ObjectiveTo establish a model of dry eye with lung Yin deficiency syndrome in mice. MethodsA total of 40 SPF C57BL/6J mice were assigned via the random number table method into 5 groups （n=8）： Normal control， model control， and high-， medium-， and low-dose （11.7， 5.85， and 2.925 g·kg^-1， respectively） Yangyin Qingfeitang. Mice in the normal control group were fed normally without any intervention. Mice in Yangyin Qingfeitang group and model control group were treated with 0.2% benzalkonium chloride eye drops （5 μL） twice a day and fed in a controlled drying system in a dry environment for 28 days. At the same time， the mice were administrated with thyroxine tablet solution by gavage and placed in a glass fumigation tank （SO₂ concentration： 0.5 g·m^-3） for 14 days. After 4 weeks， mice in Yangyin Qingfeitang groups were treated with Yangyin Qingfeitang by gavage and those in the normal control group and model control group were administrated with deionized water at 0.01 mL·g^-1. The body mass， anal temperature， four examination information （claw and nail appearance）， basic tear secretion test， tear film rupture time， corneal fluorescein staining， and lacrimal gland HE staining were compared among groups. Compound Yangyin Qingfeitang granules were used to measure the syndrome to verify the success of modeling. ResultsAfter 28 days of continuous modeling， compared with the normal control group， the model group exhibited listless and emaciated status， coughing， drowsiness， dry and dull hair， dry and hard stool， reduced food intake and water intake， red lip circumference， red tongue with reduced fluid， dry nose and teeth， red claws and nails， body mass gain， decreased anal mild tear secretion （P<0.05）， and shortened tear film rupture time （P<0.05）. After 28 days of modeling， the mice showed large corneal fluorescein staining range， severe corneal injury， and increased content of interleukin （IL）-18， IL-β， and tumor necrosis factor （TNF）-α in lacrimal gland， compared with those in the normal control group （P<0.05）. After the treatment with Yangyin Qingfeitang， the mice had good drinking and eating conditions， with lighter redness of the tongue， moist nose， moist and shiny teeth， and the claw and nail color close to that in the normal group. Compared with the model control group， Yangyin Qingfeitang groups showed increases in body mass and anal temperature （P<0.05）， tear secretion （P<0.05）， and tear film rupture time （P<0.05）， narrowed range of corneal fluorescein staining， and declined levels of IL-18， IL-β， and TNF-α in lacrimal glands （P<0.01）. The high-dose group had the best effect， with the indicators close to the levels in the normal control group. ConclusionThe animal model of dry eye with lung Yin deficiency syndrome can be established by culture in a controlled drying system， treatment with benzalkonium chloride eye drops for 28 days， and administration of thyroxine tablet solution combined with SO₂ fumigation for 14 days.

Objective:To investigate the neural function and Insulin-like growth factor-1 (IGF-1) in post-stroke depression (PSD) model rats. The effect of IGF-1 on mitogen activated protein kinase (MAPK) signaling pathway.Methods:15 male SD rats were selected as sham-operation group. PSD rat model was prepared by Longa method and chronic unpredictability mild stress method with 70 rats. The successfully constructed PSD rats were divided into model group, fluoxetine group (2.31 mg/kg fluoxetine, gavage), electroacupuncture group [stimulation of "Baihui"(GV20), "Fengfu"(GV16), "Shenting"(GV24) and "Taichong"(LR3) acupoints by electroacupuncture]and positive drug group [stimulation of "Baihui"(GV20), "Fengfu"(GV16), "Shenting"(GV24) and "Taichong"(LR3) acupoints by electroacupuncture + 5 μl of Sb202190 solution was injected into the lateral ventricle with a concentration of 10 μmol/L]. According to random number table method, with 15 rats in each group. Each group received relevant administration, and the rats' body mass was measured at the end of treatment. mNSS scale was used to evaluate the neurological impairment of rats; the behavioral function of rats was evaluated by sugar water preference test and forced swimming test; Nissl and TUNEL staining were used to observe the number of NissL bodies and the apoptosis rate of neurons in hippocampus; the level of serum IGF-1 was Nissl by enzyme-linked immunosorbent assay (ELISA); Western blot was used to detect the expressions of Caspase-3, Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), cyclic adenosine monophosphate response element binding protein (CREB), p-CREB, IGF-1, mitogen activated protein kinase (MEK), p-MEK, ERK, p-ERK, JNK, p-JNK, p38 mitogen activated protein kinase (p38), p-p38 protein in brain tissue.Results:Compared with the model group, the weight of rats increased in the fluoxetine, electroacupuncture, and positive drug groups ( P<0.05); mNSS and forced swim test immobility time decreased ( P<0.05). Sucrose consumption percentage and struggling time in the forced swim test were markedly elevated ( P<0.05); Nissl body counts in hippocampal neurons increased ( P<0.05), accompanied by reduced neuronal apoptosis rates ( P<0.05); serum IGF-1 level significantly increased ( P<0.05); the protein expressions of Caspase-3 and Bax in hippocampus decreased ( P<0.05), while the protein expressions of Bcl-2, p-CREB/CREB, BDNF, IGF-1, p-MEK/MEK, p-ERK/ERK, p-JNK/JNK and p-p38/p38 increased ( P<0.05). Conclusions:Electroacupuncture can improve neural function and depressive behavior in rats, reduce pathological damage in hippocampus, increase the number of Nissl bodies, and inhibit apoptosis. The mechanism of electroacupuncture may be related to the increase of IGF-1 and the activation of MAPK signaling pathway.

Objective: To explore the association of physical activity and sugar sweetened beverage consumption with psychological sub health among middle school students in Bao an District, Shenzhen, so as to provide a reference for adolescent mental health promotion. Methods: A questionnaire survey was conducted in November 2024 by a stratified cluster random sampling method to select 6 926 junior and senior middle school students from 5 middle schools in Shenzhen. The questionnaire from Youth Risk Behavior Surveillance System was used to assess the consumption of sugar sweetened beverages, and physical activity Rating Scale was used to assess the level of physical activity, and Brief Instrument on Psychological Health of Youths was used to evaluate the psychological sub health status. The Chi -square test was used to analyze the differences in the detection rates of psychological sub health among different groups of middle school students, and a multivariate Logistic regression model was established to analyze the effects of physical activity and sugar sweetened beverage consumption and their combined effects on the psychological sub health of middle school students. Results: The detection rate of psychological sub health among middle school students in Bao an District, Shenzhen was 18.93%. Multivariate Logistic regression analysis showed that, after controlling for confounding factors such as gender, school stage, family residence, family economic status, parental literacy, academic stress and number of friends, lack of physical activity or excessive sugar sweetened beverage consumption were associated with increased risks of psychological sub health among middle school students ( OR =1.36, 1.45); and the highest risk of psychological sub health was found in middle school students who were lack of physical activity and excessive sugar sweetened beverage consumption ( OR =2.59) ( P <0.01). Further analysis by school stages showed that junior high school students with sufficient physical activity and excessive intake of sugary drinks ( ROR =2.10), lack of physical activity and excessive intake of sugary drinks ( ROR =2.31) were at higher risks of psychological sub health than senior high school students( P <0.05). Conclusions Insufficient physical activity and excessive sugar sweetened beverage consumption are closely associated with an increased risk of psychological sub health among middle school students. Effective interventions should be targeted to reduce the risk of psychological sub health problems among middle school students.

ObjectiveTo investigate the effects of different fermentation methods and times on the fungal flora and chemical composition of Aurantii Fructus， in order to obtain the optimal fermentation conditions and flora structure， and to ensure the stability and controllability of the fermented varieties. MethodsScanning electron microscopy was used to observe and analyze the colony characteristics on the surface of Aurantii Fructus under different fermentation conditions. Internal transcribed spacer 2（ITS2） high-throughput sequencing， combined with fungal community diversity analysis and fungal community structure analysis， were used to obtain the fungal flora microbial categories of Aurantii Fructus under the conditions of traditional pressure-shelf fermentation and non-pressure-shelf natural fermentation for 7， 14， 21 d（numbered Y1-Y3 for the former， and numbered F1-F3 for the latter）， respectively. At the same time， the chemical components in the fermentation process were detected by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）， combined with principal component analysis（PCA）， partial least squares-discriminant analysis（PLS-DA） and compound retention time， parent ions， characteristic fragment ions and other information， the differential compounds between the different fermentation samples were screened and identified. ResultsThe analysis of fungal community diversity showed that the dominant flora did not change at different fermentation time points in the traditional pressure-shelf fermentation method， while in the non-pressure-shelf natural fermentation method， there was a significant difference with the fermentation process， and at the genus level， the dominant genus of samples Y1， Y2， Y3 and F2 was Aspergillus， while the dominant genera of samples F1 and F3 were both Rhizopus. This indicated that the microbial growth environment provided by the traditional fermentation method was more stable， and the microbial community structure was more stable， which was more conducive to the stable and controllable fermentation process and fermented products. A total of 155 compounds were identified by compositional analysis， including 70 flavonoids， 38 coumarins， 10 alkaloids， 34 organic acids and 3 other compounds. After fermentation， two new components of ribalinine and pranferin were produced. Different fermentation conditions also brought about differences in chemical composition， multivariate statistical analysis obtained 26 differential compounds under two different fermentation methods， mainly including flavonoids， organic acids and coumarins. Comprehensively， the microbial community structure of samples fermented by the traditional pressure-shelf method of Aurantii Fructus for 14 d was stable， the species richness was high and the overall content of differential compounds was high， which was the optimal processing condition. ConclusionCompared with non-pressure-shelf natural fermentation， the traditional method has obvious advantages in terms of the stability of the microbial community structure and the content of chemical compounds， and the optimal condition is 14 days of fermentation. This study is helpful to promote the quality stability and fermentation bioavailability of fermented products of Aurantii Fructus， as well as to provide an experimental basis for the further improvement of the quality control methods of this variety.

ObjectiveTo investigate the effects of different fermentation methods and times on the fungal flora and chemical composition of Aurantii Fructus， in order to obtain the optimal fermentation conditions and flora structure， and to ensure the stability and controllability of the fermented varieties. MethodsScanning electron microscopy was used to observe and analyze the colony characteristics on the surface of Aurantii Fructus under different fermentation conditions. Internal transcribed spacer 2（ITS2） high-throughput sequencing， combined with fungal community diversity analysis and fungal community structure analysis， were used to obtain the fungal flora microbial categories of Aurantii Fructus under the conditions of traditional pressure-shelf fermentation and non-pressure-shelf natural fermentation for 7， 14， 21 d（numbered Y1-Y3 for the former， and numbered F1-F3 for the latter）， respectively. At the same time， the chemical components in the fermentation process were detected by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）， combined with principal component analysis（PCA）， partial least squares-discriminant analysis（PLS-DA） and compound retention time， parent ions， characteristic fragment ions and other information， the differential compounds between the different fermentation samples were screened and identified. ResultsThe analysis of fungal community diversity showed that the dominant flora did not change at different fermentation time points in the traditional pressure-shelf fermentation method， while in the non-pressure-shelf natural fermentation method， there was a significant difference with the fermentation process， and at the genus level， the dominant genus of samples Y1， Y2， Y3 and F2 was Aspergillus， while the dominant genera of samples F1 and F3 were both Rhizopus. This indicated that the microbial growth environment provided by the traditional fermentation method was more stable， and the microbial community structure was more stable， which was more conducive to the stable and controllable fermentation process and fermented products. A total of 155 compounds were identified by compositional analysis， including 70 flavonoids， 38 coumarins， 10 alkaloids， 34 organic acids and 3 other compounds. After fermentation， two new components of ribalinine and pranferin were produced. Different fermentation conditions also brought about differences in chemical composition， multivariate statistical analysis obtained 26 differential compounds under two different fermentation methods， mainly including flavonoids， organic acids and coumarins. Comprehensively， the microbial community structure of samples fermented by the traditional pressure-shelf method of Aurantii Fructus for 14 d was stable， the species richness was high and the overall content of differential compounds was high， which was the optimal processing condition. ConclusionCompared with non-pressure-shelf natural fermentation， the traditional method has obvious advantages in terms of the stability of the microbial community structure and the content of chemical compounds， and the optimal condition is 14 days of fermentation. This study is helpful to promote the quality stability and fermentation bioavailability of fermented products of Aurantii Fructus， as well as to provide an experimental basis for the further improvement of the quality control methods of this variety.

Metformin has been demonstrated to attenuate hyperglycaemia by modulating the gut microbiota. However, the mechanisms through which the microbiome mediates metformin monotherapy failure (MMF) are unclear. Herein, in a prospective clinical cohort study of newly diagnosed type 2 diabetes mellitus (T2DM) patients treated with metformin monotherapy, metagenomic sequencing of faecal samples revealed that Phocaeicola vulgatus abundance was approximately 12 times higher in nonresponders than in responders. P. vulgatus rapidly hydrolysed taurine-conjugated bile acids, leading to ceramide accumulation and reversing the improvements in glucose intolerance conferred by metformin in high-fat diet-fed mice. Interestingly, C22:0 ceramide bound to mitochondrial fission factor to induce mitochondrial fragmentation and impair hepatic oxidative phosphorylation in P. vulgatus-colonized hyperglycaemic mice, which could be exacerbated by metformin. This work suggests that metformin may be unsuitable for P. vulgatus-rich T2DM patients and that clinicians should be aware of metformin toxicity to mitochondria. Suppressing P. vulgatus growth with cefaclor or improving mitochondrial function using adenosylcobalamin may represent simple, safe, effective therapeutic strategies for addressing MMF.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective To investigate the application value of systemic inflammatory response index(SIRI)in patients with acute-on-chronic liver failure(ACLF)and co-infection.Methods A retrospective analysis was performed for the clinical data of 579 ACLF patients with co-infection who were diagnosed and treated in The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to March 2016,including demographic features,laboratory markers,and complications,and SIRI,Model for End-Stage Liver Disease(MELD)score,MELD combined with serum sodium concentration(MELD-Na)score,and Child-Pugh score were calculated.According to the results of follow-up on day 90,the patients were divided into survival group with 210 patients and death group with 369 patients.The independent-samples t test was used for comparison of normally distributed continuous data between two groups;the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test were used for comparison of categorical data between two groups.The binary logistic regression analysis was used to investigate the independent risk factors for 90-day death.The receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to assess the performance of SIRI,MELD-Na score,and Child-Pugh score in predicting the prognosis of ACLF patients with co-infection.The Kaplan-Meier survival analysis was performed based on the optimal cut-off value of SIRI.Results Among the 597 ACLF patients with co-infection,384(66.32%)had HBV-related ACLF and 114(19.69%)had alcohol-related ACLF;as for the main infection sites,316(54.58%)had abdominal infection and 133(22.97%)had pulmonary infection;the 90-day mortality rate was 63.73%.The multivariate logistic regression analysis showed that SIRI(odds ratio[OR]=1.177,95%confidence interval[CI]:1.117-1.239,P<0.05),blood ammonia(OR=1.009,95%CI:1.001-1.018,P<0.05),MELD-Na score(OR=1.047,95%CI:1.016-1.080,P<0.05),Child-Pugh score(OR=1.351,95%CI:1.054-1.730,P<0.05),age(OR=1.045,95%CI:1.021-1.070,P<0.05),comorbidity with hepatic encephalopathy(OR=2.269,95%CI:1.305-3.946,P<0.05),and comorbidity with acute kidney injury(OR=1.730,95%CI:0.990-3.023,P<0.05)were independent risk factors for 90-day death in ACLF patients with co-infection.The Pearson correlation analysis showed that SIRI was positively correlated with MELD-Na score(r=0.282,P<0.001)and Child-Pugh score(r=0.168,P<0.001).SIRI,MELD-Na score,and Child-Pugh score had an AUC of 0.855,0.734,and 0.690,respectively,in predicting 90-day death,and SIRI had a higher predictive efficiency than MELD-Na score and Child-Pugh score(Z=4.922 and 6.289,both P<0.001),with a sensitivity of 76.7%and a specificity of 82.9%.In addition,SIRI combined with MELD-Na score or Child-Pugh score improved the predictive efficiency of MELD-Na score(0.854 vs 0.734,Z=6.899,P<0.001)and Child-Pugh score(0.858 vs 0.690,Z=8.725,P<0.001).The patients with high SIRI(≥4.08)had a 90-day survival rate of 11.29%(36/319),which was significantly lower than that in the patients with low SIRI(<4.08)(χ2=225.24,P<0.001).Conclusion SIRI is an independent risk factor for death in ACLF patients with co-infection and has a good clinical value in predicting prognosis,with the advantages of convenience and low costs.

Objective To investigate the mechanism of electroacupuncture-mediated PTEN-induced kinase 1(PINK 1)/Parkin signal pathway activation in treating functional dyspepsia model rats.Methods Thirty-six SD rats were randomly divided into the blank control(n=8)and the modeling groups(n=28)using the random number table method.The functional dyspepsia model was established using the compound etiology modeling method.After successful modeling,24 rats were divided into the model,electroacupuncture,and mosapride groups using the random number table method,with eight rats per group.The blank group was not intervened.The electroacupuncture,mosapride,and model groups were bound for 30 min,and only the electroacupuncture group was administered"Neiguan"(PC 6)and"Gongsun"(SP 4)while bound.The electroacupuncture and model groups were administered the same amount of normal saline,and the mosapride group was given mosapride citrate solution(1.35 mg/kg).The above intervention method were performed once a day for 7 consecutive days to observe the general condition of rats.Gastric emptying and small intestinal propulsion experiments were used to observe gastric emptying rate and small intestine propulsion rate in each group of rats.The interstitial cells of the Cajal(ICC)ultrastructure of gastric antrum were observed under a transmission electron microscope.The protein and mRNA expressions of C-kit proto-oncogene protein(C-kit),microtubule-associated protein 1 light chain 3(LC3)Ⅱ/Ⅰ,ubiquitin-binding protein p62(p62),Bcl-2 interacting protein 1(Beclin1),PINK1,and Parkin were detected using Western blotting and real-time fluorescence PCR.Results Compared with the blank group,the rats in the model group exhibited lethargy,dull and dry fur,sluggish responses,and substantial decreases in food intake and body weight.Their feces alternated between dry and loose consistency.Furthermore,the gastric emptying and small intestinal propulsion rates were reduced(P<0.01).The ultrastructural morphology of ICC and their mitochondria in the gastric antrum tissue showed apparent damage.The protein and mRNA expressions of C-kit and p62 were decreased(P<0.01),whereas those of PINK1,Parkin,Beclin1,and LC3Ⅱ/Ⅰ were increased(P<0.01).Compared with the model group,the rats in the electroacupuncture and mosapride groups showed notable improvements in their mental state,with neat fur,enhanced activity and responsiveness,gradual increases in food intake and body weight,and well-formed feces.Additionally,the gastric emptying and intestinal propulsion rates increased(P<0.01).The ultrastructural morphology of ICC and their mitochondria in the gastric antrum tissue were notably improved.The protein and mRNA expressions of C-kit and p62 were increased(P<0.01),whereas those of PINK1,Parkin,Beclin1,and LC3Ⅱ/Ⅰwere decreased(P<0.01).Conclusion Electroacupuncture improves the gastrointestinal motility of functional dyspepsia rats,and its mechanism may be related to upregulating C-kit and p62 expression,downregulating PINK1,Parkin,Beclin1,and LC3Ⅱ/Ⅰ expression,inhibiting abnormal PINK1/Parkin signal pathway activation,and blocking the excessive mitophagy of ICC.

Objective:To explore the ideological and political education elements and methods in the introduction to nursing course, so as to enhance its ideological educational effectiveness. Methods:In February 2024, based on a "three-stage" teaching model (pre-class, in-class, and post-class), this study reformed the ideological and political education plan for the introduction to nursing course by integrating online and offline case studies and resources, expanding educational materials, and organizing teaching assessments and effectiveness surveys. A semester-long ideological and political education practice was implemented for 237 first-year nursing students from four classes in Medical College of Xinjiang University of Science and Technology. The effectiveness was evaluated by exam scores and a self-designed Introduction to Nursing Teaching Effectiveness Evaluation Scale under the ideological and political education framework. Results:Among the 237 students, there were 107 males and 130 females, aged (18.50 ± 1.12) years old, 63 achieved a passing grade, 149 achieved a good grade, and 18 achieved an excellent grade, with a pass rate of 97.05% (230/237). The scores of the six dimensions of interest stimulation in teaching methods, acceptance of teaching methods, knowledge review and application, knowledge comprehension and retention, self-challenge and improvement, and satisfaction with learning outcomes within 1 week after the end of the course scores were (3.92 ± 1.11), (4.21 ± 0.82), (4.05 ± 0.97), (4.05 ± 0.89), (4.11 ± 0.94), (4.03 ± 0.90) points, which were significantly higher than 1 week before the start of the course (3.43 ± 1.00), (3.54 ± 1.03), (3.48 ± 1.08), (3.47 ± 1.04), (3.52 ± 1.05), (3.47 ± 1.01) points. The differences were statistically significant ( t values were -19.38- -13.22, all P < 0.01). Conclusions:The "three-stage" teaching model in the introduction to nursing course effectively integrates professional education with ideological and political education, improves students′ academic performance, enhances learning effectiveness in nursing practice, and strengthens the overall impact of ideological and political education.