Objective To construct an animal model of post-stroke depression(PSD)based on the theory of"depression,stasis,phlegm",with the aim of developing and validating an objective assessment system.Methods Rats were divided randomly into five groups:control,depression,stroke,PSD,and Baishile decoction groups.A PSD syndrome-based animal model was established in rats using a combination of middle cerebral artery occlusion(MCAO)and chronic unpredictable mild stress(CUMS)."Depression,stasis,phlegm"were then evaluated in the model rats using the Morris water maze,open field,forced swimming,and sucrose preference tests,and by detection of neurotransmitter levels,brain tissue pathology,tongue and forepaw color RGB values,and blood rheology.Results PSD rats exhibited significantly shorter target quadrant dwelling times,platform crossings,and climbing and rearing frequencies,a significantly lower sucrose preference,and a significantly higher immobility time in the forced swim test compared with control rats.Hematoxylin and eosin and Nissl staining revealed brain tissue damage in PSD rats.Serum and cerebrospinal fluid levels of 5-hydroxytryptamine(5-HT)were significantly decreased,glutamate levels were significantly increased,and tongue and forepaw RGB values were all decreased.Blood rheology showed a hypercoagulable state and blood lipid metabolism-related indicators were significantly abnormal.Rats in the Baishile decoction group showed significant improvements compared with the PSD group,including increased target quadrant dwelling times,number of platform crossings,and climbing and rearing frequencies,increased sucrose preference,decreased immobility time in the forced swim test,improved brain tissue pathology,increased serum and cerebrospinal fluid levels of 5-HT,decreased glutamate levels,increased tongue and claw RGB values,and varying degrees of improvement in blood rheology and blood lipid metabolism-related indicators.Conclusions The combination of MCAO and CUMS successfully established a syndrome-based animal model of PSD exhibiting the characteristics of"depression,stasis,phlegm",with corresponding objective assessment criteria.

Objective:To explore the longitudinal trajectory of sleep disorders and their influencing factors in newly diagnosed breast cancer patients, and provide theoretical basis for formulating intervention measures to improve sleep quality of breast cancer patients.Methods:A longitudinal study was conducted using convenience sampling to select newly diagnosed breast cancer patients from Shandong Provincial Third Hospital and Shandong First Medical University Affiliated Provincial Hospital from April 2023 to June 2024. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), the Concerns About Recurrence Scale (CARS), and the Distress Disclosure Index (DDI) were used for the survey. The Kruskal-Wallis H test and generalized estimating equation models were used to examine sleep disorders and their influencing factors. Results:A total of 473 valid questionnaires were collected. Among the 473 newly diagnosed breast cancer patients, 435 were female and 38 were male, aged (49.5 ± 11.0) years old. The CARS score at admission was (3.00 ± 1.12) points, with concerns about death (0.71 ± 0.67) points and concerns about female characteristics (0.81 ± 0.72) points. The DDI score at admission was (27.00 ± 10.03) points. The PSQI scores at admission, discharge, and one month after discharge were (15.34 ± 3.05), (12.12 ± 3.01), and (10.13 ± 1.78) points, respectively, the difference was statistically significant ( H =33.19, P<0.05). The PSQI scores at these three time points were positively correlated with the CARS score and concerns about death and female characteristics ( r values were 0.42-0.79, all P<0.05), and negatively correlated with the DDI score ( r =-0.41, -0.37, -0.31, all P<0.05). The generalized estimating equation model showed that female gender ( β=1.35, 95% CI 0.27-2.30), education level of junior high school or below ( β=1.89, 95% CI 0.24-3.19), severe pain ( β=1.72, 95% CI 0.32-3.12), moderate pain ( β=2.51, 95% CI 0.37-4.66), invasive special cancer ( β=2.57, 95% CI 1.67-4.07), invasive non-special cancer ( β=2.11, 95% CI 1.98-3.12), partial understanding of the condition ( β=1.91, 95% CI 1.23-3.01), concerns about death ( β=1.61, 95% CI 0.17-2.78), and concerns about femininity ( β=1.34, 95% CI 0.37-2.15) positively predicted the sleep quality index in newly diagnosed breast cancer patients (all P<0.05). Non-invasive cancer ( β=-3.82, 95% CI -6.79--3.36), lack of understanding of the condition ( β=-3.96, 95% CI -7.09--4.62), and DDI score ( β=-1.45, 95% CI -2.14--0.15) negatively predicted the sleep quality index (all P<0.05). Conclusions:The overall sleep quality of newly diagnosed breast cancer patients is low, with the lowest at admission and gradual improvement at discharge and one month after discharge. Medical staff should pay attention to high-risk patients who are female, have lower education levels, higher pain scores, poorer pathological types, and partial understanding of their condition.

Objective To construct an animal model of post-stroke depression(PSD)based on the theory of"depression,stasis,phlegm",with the aim of developing and validating an objective assessment system.Methods Rats were divided randomly into five groups:control,depression,stroke,PSD,and Baishile decoction groups.A PSD syndrome-based animal model was established in rats using a combination of middle cerebral artery occlusion(MCAO)and chronic unpredictable mild stress(CUMS)."Depression,stasis,phlegm"were then evaluated in the model rats using the Morris water maze,open field,forced swimming,and sucrose preference tests,and by detection of neurotransmitter levels,brain tissue pathology,tongue and forepaw color RGB values,and blood rheology.Results PSD rats exhibited significantly shorter target quadrant dwelling times,platform crossings,and climbing and rearing frequencies,a significantly lower sucrose preference,and a significantly higher immobility time in the forced swim test compared with control rats.Hematoxylin and eosin and Nissl staining revealed brain tissue damage in PSD rats.Serum and cerebrospinal fluid levels of 5-hydroxytryptamine(5-HT)were significantly decreased,glutamate levels were significantly increased,and tongue and forepaw RGB values were all decreased.Blood rheology showed a hypercoagulable state and blood lipid metabolism-related indicators were significantly abnormal.Rats in the Baishile decoction group showed significant improvements compared with the PSD group,including increased target quadrant dwelling times,number of platform crossings,and climbing and rearing frequencies,increased sucrose preference,decreased immobility time in the forced swim test,improved brain tissue pathology,increased serum and cerebrospinal fluid levels of 5-HT,decreased glutamate levels,increased tongue and claw RGB values,and varying degrees of improvement in blood rheology and blood lipid metabolism-related indicators.Conclusions The combination of MCAO and CUMS successfully established a syndrome-based animal model of PSD exhibiting the characteristics of"depression,stasis,phlegm",with corresponding objective assessment criteria.

Objective To evaluate the effectiveness of the PDCA cycle in critical value management.Methods PDCA cycle method was applied to manage critical values in an occupational disease hospital.Critical value data from October 2021 to March 2022 were analyzed to identify root causes,followed by corrective measures development and implementation.Post-inter-vention data,from July 2022 to November 2022,were compared with the pre-management data to evaluate the implementation effect of the PDCA cycle on critical value management.Results The application of the PDCA cycle led to a statistically signifi-cant increase in the execution compliance rate for emergency value execution in medical and technical departments increased to 100.00％,and in the clinical departments to 96.77％(P＜0.05).Conclusion PDCA cycle can improve the qualified rate of the implementation of critical value system,ensure patients safety,significantly reduce medical risks,and advance the level of standardization and precision in critical value management within our hospital.

Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibu-lar segmental resection and reconstruction with free fibula flaps(FFFs).Methods Patients who underwent mandibular segmental re-section and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed.All cases were divided into transoral approach and submandibular approach groups.Clinical characteristics of the patients were recorded including age,gender,follow-up time,pathologi-cal diagnosis,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,James Brown classification of mandibular defect and number of fibular segments.The perioperative indexes,such as average operation time,average bleeding vol-ume,average blood transfusion volume,average drainage volume,average hospitalization time and postoperative complications such as malocclusion,fistula,infection,flap failure,and restriction of mouth opening were compared between the two groups.The University of Washington Quality of Life Questionnaire was used to investigate the appearance,function of swallow and speech more than 6-month postoperatively.Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral ap-proach group than in the submandibular approach group(P=0.013 9,P=0.001 9).The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37)vs.(67.19±13.64)(P＜0.000 1).The differ-ences between the two groups in other variables were not statistically significant.Conclusion Cases of transoral approach had signifi-cantly better aesthetic outcomes compared with those of submandibular approach.

Objective To develop a postoperative precision nursing program for children with obstructive sleep apnea-hypopnea syndrome(OSAHS),so as to provide references for the improvement of nursing quality for children with OSAHS.Methods Literature in precision nursing for children with OSAHS was systematically reviewed and summarised based on precision nursing theory and a postoperative precision nursing program was drafted.Using the Delphi's Method,two rounds of expert consultation were conducted and the postoperative precision nursing program for children with OSAHS was revised and finalised.Results The response rates of the two rounds of expert consultation were 100.00%with the expert authority coefficient of 0.875.The Kendall coefficient of concordance(W)of levels 1,2 and 3 indices in the second round of expert consultation were 0.289,0.203,0.187,respectively(all P<0.01).The importance score of each inclicator ranged from 4.50～4.94.The coefficient of variations for the three-level indices ranged from 0.05 to 0.21.The finalised program composed 8 level-1 indices(postoperative position assessment,intervention,prevention and care of bleeding,maintaining postoperative airway patency,postoperative nausea and vomiting care,postoperative pain assessment and care,dietary care,complication prevention and care,discharge guidance),16 level-2 indices,and 22 level-3 indices.Conclusion The postoperative precision nursing program for the children with OSAHS is scientific,innovative and applicable.It provides clinical references for nursing of the children with OSAHS.

Objective To identify key genes and potential therapeutic drugs associated with Alzheimer's disease(AD)based on microglial senescence using bioinformatics analysis,providing new targets and insights for AD diagnosis and treatment.Methods Gene expression datasets related to microglial senescence and AD,specifically GSE62420 and GSE74615,were downloaded from the Gene Expression Omnibus(GEO)database.Differential Expressed Genes(DEGs)were identified using R software.Functional enrichment analysis,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,was performed using the DAVID online tool.The STRING database was used to construct the protein-protein interaction(PPI)network,and the CytoHubba plugin in Cytoscape software was applied to identify hub genes.The differential expression of hub genes was validated using the GSE129296 and GSE208386 datasets.Potential therapeutic drugs targeting these genes were predicted using the DSigDB database.Results A total of 35 DEGs,including 34 upregulated and 1 downregulated gene,were identified from the intersection of the GSE74615 and GSE62420 datasets.GO and KEGG enrichment analyses indicated that these DEGs were significantly involved in gene expression regulation,protein binding,metal ion binding,and the hypoxia-inducible factor 1(HIF-1)signaling pathway.PPI network analysis and CytoHubba screening identified ten hub genes:HIF1A,secreted phosphoprotein 1(SPP1),integrin alpha X(ITGAX),triggering receptor expressed on myeloid cells(TREM2),glycoprotein non-metastatic melanoma protein B(GPNMB),anexelekto receptor tyrosine kinase(AXL),Cystatin F(CST7),interleukin-12B(IL12B)、lipoprteinlipase(LPL)and fatty acid-binding protein 5(FABP5).Validation using the GSE129296 dataset showed that HIF1A,SPP1,ITGAX,TREM2,GPNMB,AXL,CST7 and FABP5 were significantly upregulated in microglia of AD mice,and the differences were statistically significant(t=8.411～29.49,all P<0.05).Further validation using the GSE208386 dataset indicated that LPL,SPP1,AXL and CST7 were significantly upregulated during microglial senescence,and the differences were statistically significant(t=4.755～5.964,all P<0.05).Based on these validation results,SPP1,AXL and CST7 were identified as key genes in AD.Drug prediction analysis using DSigDB revealed that potential therapeutic compounds targeting these genes exhibit anti-aging,anti-tumor,anti-inflammatory and DNA damage repair effects.Conclusion The key genes SPP1,AXL and CST7,identified based on microglial senescence,may serve as potential biomarkers for AD.Furthermore,multiple potential therapeutic drugs were predicted,offering new targets and strategies for AD diagnosis and treatment.

Objective To analyze the influence of Dapagliflozin on ventricular remodeling,soluble suppression of tumorigenicity-2(sST2)and brain natriuretic peptide(BNP)in patients with elderly ST-segment elevation myocardial infarction(STEMI)complicated with type 2 diabetes mellitus(T2DM)after percutaneous coronary intervention(PCI).Methods From April 2021 to March 2023,118 elderly patients with STEMI complicated with T2DM treated by PCI were selected from People's Hospital of Hengshui.They were divided into conventional hypoglycemic therapy control(Con,n=59)group and conventional hypoglycemic therapy combined with Dapagliflozin(Dap,n=59)group according to the treatment strategy.All the participants were treated for 24 weeks.The general data,biochemical indexes,BNP,N-terminal pro-B-type natriuretic peptide(NT-proBNP),soluble growth stimulating expression factor 2(sST2)and lipoprotein-associated phospholipase A2(LP-PLA2),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular mass index(LVMI)were compared between the two groups.Results After 24 weeks of treatment,the BNP,NT-proBNP,fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),LVEDD,LVESD,LVMI,serum sST2 and LP-PLA2 were lower in Dap group than in Con group(P<0.05),while the LVEF was higher in Dap group than in Con group(P<0.05).The total incidence rate of major adverse cardiovascular events was significantly lower in Dap group than in Con group(P<0.05).The incidence rates of adverse drug reactions were 6.78%and 5.08%in the two groups respectively(P>0.05).Conclusions Dapagliflozin can improve the cardiac function and glucose metabolism status in elderly patients with STEMI and T2DM after PCI,and alleviate the ventricular remodeling,with good safety.

Objective The aim of this study was to explore the predictive value of the systemic inflammatory immune nutri-tion score(SIINS)for the prognosis of immunotherapy for advanced gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 202 patients with advanced gastric cancer who received treatment with programmed death-1(PD-1)inhibitors at the Harbin Medical University Cancer Hospital from October 2018 to July 2022.The LASSO regression analysis was used to screen prognostic indicators,construct SIINS indicator,determine the optimal cutoff value for predicting prognosis using subject operating characteristic curves,and divide patients into the high SIINS and low SIINS groups.Independent prognostic factors for overall survival(OS)were determined using univariate and multivariate Cox regression analyses.Results Four indicators,including lymphocyte count,lactate dehydrogenase,and neutrophil lymphocytes,were selected to construct the SIINS index.The prognosis of patients in the high SIINS group was significantly lower than that in the low SIINS group(P<0.05).The results of the multifactorial Cox regression a-nalysis showed that the Eastern Cooperative Oncology Group(ECOG)score,Geriatric Nutritional Risk Index(GNRI),SIINS,treatment regimen,and number of treatment lines(P<0.05)could serve as the independent predictive prognosis of immunotherapy for advanced gastric cancer.Conclusion SIINS can predict the prognosis of patients with advanced gastric cancer treated with PD-1 inhibitors.

Objective To analyze the value of combined prediction of peripheral blood CD4+,CD3-CD16+CD56+,CD8+,CD19+for the risk of death in patients with Epstein-Barr virus-associated hemophagocytic syn-drome(EBV-HLH).Methods A total of 84 patients with EBV-HLH who were treated in Beijing Friendship Hospital Affiliated to Capital Medical University and Peking University First Hospital from May 2021 to A-pril 2023 were selected and divided into a death group(17 cases)and a survival group(67 cases)according to their survival outcomes within 6 months.The general information and peripheral blood T lymphocyte subsets of the two groups were compared,multivariate Logistic regression analysis was conducted to investigate the influencing factors of death in EBV-HLH patients,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of peripheral blood T lymphocyte subsets on death in EBV-HLH patients.Results The platelet count,hemoglobin,CD4+and CD3-CD16+CD56+levels in the death group were lower than those in the survival group,while the levels of CD8+and CD19+were higher than those in the survival group(P＜0.05).Multivariate Logistic regression analysis showed that platelet count,hemoglobin,CD4+,and CD3-CD16+CD56+were all independent protective factors for the death of EBV-HLH patients,while CD8+and CD19+were independent risk factors for the death of EBV-HLH patients(P＜0.05).The ROC curve results showed that the area under the curve of combined prediction of CD4+,CD8+,CD19+,CD3 CD16+CD56+for death in EBV-HLH patients was 0.923,with sensitivity and specificity of 94.12％and 80.60％,respectively,which were significantly higher than those predicted by each individual indicator(P＜0.05).Conclusion The abnormal expression of CD4+,CD3-CD16+CD56+,CD8+,and CD19+in peripheral blood of EBV-HLH patients is associated with their survival outcomes,and the combined prediction of CD4+,CD3-CD16+CD56+,CD8+,and CD19+has high reference value for predicting patients'death.