The anterior cingulate cortex (ACC) has recently been proposed as a key player in the representation of itch stimuli. However, to date, little is known about the contribution of specific ACC interneuron populations to itch processing. Using c-Fos immunolabeling and in vivo Ca²⁺ imaging, we reported that both histamine and chloroquine stimuli-induced acute itch caused a marked enhancement of vasoactive intestinal peptide (VIP)-expressing interneuron activity in the ACC. Behavioral data indicated that optogenetic and chemogenetic activation of these neurons reduced scratching responses related to histaminergic and non-histaminergic acute itch. Similar neural activity and modulatory role of these neurons were seen in mice with chronic itch induced by contact dermatitis. Together, this study highlights the importance of ACC VIP⁺ neurons in modulating itch-related affect and behavior, which may help us to develop novel mechanism-based strategies to treat refractory chronic itch in the clinic.
Animals ; Pruritus/physiopathology* ; Vasoactive Intestinal Peptide/metabolism* ; Interneurons/metabolism* ; Gyrus Cinguli/metabolism* ; Mice ; Male ; Mice, Inbred C57BL ; Histamine ; Chloroquine ; Optogenetics ; Mice, Transgenic

ObjectiveTo investigate the clinical efficacy of lumbar core muscle stability training combined with kinesiology taping technique in the rehabilitation treatment of lumbar disc herniation （LDH）. MethodsA total of 99 LDH patients treated in Ningbo Yinzhou No. 2 Hospital from January 2018 to January 2020 were selected and divided into control group （n=49） and observation group （n=50）. Kinesiology taping technique was applied to patients in the control group and patients in the observation group were treated with lumbar core muscle stability training combined with kinesiology taping technique， then we compared the therapeutic effect， lumbar function and pain degree， surface electromyography of lumbar extensor muscles， lumbar range of motion， LDH recurrence and skin allergies before and after the treatment between the two groups. ResultsAfter 4 weeks of treatment， compared with those in the control group， in the observation group， the visual analogue scale （VAS） and Oswestry disability index （ODI） scores were significantly lower （P<0.05）； the Japanese Orthopaedic Association （JOA） score， mean power frequency of lumbar extensor muscles， integral electromyography value and lumbar function score were significantly higher （P<0.05）. During the treatment， there was no significant difference in the incidence of complications between two groups （P>0.05）. After 4 weeks of treatment， the observation group had a significantly lower LDH recurrence rate than the control group （P<0.05）. ConclusionLumbar core muscle stability training combined with kinesiology taping technique achieves a significantly better therapeutic effect than kinesiology taping technique in the rehabilitation treatment of LDH and can effectively relieve muscle fatigue， help alleviate lumbar spine pain and improve the function of lumbar spine.

Objective To investigate the role of lncSIL in transforming growth factor-β1(TGF-β1)-induced alveo-lar epithelial interstitial transformation(EMT)and its related signaling pathways.Methods Western blot was used to detect the effect of lncSIL silencing on the expression of E-cadherin(E-cad),alpha-smooth muscle actin(α-SMA)and Collagen I(Col I)in the process of EMT induced by TGF-β1.LncSIL interacting proteins were ana-lyzed by RNA pulldown.Western blot was used to detect the effect of overexpression or silencing of lncSIL on the expression of its target gene enhancer of zeste homolog 2(EZH2)and its downstream factors P21 and cyclin-de-pendent kinase 6(CDK6).Flow cytometry was used to analyze the effect of lncSIL on cell cycle progression.Re-sults After lncSIL silencing,the expression of α-SMA and Col I increased,the expression of E-cad decreased.RNA pulldown assay showed that EZH2 was the target protein that interacted with lncSIL,and the expression of EZH2 increased after silencing lncSIL,the expression of EZH2 downstream gene P21 decreased,CDK6 increased.Flow cytometry showed that the number of cells in S phase significantly increased.When lncSIL was overexpressed,the expression of EZH2 and CDK6 was down-regulated,the expression of P21 was up-regulated,and the number of S phase cells significantly decreased.Conclusion LncSIL inhibits TGF-β1-induced alveolar epithelial cell mesen-chymal transition by negatively regulating EZH2/P21/CDK6 signaling pathway to inhibit cell cycle progression.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To compare the efficacy between Kirschner wire and clavicular hook plate in the fixation of distal clavicle fractures in older children.Methods:A retrospective analysis was conducted of the 28 pediatric patients with distal clavicle fracture who had undergone surgical treatment at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from December 2014 to December 2023. There were 20 boys and 8 girls. Age: 10.0 (9.0, 12.8) years old; 22 left sides and 6 right sides; by the Craig modified Neer classification: 22 cases of type Ⅱ, 5 cases of type Ⅳ, and 1 case of type Ⅴ. The patients were divided into 2 groups based on their internal fixation methods. The Kirschner wire group of 12 cases were treated with open reduction and Kirschner wire fixation; the hook plate group of 16 cases were treated with open reduction and clavicular hook plate fixation. Operation time, hospital stay, fracture healing time, incidence of complications, and scores at the final follow-up (the Constant-Murley shoulder function score, quick disabilities of the arm, shoulder, and hand (quickDASH) score, and visual analog scale (VAS) for aesthetic satisfaction) were recorded and compared between the 2 groups.Results:There were no statistically significant differences in the baseline data between the 2 groups, indicating comparability ( P>0.05). The postoperative follow-up period for the 28 patients was (14.8±6.5) months. The operation time in the Kirschner wire group [(34.3±12.1) min] was significantly shorter than that in the hook plate group [(49.4±16.8) min] ( P<0.05), and the VAS score for aesthetic satisfaction at the final follow-up in the Kirschner wire group [(8.2±1.1) points] was significantly higher than that in the hook plate group [(6.2±2.6) points] ( P<0.05). There were no statistically significant differences between the 2 groups in terms of fracture healing time, hospital stay, incidence of complications, or Constant-Murley score and quickDASH score at the final follow-up ( P>0.05). Conclusions:For pediatric patients with distal clavicle fracture, both Kirschner wire fixation and clavicular hook plate fixation can achieve good functional outcomes. However, Kirschner wire fixation has advantages of shorter operation time, higher postoperative aesthetic satisfaction, and no need of a secondary surgery for implant removal.

Objective:To understand the infection status of mycobacterium tuberculosis among health workers in tuberculosis designated medical institutions and explore the risk factors of infection.Methods:From September 2021 to June 2022, a questionnaire survey was conducted among health workers in relevant departments of 4 tuberculosis designated medical institutions by cluster stratified sampling, including the implementation of hospital infection control measures in medical institutions and occupational exposure of medical staff to mycobacterium tuberculosis. Peripheral blood interferon gamma release assays (IGRAs) and lung imaging examination were performed to determine the mycobacterium tuberculosis infection. Factors with statistical significance in univariate analysis were included in multivariate logistic regression to analyze the risk factors of mycobacterium tuberculosis infection.Results:A total of 657 people completed the lung imaging examination and questionnaire, of which 654 people had peripheral blood IGRAs detection, and the latent infection rate of tuberculosis was 39.45% (258/654) . Univariate analysis showed that age, sex, marital status, economic income, occupational category, professional title, length of service, and other variables had statistical significances in tuberculosis latent infection ( P<0.05) . In terms of personal health status, there were statistically significant differences in the distribution of health workers in terms of their tuberculosis history, tuberculosis history of their immediate family members, previous tuberculin skin test (TST) ( P<0.05) . Multivariate analysis showed that there were four risk factors related to tuberculosis, including professional title ( X1) , years of tuberculosis related works ( X2) , tuberculosis history ( X3) and previous TST ( X4) . The regression equation of the probability of tuberculosis among health workers was y=-1.920+0.246 X1+0.046 X2+1.231 X3+0.478 X4. Conclusion:The latent infection rate of tuberculosis among health workers in tuberculosis designated medical institutions is high. It is necessary to strengthen the management of infection control, carry out regular screening, enhance the self-protection awareness of health workers, and reduce their exposure to mycobacterium tuberculosis and infection risk.

Asthma is a common chronic respiratory disease characterized by repeated attacks and prolonged illness.Traditional Chinese medicine believes that the formation of Sugen is the core pathogenesis of repeated asthma attacks.By tracing the origin of Sug-en theory,summarizing the connotation of ancient asthma Sugen theory and the innovative understanding of modern medical scholars on asthma Sugen,this paper explores the potential connection between the traditional Chinese medicine Sugen theory and the pathogenesis of modern asthma,in order to provide new ideas and methods for the treatment and research of asthma.

Objective To compare the interaction efficiency of three human-machine interaction modes with hand-touch control,eye movement control and voice control,based on a multi-channel human-machine interaction system in flight mission scenarios.Methods 20 pilots took part in the study and completed the first level(relatively simple)and second level(relatively complex)interactive experimental tasks in three human-computer interaction modes based on specific flight mission scenarios.The interaction efficiency indicators included the system's interaction time,response time,fusion calculation time,and number of errors.After the experiment was completed,the pilots conducted a subjective evaluation,which included the suitability of the interaction mode to the task,consistency with expected usage,fault-tolerance,effective feedback,and the tendency of the interaction mode to be applied in future flight fields.Results There were generally significant differences in interaction efficiency between hand-touch control,voice control,and eye movement control in flight mission scenarios,but the differences differed in first-level and second-level interaction tasks.Based on the comprehensive interaction experimental tasks at all levels,the experimental results obtained included:(1)the interaction time of hand-touch control was the shortest,the interaction time of voice control was the longest,and the main effect of the interaction mode was significant(F=18.214,P<0.001,η2=0.565);(2)The response time of hand-touch control was the shortest,while the response time of eye movement control was the longest.The main effect of interaction mode was significant(F=153.085,P<0.001,η2=0.944);(3)The fusion calculation time for hand-touch control was the shortest,while the fusion calculation time for voice control was the longest.The main effect of the interaction mode was significant(F=41.702,P<0.001,η2=0.777);(4)The errors in voice control were the least,while those in eye movement control were the most.The main effect of interaction mode was significant(χ2=22.845,P<0.001,φ=1.097);(5)The subjective evaluation scores of pilots on voice control were higher than those on eye movement control,and all had statistical significance(P<0.001,P<0.01).Conclusions This study focuses on flight interaction tasks and compares the interaction efficiency of three interaction modes of hand-touch control,voice control,and eye movement control,through a combination of experiments and subjective evaluations.The differences in various interaction efficiency indicators among different interaction modes are found,and the interaction modes have a significant impact on interaction efficiency.Hand-touch control has a significant advantage in interaction time efficiency,voice control has an advantage in accuracy for simple tasks,while eye movement control has relatively weak time efficiency and accuracy;Compared to eye movement control,pilots exhibit higher evaluations and tendencies towards voice control.The research results can provide reference for the future design,evaluation,and application of multi-modal interaction systems.

Objective To summarize the clinical characteristics and outcomes of corona virus disease 2019(COVID-19)in patients with adrenal insufficiency(AI),and analyze the risk factors of outcomes.Methods The clinical data of COVID-19 patients with AI in Peking Union Medical College Hospital in December 2022 were ana-lyzed retrospectively and the patients were followed up to collect outcomes of their diseases.Results Among 28 COVID-19 patients with AI,20 cases(71.4%)received basal corticosteroid replacement.Among the 18 patients with community-acquired COVID-19,11 cases(61.1%)increased the corticosteroid dosage proactively at home.The most common symptoms of COVID-19 were fever(96.4%),gastrointestinal symptoms(82.1%)and con-sciousness disturbance(78.6%).Occurrence of severe consciousness disturbance was associated with older age and lower basal corticosteroid replacement dose(P＜0.05). Adrenal crisis(AC)occurred in 20 patients(71.4%),which was associated with lower basal corticosteroid replacement dose,hypochloremia,lower eosinophil,lower platelet,and longer activated partial thromboplastin time(APTT)(P＜0.05). 2 patients died during hospitalization.26.3%(5/19)of surviving patient's recovered consciousness longer than 48 hours.Delayed recovery of conscious-ness was associated with lower systolic pressure,higher blood creatinine,and higher fibrinogen(P＜0.05).Long COVID-19 symptoms such as fatigue and poor appetite occurred in 48.0%(12/25)of patients.Among patients with increased corticosteroid dosage,50.0%(12/24)had their dose reduced to baseline within 3 weeks.Conclusions COVID-19 patients with AI have a high frequency of consciousness disturbance and AC.AI patients are lack of awareness of adjusting corticosteroid dosage proactively in case of infection stress,thus education of"sick day rules"for AI patients should be strengthened in clinical practice.

Objective:To describe the implementation status of home enteral nutrition (HEN) in pediatric patients, providing reference for the management of HEN in pediatric patients.Methods:This study was a cross-sectional study. From March 2020 to May 2021, convenience sampling was used to select 161 pediatric patients who were discharged from the Children's Hospital of Fudan University and underwent HEN as participants. The survey questionnaire was designed to collect clinical data based on the research purpose.Results:Among the 161 pediatric patients who underwent HEN, congenital malformations, digestive system diseases, neurological diseases, malignant tumors, and respiratory system diseases accounted for 38.5% (62/161), 21.7% (35/161), 19.3% (31/161), 11.2% (18/161), and 9.3% (15/161), respectively. A total of 120 pediatric patients were followed up and recorded with nutritional supplements, 49 pediatric patients received whole protein nutritional supplements, 19 received amino acid nutritional supplements, 16 received whole protein nutritional supplements with homemade homogenization, 15 received short peptide nutritional supplements, seven received breast milk with whole protein nutritional supplements, five received homemade homogenization, five received animal milk, two received breast milk, and two received amino acid nutritional supplements with homemade homogenization. A total of 118 pediatric patients were followed up with tube feeding, including 107 cases using intermittent feeding, nine cases using continuous feeding, and two cases using intermittent combined continuous feeding. There were 46 children with tube slippage, nine cases of vomiting, six cases of tube blockage, three cases of abdominal pain and bloating, two cases of diarrhea, one case of nasal redness, one case of aspiration pneumonia, and one case of exudation around the stoma. After a short-term HEN, 74 cases continued to receive tube feeding, 49 cases were successfully removed from the tube and switched to oral feeding, three cases were switched to tube and oral combined feeding, five cases died due to severe illness.Conclusions:Pediatric patients undergoing HEN have a wide range of diseases and a high incidence of tube slippage. Education should be provided to family caregivers to enhance their ability to identify and handle complications, as well as to make correct choices in feeding formulations and methods. We should also establish a sound follow-up system, closely monitor the nutritional status of pediatric patients, and actively assist in preventing complications.