Objective:This study aimed to compare postoperative pain between minimally invasive coronary artery bypass grafting (MICS-CABG) and conventional CABG for multivessel coronary artery disease, comparing baseline characteristics and perioperative data between the two groups, and analyzing risk factors influencing postoperative pain.Methods:A total of 545 patients undergoing elective off-pump coronary artery bypass grafting (OPCABG) for multivessel coronary artery disease at Beijing Anzhen Hospital from July 2022 to July 2023 were included. There were 397 patients in the conventional CABG group (289 males, 108 females, aged 35-77 years) and 148 patients in the minimally invasive CABG group (121 males, 27 females, aged 37-84 years), with 148 patients in each group after propensity score matching. Pain levels were assessed using the Numeric Rating Scale (NRS) at the first 5 days postoperatively (acute postoperative pain, APP) and at 3, 6, and 12 months postoperatively (chronic post-surgical pain, CPSP). Logistic regression was used to analyze risk factors for CPSP at 3 months postoperatively in both groups. Results:Within 48 hours postoperatively, both groups reported maximum NRS pain intensities at rest (NRS 4.0 vs. 6.0) and during activity (NRS 5.2 vs. 7.5). From the third day after surgery, there were no significant differences in resting pain intensity between the two groups, and from the fourth day after surgery, there were no significant differences in pain intensity during movement. With 60.2% in the conventional group and 92.6% in the minimally invasive group experiencing moderate to severe pain at rest (NRS ≥ 4), and 83.5% in the conventional group and 98.0% in the minimally invasive group experiencing moderate to severe pain during activity (NRS ≥ 4). Immediately after drain removal, there was a significant reduction in pain intensity at rest in the minimally invasive group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7), compared to the conventional group (pre-drain removal NRS 4.0 vs. post-drain removal NRS 2.3). However, there was no significant difference in the reduction of pain intensity during activity between the minimally invasive group (pre-drain removal NRS 7.5 vs. post-drain removal NRS 4.2) and the conventional group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7). At 3 months postoperatively, the incidence of CPSP was 35.9% in the conventional group and 35.1% in the minimally invasive group. At 6 months postoperatively, the incidence of CPSP was significantly lower compared to 3 months in both groups (conventional group 8.7% vs. minimally invasive group 6.8%, P<0.001). In the conventional group, higher Europe SCORE Ⅱ was identified as an independent risk factor for CPSP at 3 months postoperatively, while in the minimally invasive group, higher BMI and postoperative use of flurbiprofen for rescue analgesia were identified as independent risk factors. Conclusion:In patients undergoing minimally invasive coronary artery bypass grafting (CABG), the early postoperative acute pain intensity and incidence were higher than those in the conventional CABG group. After drain removal, there were no significant differences in resting pain intensity between the two groups, but pain intensity during movement remained higher in the minimally invasive group compared to the conventional group. The incidence of chronic pain did not differ between the two groups but decreased significantly from 3 months postoperatively. Conventional CABG patients with high preoperative Europe SCORE Ⅱ scores, high preoperative BMI and severe postoperative acute pain tend to have more chronic pain after minimally invasive bypass surgery.

To investigate the potential protective effect of thalidomide (THD) on diabetic nephropathy (DN) and its underlying mechanisms. Twenty-four C57BL/6J mice were randomly divided into control, DN and DN+THD200 groups by random number table method. The DN mouse model was established via intraperitoneal injection of streptozotocin. The DN+THD200 group received THD treatment (200 mg·kg -1·d -1) for 8 weeks. Blood and urine biochemical parameters, as well as renal histopathological changes, were compared among the three groups. For in vitro experiments, a high glucose (HG)-induced injury model was established in mouse glomerular podocytes (MPC5). Cells were divided into control (NG), HG, HG+DMSO, HG+THD100 (100 μg/ml), and HG+THD200 (200 μg/ml) groups. THD-treated cells were exposed to THD for 24 h. Western blotting and real-time quantitative PCR were performed to respectively detect protein and mRNA expression levels of ferroptosis-related molecules, including nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase 1 (HO-1), and glutathione peroxidase 4 (GPX4). Immunofluorescence was used to evaluate the expression of solute carrier family 7 member 11 (SLC7A11) and 4-hydroxynonenal (4-HNE). The results showed that, compared with control group, DN group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Compared with DN group, DN+THD200 group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Histopathological examination revealed glomerular expansion, mesangial widening, and basement membrane thickening in DN group compared to control group, which were markedly ameliorated by THD treatment. In vitro, HG group showed significantly decreased protein and mRNA expression levels of GPX4, NRF2 and HO-1 compared to NG group. Both HG+THD100 and HG+THD200 groups exhibited upregulated expression levels of these proteins and corresponding mRNA compared to HG group (all P<0.05). Immunofluorescence demonstrated HG group had enhanced 4-HNE fluorescence intensity and reduced SLC7A11 fluorescence intensity, which were reversed by THD treatment. THD alleviates renal injury in DN mice and mitigates HG-induced ferroptosis in MPC5 cells, potentially via activation of NRF2-HO-1-GPX4 signaling pathway.

To investigate the potential protective effect of thalidomide (THD) on diabetic nephropathy (DN) and its underlying mechanisms. Twenty-four C57BL/6J mice were randomly divided into control, DN and DN+THD200 groups by random number table method. The DN mouse model was established via intraperitoneal injection of streptozotocin. The DN+THD200 group received THD treatment (200 mg·kg -1·d -1) for 8 weeks. Blood and urine biochemical parameters, as well as renal histopathological changes, were compared among the three groups. For in vitro experiments, a high glucose (HG)-induced injury model was established in mouse glomerular podocytes (MPC5). Cells were divided into control (NG), HG, HG+DMSO, HG+THD100 (100 μg/ml), and HG+THD200 (200 μg/ml) groups. THD-treated cells were exposed to THD for 24 h. Western blotting and real-time quantitative PCR were performed to respectively detect protein and mRNA expression levels of ferroptosis-related molecules, including nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase 1 (HO-1), and glutathione peroxidase 4 (GPX4). Immunofluorescence was used to evaluate the expression of solute carrier family 7 member 11 (SLC7A11) and 4-hydroxynonenal (4-HNE). The results showed that, compared with control group, DN group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Compared with DN group, DN+THD200 group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Histopathological examination revealed glomerular expansion, mesangial widening, and basement membrane thickening in DN group compared to control group, which were markedly ameliorated by THD treatment. In vitro, HG group showed significantly decreased protein and mRNA expression levels of GPX4, NRF2 and HO-1 compared to NG group. Both HG+THD100 and HG+THD200 groups exhibited upregulated expression levels of these proteins and corresponding mRNA compared to HG group (all P<0.05). Immunofluorescence demonstrated HG group had enhanced 4-HNE fluorescence intensity and reduced SLC7A11 fluorescence intensity, which were reversed by THD treatment. THD alleviates renal injury in DN mice and mitigates HG-induced ferroptosis in MPC5 cells, potentially via activation of NRF2-HO-1-GPX4 signaling pathway.

Objective:This study aimed to compare postoperative pain between minimally invasive coronary artery bypass grafting (MICS-CABG) and conventional CABG for multivessel coronary artery disease, comparing baseline characteristics and perioperative data between the two groups, and analyzing risk factors influencing postoperative pain.Methods:A total of 545 patients undergoing elective off-pump coronary artery bypass grafting (OPCABG) for multivessel coronary artery disease at Beijing Anzhen Hospital from July 2022 to July 2023 were included. There were 397 patients in the conventional CABG group (289 males, 108 females, aged 35-77 years) and 148 patients in the minimally invasive CABG group (121 males, 27 females, aged 37-84 years), with 148 patients in each group after propensity score matching. Pain levels were assessed using the Numeric Rating Scale (NRS) at the first 5 days postoperatively (acute postoperative pain, APP) and at 3, 6, and 12 months postoperatively (chronic post-surgical pain, CPSP). Logistic regression was used to analyze risk factors for CPSP at 3 months postoperatively in both groups. Results:Within 48 hours postoperatively, both groups reported maximum NRS pain intensities at rest (NRS 4.0 vs. 6.0) and during activity (NRS 5.2 vs. 7.5). From the third day after surgery, there were no significant differences in resting pain intensity between the two groups, and from the fourth day after surgery, there were no significant differences in pain intensity during movement. With 60.2% in the conventional group and 92.6% in the minimally invasive group experiencing moderate to severe pain at rest (NRS ≥ 4), and 83.5% in the conventional group and 98.0% in the minimally invasive group experiencing moderate to severe pain during activity (NRS ≥ 4). Immediately after drain removal, there was a significant reduction in pain intensity at rest in the minimally invasive group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7), compared to the conventional group (pre-drain removal NRS 4.0 vs. post-drain removal NRS 2.3). However, there was no significant difference in the reduction of pain intensity during activity between the minimally invasive group (pre-drain removal NRS 7.5 vs. post-drain removal NRS 4.2) and the conventional group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7). At 3 months postoperatively, the incidence of CPSP was 35.9% in the conventional group and 35.1% in the minimally invasive group. At 6 months postoperatively, the incidence of CPSP was significantly lower compared to 3 months in both groups (conventional group 8.7% vs. minimally invasive group 6.8%, P<0.001). In the conventional group, higher Europe SCORE Ⅱ was identified as an independent risk factor for CPSP at 3 months postoperatively, while in the minimally invasive group, higher BMI and postoperative use of flurbiprofen for rescue analgesia were identified as independent risk factors. Conclusion:In patients undergoing minimally invasive coronary artery bypass grafting (CABG), the early postoperative acute pain intensity and incidence were higher than those in the conventional CABG group. After drain removal, there were no significant differences in resting pain intensity between the two groups, but pain intensity during movement remained higher in the minimally invasive group compared to the conventional group. The incidence of chronic pain did not differ between the two groups but decreased significantly from 3 months postoperatively. Conventional CABG patients with high preoperative Europe SCORE Ⅱ scores, high preoperative BMI and severe postoperative acute pain tend to have more chronic pain after minimally invasive bypass surgery.

There are different views on the theory of “spleen governs time”， which is still a hot spot in the study of Zangxiang （藏象） theory. Based on Zangxiang time-space view， it is found that the thinking mode of the spleen governing time theory follows space-time logic. It is believed that the different time views of the spleen governing time are all formed based on the space view that the spleen belongs to earth and resides in the center， and the zang time theory is developed with the unified time and space logic. Guided by Zangxiang time-space view， the origin of the spleen belonging to earth and residing in the center is traced， and the theoretical connotation and its clinical application of spleen governing time under different time-space logic are explored with reference to the four season and five zang theory， five season and five zang theory， six season and six zang theory， and eight season and eight zang theory.

The seventy-two grid palm technique is an important theoretical source of traditional Chinese medicine hand diagnosis. Starting from the ecological medical model， we analyse the seventy-two grid palm technique， and believe that its diagnosis of human body integrates biological， ecological， psychological， social and other factors， and each factor is based on physiological and pathological theories， and its external social interpretation of the nature of the human body is inseparable from health state. It is proposed that the seventy-two grid palm technique should be integrated with the ecological and natural viewpoints based on the biomedical models or bio-psycho-social medical models， and the research should be conducted from the perspective of the ecological medical model， in order to promote the development of hand diagnosis.

Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period(ICSAKOPP). Methods From May,2022 to April,2023,320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital,China-Japan Friendship Hospital,Peking University First Hospital and Chinese PLA General Hospital.Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty,three days(±one day)after arthroplasty,three weeks(±one week)after arthroplasty,and three months(±one month)after ar-throplasty.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were recorded at the same time.Five professionals were asked to score all the items of Brief ICSAKOPP,and the content validity index(CVI)was caculated. Results A total of 64 cases were dropped down.CVI of all the items of the Brief ICSAKOPP were above 0.8,with a av-erage CVI of the scale of 0.938.The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813.There was a moderate correlation(r=0.681,P<0.001)between the overall Brief ICSAKOPP and WOMAC scores,as well as body functional dimension score(r=0.668,P<0.001)and activities and participation dimension score(r=0.657,P<0.001). Conclusion Brief ICSAKOPP is good in content validity,internal consistency reliability and criterion validity.

Psoriasis is an autoimmune disease characterized by chronic skin inflammation, and its etiology and pathogenesis have not been fully elucidated to date. In the previous study, rhIL23R-CHR/Fc fusion protein had been found to significantly relieve the symptoms of psoriasis mice and the pharmacological mechanism had been initially elucidated.In this study, we established a psoriasis cell model (Act-HaCaT) using TNF-α-activated human immortalized keratinocytes (HaCat).In our current study, the lncRNA that plays a key role in the regulation of Act-HaCaT function by the rhIL23R-CHR/Fc fusion protein was screened by transcriptome sequencing combined with qRT-PCR.The results showed that rhIL23R-CHR/Fc fusion protein significantly inhibited cell proliferation and inflammatory factor production in Act-HaCaT.lncRNA ENST00000522718 was obtained by screening, and knockdown of ENST00000522718 was found to significantly inhibit cell proliferation and inflammatory factor production.Our findings suggest that ENST00000522718 plays an important role in the pathological mechanism of psoriasis.

Objective:To investigate the application of system relaxation training on the posttraumatic stress disorder for the families of burned children, so as to provide a basis for the application of valid nursing in children families.Methods:A total of 80 cases of burned children in Children′s Hospital of Nanjing Medical University and corresponding 80 households were recruited and divided into the observation group and the control group with 40 cases each group. The patients and households from January 2019 to May 2019 in the control group received routine care, while the patients and households from February 2020 to June 2020 in the observation group received system relaxation training based on the routine care for four days. The posttraumatic stress disorder and uncertainty in illness of children families before and after intervention were evaluated by Posttraumatic stress Checklist-Civilian version(PLC-C) and Mishel Uncertainty in Illness Scale-Family Member form(MUIS-FM) and compared between the two groups.Results:There was no significant difference in the scores of PLC-C and MUIS-FM before intervention in the households between the two groups( P>0.05). After intervention, the scores of re-experiencing symptoms, avoidance/numbing, increased arousal symptoms and total PTSD scores in the households were (8.40 ± 1.79), (14.35 ± 2.85), (8.25 ± 1.28), (31.10 ± 3.52) points in the observation group and (11.28 ± 2.37), (16.75 ± 2.09), (9.10 ± 1.93), (37.13 ± 4.40) points in the control group, the differences were statistically significant ( t values were -6.76 - -2.32, all P<0.05). After intervention, the scores of ambiguity, deficit information and total MUIS-FM scores of the households were (37.08 ± 6.58), (20.15 ± 4.38), (84.38 ± 6.90) points in the observation group and (41.13 ± 6.54), (22.05 ± 3.32), (90.13 ± 7.85) points in the control group, the differences were statistically significant ( t =-2.76, -2.19, -3.48, all P<0.05). Conclusions:System relaxation training can alleviate posttraumatic stress disorder and reduce uncertainty in illness of the families of burned children.

Microglia are the immune cells in central neural system. Microglia play an important role in central neural system such as surrounding environment monitoring, apoptosis induction and mature synapse formation. Besides, as a pathological process, traumatic brain injury (TBI) can cause the structure and function damage of central nervous system. While the activated microglia can change the TBI-induced pathological process and play an important role during the course of injury. Therefore, the authors review the important physiological function of microglia and its pathological role so as to provide references for clinical treatment.