OBJECTIVE To investigate the effects of triptolide （TP） exposure during pregnancy and lactation on the reproductive system development and function in male offspring of rats， providing a reference for medication safety during pregnancy and lactation. METHODS Pregnant rats were randomly divided into control group （12 rats， normal saline） and T1-T4 groups [12， 13， 14， 17 rats that received TP at 200， 400， 600， and 800 μg/（kg·d） respectively]. They were given relevant medicine/normal saline intragastrically， once a day， until the offspring were born and naturally weaned， the intragastric administration volume of each rat was consistently 2 mL. After 60 days of feeding， reproductive organ weights and coefficients were measured in male offspring， testicular and epididymal histology and sperm morphology were observed. Sperm motility， sperm count， and serum levels of gonadotropin-releasing hormone （GnRH）， follicle stimulating hormone （FSH）， luteinizing hormone （LH）， and testosterone （T） in the epididymides were analyzed. Protein expressions of glycogen synthase kinase 3α （GSK3α）， phosphorylated GSK3α （p-GSK3α）， and phosphatase 1γ2 （PP1γ2） in sperm were also determined. RESULTS Compared with the control group， the testicular and epididymal weights， serum levels of GnRH and T， the relative protein expression of PP1γ2 were significantly decreased in T1-T4 groups. Additionally， in the T2 to T4 groups， there were significant reductions in the weight and coefficient of the seminal vesicle， total number of sperm， sperm concentration， sperm motility as well as relative protein expressions of GSKα， p-GSK3α in the offspring rats. Furthermore， the epididymal coefficient in the T3 and T4 groups， the testicular coefficient， mean sperm track velocity and sperm curvature velocity in the T4 group were significantly decreased （P＜ 0.05）； the number of abnormal sperm， rate of sperm abnormality， and levels of FSH and LH in the offspring rats of the T1 to T4 groups were all significantly increased （P＜0.05）； in the offspring rats of the T1 to T4 groups， there was a decrease in the number of epithelial cells in the seminiferous tubules of the testes. Within the epididymal tissue， degenerative and necrotic changes in the epithelial cells were visible， accompanied by mild infiltration of inflammatory cells in the stroma. CONCLUSIONS TP exposure during pregnancy and lactation disrupts reproductive organ development， impairs spermatogenesis and sperm motility， as well as suppresses androgen synthesis in male offspring，thereby having a negative impact on the development of the reproductive system. These effects may be mechanistically linked to regulation of GSK3α， p-GSK3α and PP1γ2 protein expressions.

Objective:To construct a transcultural nursing competency framework for master of nursing specialist, providing reference for the cultivation and evaluation of transcultural nursing competency for master of nursing specialist.Methods:From December 2022 to March 2023, based on the cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire (ASKED) model of cultural competency and the group discussion, a preliminary pool of transcultural nursing competency elements for master of nursing specialist was formed using literature analysis, questionnaire survey, and semi-structured interviews. From April to July 2023, purposive sampling was used to select 20 nursing experts from universities and their affiliated hospitals in seven provinces, autonomous regions, and municipalities including Guangdong Province, Guangxi Zhuang Autonomous Region, Beijing City, Zhejiang Province, Hebei Province, Hunan Province, and Shaanxi Province as consultant experts. The transcultural nursing competency framework for master of nursing specialist was established using the Delphi method.Results:A total of 17 experts completed two rounds of consultation. The positive coefficients of the two rounds of expert consultation were 85.00% (17/20) and 100.00% (17/17), respectively. The authority coefficients of the two rounds of consultant experts were 0.826 and 0.878, respectively. The Kendall harmony coefficients for the first and second level elements in the second round of expert consultation were 0.302 ( P<0.01) and 0.304 ( P<0.01). After two rounds of expert consultations, a transcultural nursing competency framework for master of nursing specialist was established, which included five first-level elements of cultural awareness, cultural attitude, cultural knowledge, cultural skills, and cultural interaction, as well as 21 second-level elements. Conclusions:The transcultural nursing competency framework for master of nursing specialist is scientific and reliable, which can provide reference for formulating transcultural nursing competency standards for master of nursing specialist and lay a foundation for improving their cross-cultural nursing competency.

Ankylosing spondylitis is an autoimmune disease with sacroiliac arthritis and spinal arthritis as the main manifestations.The disease mainly occurs in young men,has a high disability rate,and is a serious threat to the life and health of patients.Biological agents are expensive,and many adverse reactions to hormones,non-steroidal anti-inflammatory drugs,and anti-rheumatic drugs have been recorded.Traditional Chinese medicine can regulate the immunity and anti-inflammatory effects of the disease,and has good clinical effects.To promote the further study of the pathogenesis of ankylosing spondylitis and the development and screening of therapeutic drugs and therapies,in this paper,we summarize the method and mechanisms of modeling of the existing animal model of ankylosing spondylitis and analyze the advantages and disadvantages of the model.To evaluate the agreements between Chinese and Western medicine clinical characteristics,we compare the characteristics of Chinese and Western medical syndromes of the animal model.Building an animal model of ankylosing spondylitis with a higher degree of consistency between traditional Chinese and Western medicine is the key to innovative research into traditional Chinese medicine method of treating ankylosing spondylitis.To lay the foundation for research into traditional Chinese medicines and acupuncture for ankylosing spondylitis,this paper analyzes the degree of concurrence between the Chinese and Western medicine clinical characteristics of animal models.

Objective　To investigate the current status and attrition among HIV-infected persons receiving antiretroviral therapy (ART), and to analyze factors affecting attrition in Hainan. Methods　In this study, HIV-infected patients who started ART treatment in Hainan Province from 2005 to 2022 were selected from the antiviral treatment submodule of China Disease Prevention and Control Information System.According to the inclusion and exclusion criteria,a total of 4 286 HIV-infected persons were receiving . A Cox proportional hazards regression model was used to analyze factors affecting attrition. Results　Among the 4 286 study subjects, 3 718 were males (86.7%), with a sex ratio of 6.55∶1. Unmarried individuals accounted for 58.4%, and the average age was (39.68±13.17) years. Transmission through homosexual contact accounted for 49.8%, and 84.3% were in WHO clinical stage I. Treatment regimens containing Efavirenz (EFV) accounted for 71.7%. During a follow-up of 19 677.44 person-years, the overall attrition rate was 0.80 per 100 person-years, with the first-year post-ART initiation attrition rate being 21.10 per 100 person-years. The results of Cox regression analysis showed that the time of treatment initiation in 2016-2022 (AHR=2.40, 95%CI: 1.40-4.10), and the last HIV viral load (VL) 20-<1 000 copies/mL (AHR=3.69, 95%CI: 2.08-6.54), the last HIV-1 VL≥1 000 copies/mL (AHR=15.98, 95%CI: 9.46-27.01), and no last HIV-1 VL test (AHR=92.90, 95%CI: 57.68-149.62), the time interval from diagnosis to treatment for 1-12 months (AHR=1.62, 95%CI: 1.12-2.36), and an interval longer than 12 months (AHR=1.68, 95%CI: 1.07-2.62) were the main factors that increased the risk of attrition. Treatment regimens containing Lopinavir/ritonavir (Lpv/r) (AHR=0.34, 95%CI:0.18-0.66) and treatment regimens containing integrase strand transfer inhibitors (INSTIs) (AHR=0.24, 95%CI: 0.09-0.58) were the factors that reduced the risk of attrition after antiretroviral therapy. Conclusions　The attrition of ART in HIV/AIDS patients in Hainan Province is related to a longer interval from diagnosis to treatment, treatment plan, and abnormal HIV viral load test results. Case-based measures should be taken to address factors influencing antiretroviral treatment attrition, while improving the timeliness of antiviral treatment and treatment management service quality to further improve the efficacy of antiviral treatment.

Objectives:Aimed to establish a rapid, high-throughput, automated method for determining the creatine kinase (CK-MM) isoform levels.Methods:Magnetic beads labeled with anti-CK-MM antibodies were combined with alkaline phosphatase-based chemiluminescence detection. Clinical and diagnostic performance validation of the assay was determined by analysis of 998 and 75 dried blood spot samples from healthy newborns and Duchenne muscular dystrophy (DMD) patients, respectively, and the CK activity was also determined. The blank and detection limits, cross-reactivity, recovery rate of the method, intra-and inter-assay coefficient, and the hook effect were evaluated.Results:Blank and detection limits were 17.4 and 39.3 ng/ml, respectively. Cross-reactivity toward CK-MB and CK-BB isoforms was 0.2% and 0.02%, respectively. Intra-and inter-assay coefficients of variation were<1%. Mean recovery was 100.32%, with no hook effect in CK-MM levels<50 000 ng/ml. Overall, the mean CK-MM concentrations in newborns and DMD patients were (27.05±0.97) and (3 720±300.5) ng/ml, respectively. A significant positive correlation between the dried blood spot detected CK-MM levels and total CK enzyme activity, evaluated in corresponding serum samples from the 75 DMD patients, was observed ( r=0.91, P<0.001), ?which is in good agreement with the clinical. Conclusions:An assay for rapid quantitative determination of CK-MM that meets clinical newborn screening requirements was established. It had a good value for application.

Objective:To analyze the influencing factors and improvement paths of the cultivation of full-time doctoral scientific and technological innovation ability in large public hospitals, and propose countermeasures and suggestions.Methods:This studyed conducted a survey and analysis of 122 doctors from Linyi People′s Hospital in Shandong Province, and completed a current situation study based on the analysis results.Results:There was no significant difference between the two groups in gender, age, degree type, professional category, discipline level, Graduate School type, job type and other indicators. There were significant differences between the two groups in scientific research topic selection ability score, project design ability score, data analysis ability score, data interpretation ability score, project approval in recent 5 years, project level, number of SCI journal papers published in recent 5 years, cumulative impact factors of SCI journal papers, and annual number of academic activities ( P<0.05). Conclusions:The hospital can improve the scientific and technological innovation ability of full-time doctors by setting up a special cultivation plan, establishing an interdisciplinary team, optimizing scientific research management services, improving the evaluation and assessment system, and improving welfare protection.

Objective:To observe the inhibiting effects of manual acupuncture(MA)on bladder cell apoptosis in rats with diabetic neurogenic bladder(DNB)based on the protein and mRNA expression of B-cell lymphoma-leukemia(Bcl)-2,Bcl-2-associated X(Bax)protein,caspase-3,and the protein expression of α-smooth muscle actin(α-SMA),transforming growth factor(TGF)-β in the bladder tissue. Methods:A DNB rat model was established via intraperitoneal injection of streptozotocin(STZ).The rats were randomly divided into a control group,a model group,and an MA group,with 10 rats in each group.For the MA group,MA was applied after modeling.The body mass,fasting blood glucose(FBG),bladder wet weight,and bladder histomorphology were observed.Protein and mRNA expression levels of Bcl-2,Bax,and caspase-3 and the protein expression of α-SMA and TGF-β in the bladder tissue were determined.The apoptotic index of bladder cells was also evaluated. Results:After STZ injection,compared with the control group,the model group and the MA group both showed higher FBG from week 3 and lower body mass from week 9(P<0.05),and had a larger bladder wet weight(P<0.05).Compared with the model group,the MA group showed a smaller bladder wet weight(P<0.05).The histopathological evaluation indicated that MA improved muscle fiber alignment and detrusor cell compensatory hypertrophy in the bladder tissue.In addition,compared with the control group,the apoptotic index increased significantly in the model group and the MA group(P<0.05);the protein and mRNA expression levels of Bax and caspase-3 and the protein expression level of TGF-β in the bladder tissue in the model group and the MA group increased significantly(P<0.05),while the protein and mRNA expression levels of Bcl-2 and the protein expression level of α-SMA in the bladder tissue decreased significantly(P<0.05).Compared with the model group,the apoptotic index of the MA group decreased significantly(P<0.05);the protein and mRNA expression levels of Bax and caspase-3 and the protein expression level of TGF-β in the bladder tissue decreased significantly(P<0.05),while the protein and mRNA expression levels of Bcl-2 and the protein expression level of α-SMA in the bladder tissue increased significantly(P<0.05). Conclusion:MA can protect the bladder by inhibiting the excessive apoptosis of bladder cells,which may be related to the down-regulation of Bax and caspase-3 proteins and mRNAs and TGF-β protein expression,and the up-regulation of Bcl-2 protein and mRNA and α-SMA protein expression.

Objective:To conduct visualization analysis on the literature on dietary restriction(DR)regulating inflammation based on CiteSpace and VOSviewer visualization software,and to explore research hotspots and trends in this field.Methods:The literature on DR regulation inflammation in Web of Science core databases from January 1 2010 to September 29 2022 were searched.CiteSpace and VOSviewer visualization software was used to conduct quantitative and visual analysis of the annual publication volume,countries,institutions,authors,citation frequency and keywords of the retrieved literature.Results:A total of 1 344 papers related to the topic were included,and the annual number of papers was generally on the rise,with the highest citation frequency of 1 676 times.The United States(481 papers)is the country with the largest number of publications,followed by China(181 papers).The research hotspots in this field focused on calorie restriction(CR),ketogenic diet,aging,metabolic diseases,adipose tissue and gut microbiota.Conclusion:DR regulation of inflammation is increasingly favored by international and domestic researchers,and future research hotspots may be CR mimics(CRMs),intestinal microbiota,neurodegenerative diseases and cardiovascular diseases.The overall research trend is to further clarify the anti-inflammatory mechanism of DR,find new therapeutic targets,and conduct more rigorous clinical trials with more effective regimens that have been proven in vitro and animal models.

Objective To explore the acupoint selection rules in the treatment of perimenopausal syndrome(PMS)with acupuncture by using data mining technology.Methods The clinical research literature on acupuncture treatment of PMS was retrieved from CNKI,Wanfang Data,VIP,CBM,Cochrane Library,Embase,PubMed and ScienceDirect from the establishment of the databases to August 16,2023.Excel 2021 was used to establish a prescription database for acupuncture treatment of PMS,and frequency statistics and classification of acupoints were conducted.SPSS Modeler 18.0 and SPSS Statistics 26.0 software were used to conduct association rules,clustering analysis and decision tree analysis,to explore the characteristics and compatibility rules of acupoint selection in acupuncture and moxibustion treatment of PMS.Results Totally 114 articles were included,including 115 acupoint prescriptions,and 108 acupoints with a total frequency of 787.The high-frequency acupoints were Sanyinjiao,Guanyuan,Shenshu,etc.The commonly used meridians were the bladder meridian and Conception Vessel.The majority specific acupoints were intersection acupoints,wu-shu points and back-shu points.The involved acupoints were mostly located in the lower limbs,abdomen and back.Acupuncture techniques often used the method of flat reinforcement and reduction,with the most commonly used waveform of electroacupuncture being the dilatational wave and the duration of needle retention being 10-30 minutes.The decision tree selected three simplified selection paths based on the dependent variable of Guanyuan.The core acupoints group was analyzed,and 14 groups of association rules and 7 effective cluster groups were obtained.Conclusion Acupuncture treatment of PMS follows the therapeutic principles of tonifying the kidney and harmonizing yin and yang.The acupoint combinations and core acupoint groups obtained from data mining can provide reference for clinical and scientific research.

Objective To explore the clinical acupoint selection law of acupuncture in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)by data mining.Methods The clinical research literature on acupuncture treatment of CP/CPPS was retrieved from CNKI,VIP,Wanfang Data,China Biology Medicine Database,Embase,PubMed,Cochrane Library and Web of Science from the establishment of the databases to November 17,2023.The prescription database was established using Excel 2021 to perform frequency statistics of acupoints.SPSS Modeler 18.0 and SPSS Statistics 26.0 were used to conduct association rules,factor analysis and clustering analysis,to explore the characteristics and acupoint selection and compatibility law in acupuncture treatment of CP/CPPS.Results A total of 105 articles was included,and 105 acupoint prescriptions were extracted,involving a total of 75 acupoints,with a total frequency of 611 times.The high-frequency acupoints were Zhongji,Sanyinjiao,Guanyuan,etc.The commonly used meridians were Conception Vessel and the bladder meridian.Jiaohui acupoints,Mu acupoints and Wushu acupoints accounted for the vast majority.The involved acupoints were mostly located in the abdomen,lower limbs,and lumbosacral region.The core acupoints was analyzed,and 19 groups of association rules,8 factors and 8 effective cluster groups were obtained.Conclusion Acupuncture treatment of CP/CPPS follows the therapeutic principles of tonifying the kidney,removing dampness,soothing the liver and removing blood stasis.The core acupoints group is Guanyuan-Zhongji-Sanyinjiao,with differentiation of syndromes and compatibility with other acupoints.