of obsessive symptoms and somatization factor in breast cancer patients were higher than those of other factors(P＜0.05).In breast cancer patients,the proportion of workers and cadres with obsessive symptoms was higher than that of farmers.The family support attitude was good,and the proportion of obsessive symptoms was lower.The higher the education level,the lower the proportion of somatic symptoms.Conclusion Aiming at the existence of mental problems of higher somatization and obsessive symptoms,conducting the psychological counseling and intervention can improve the quality of life in the patients with breast cancer.