Background The increasing demand for emergency services coupled with the special working environment has exacerbated occupational stress and work-related rumination among emergency medical dispatchers, which is noteworthy for its impact on dispatchers' sleep quality. Objective To explore the relationship among occupational stress, work-related rumination, and sleep quality of emergency medical dispatchers, so as to provide reference for improving sleep quality and maintaining physical and mental health of this occupational group. Methods A total of 386 emergency medical dispatchers from 16 provinces and municipalities including Beijing, Shanghai, Tianjin, Inner Mongolia, Zhejiang, Shanxi, Jiangxi, Anhui, Hubei, Hebei, Henan, Sichuan, Guizhou, Yunnan, Fujian, and Hainan of China were investigated with the Chinese version of Effort-Reward Imbalance Questionnaire, Work-Related Rumination Questionnaire, and Insomnia Severity Index. Spearman correlation was used to analyze the association among occupational stress, work-related rumination, and sleep quality. A structural equation model was constructed, with occupational stress as independent variable, the two dimensions of work-related rumination as mediating variables, and sleep quality as dependent variable, respectively. Bootstrap testing was then used to verify potential mediating effect of work-related rumination on the relationship between occupational stress and sleep quality among the emergency medical dispatchers. Results Among the enrolled emergency medical dispatchers, the effort-reward imbalance (ERI) index was 1.03, the score of affective rumination was 15.35±5.26, the score of problem-solving rumination was 17.64±4.63, and the total score of sleep quality was 21.10±6.53. Their ERI index was positively correlated with affective rumination scores (r=0.636, P<0.01), but not with problem-solving rumination scores (P>0.05). Their ERI index, affective rumination scores, and problem-solving rumination scores were positively correlated with sleep quality scores (P<0.05). The direct effect size of occupational stress on sleep quality was 0.627, the indirect effect size of affective rumination was 0.124, and the mediating effect of affective rumination accounted for 16.4% of the total effect (0.755), while the problem-solving rumination had no mediating effect on the relationship between occupational stress and sleep quality. Conclusion Occupational stress and affective rumination in emergency medical dispatchers can predict their sleep quality. Occupational stress can directly affect sleep quality, and indirectly affect it through affective rumination. Managers should pay attention to and evaluate the affective rumination level of emergency medical dispatchers, so as to take corresponding intervention measures to reduce their occupational stress and improve their sleep quality.

Carbamate pesticides, a new type of broad-spectrum pesticides for controlling pests, mites, and weeds, are developed to address the shortcomings of organochlorine and organophosphorus pesticides. Their widespread use and slow degradation have led to environmental pollution, causing damage to ecosystems and human health. Managing pesticide residues is a pressing issue in the current environmental protection. This study aims to investigate the expression of SyEst870, a member of the SGNH/GDSL hydrolase family in Sphingobium yanoikuyae, in a prokaryotic system and evaluate the ability of the recombinant protein to degrade carbamate pesticides. The prokaryotic expression vector pET-32a-SyEst870 was constructed and transformed into the Escherichia coli BL21 for heterologous expression. The purified protein was studied in terms of enzyme activity and effects of temperature, pH, and metal ions on the enzyme activity, with p-nitrophenol acetate as the substrate and based on the standard curve of p-nitrophenol. LC-MS (liquid chromatography-mass spectrometry) was employed to examine the degradation effects of SyEst870 on carbaryl, metolcarb, and isoprocarb. GC-MS (gas chromatography-mass spectrometry) was employed to detect the degradation products of SyEst870 for the three pesticides. The soluble protein SyEst870 was successfully obtained through the heterologous expression in Escherichia coli, which yielded an enzyme with the activity of 677.5 U after affinity chromatography. SyEst870 exhibited degradation rates of 82.34%, 84.43%, and 92.87% for carbaryl, metolcarb, and isoprocarb, respectively, at an initial concentration of 100 mg/L within 24 h at 30 ℃ and pH 7.0. The primary degradation products of carbaryl were identified as α-naphthol and methyl isocyanate. Metolcarb was mainly degraded into m-cresol and methyl isocyanate, and isoprocarb was mainly degraded into 2-isopropylphenol and methyl isocyanate. Compared with the half-life of carbamate pesticides in the natural environment, which ranges from a few days to several weeks, the recombinant protein SyEst870 can rapidly eliminate the residues of carbamate pesticides. This study lays a foundation for addressing pesticide residues in the environment and in fruits and vegetables.
Escherichia coli/metabolism* ; Sphingomonadaceae/genetics* ; Recombinant Proteins/metabolism* ; Biodegradation, Environmental ; Esterases/metabolism* ; Pesticides/isolation & purification* ; Carbamates/isolation & purification*

Objective:To investigate the clinical characteristics, postoperative complications, and risk factors for pouchitis in surgical patients with ulcerative colitis (UC).Methods:This was a retrospective observational study. The clinical data of 336 UC patients who had undergone surgical treatment at the Inflammatory Bowel Disease Center of the Department of General Surgery, Jinling Hospital Affiliated to Nanjing University Medical School from February 2014 to February 2024 were enrolled. The study patients were stratified into 2014-2019 ( n = 158) and 2020–2024 groups ( n = 178), these being the periods before and after biologics were covered for treatment of UC by national insurance in China in 2020. Clinical characteristics and surgical complications were analyzed and compared between the 2014-2019 and 2020-2024 groups. Multivariable logistic regression was performed to identify the risk factors associated with pouchitis in UC patients undergoing total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA). Results:The study cohort comprised 336 UC patients, 193 (57.4%) of whom were men. The median preoperative disease course was 48.0 months and the mean age at colectomy was 46.4±15.4 years. TPC-IPAA had been performed on 275 patients (81.8%), 129 in the 2014-2019 group and 146 in the 2020-2024 group. Sixty-one patients had undergone total or subtotal colectomy, 29 in the 2014-2019 group and 32 in the 2020-2024 group. 262 (78.0%) UC patients underwent surgery due to medical refractory. Ninety-nine (29.5%) had used biopharmaceuticals within 2 months prior to surgery, 63 (18.8%) of them having received infliximab. A smaller proportion of patients had undergone surgery for UC that was refractory to medications in the 2020–2024 group than in the 2014–2019 group (73.0% [130/178] vs. 83.5% [132/158], χ 2=5.384, P=0.020), the patients were older at colectomy (48.0±15.4 years vs. 44.6±15.2 years, t=-2.008, P=0.045), the body mass index was higher (20.2±3.1 kg/m 2 vs. 19.4±3.2 kg/m 2, t=-2.201, P=0.028), the Mayo score prior to surgery was lower ( M[ Q1, Q3]: 11.0 [9.2, 12.0 points] vs. 12.0 [11.0, 12.0) points, Z=-4.242, P=0.001), the rate of Charlson Comorbidity Index ≥ 3 scores was higher (27.0% [48/178] vs. 17.1% [27/158], χ 2=5.384, P=0.020), a greater percentage of patients had received biologics prior to surgery (41.0% [73/178) vs. 16.5% [26/158], χ 2=24.285, P<0.001), and intraoperative blood loss was greater ( M[ Q1, Q3]: 100.0 [100.0, 150.0] ml vs. 50.0 [30.0, 100.0] ml, Z=-7.054, P<0.001) despite the operation time being shorter (253.8±74.6 minutes vs. 315.2±96.8 minutes, t=6.265, P<0.001). Among the 275 patients undergoing TPC-IPAA, 95 (34.6%) had early complications (within 30 days after surgery), 20 (7.3%) of which were Clavien-Dindo Grade III–IV complications. Among these patients, 50 (18.2%) had ileus or small bowel obstruction, 11 in the 2014-2019 group and 39 in the 2020-2024 group; this difference is statistically significant (χ 2=15.225, P<0.001). Ninety-one patients (33.1%) had late complications (more than 30 days after surgery), 75 (27.3%) being pouchitis (36 in the 2014-2019 group and 39 in the 2020-2024 group); this difference is not statistically significant (χ 2=0.049, P=0.824). Five patients (1.8%) had undergone pouch excision with permanent ileostomy. Among the 61 patients who had undergone total or subtotal colectomy, 26 (42.6%) developed early postoperative complications, including 10 (16.4%) Clavien-Dindo Grade III-IV complications and one death (1.6%), the last being attributable to multiorgan dysfunction. Three patients (4.9%) had late complications; the difference in incidence of postoperative complications between the 2014-2019 and 2020-2024 groups is not statistically significant (both P>0.05). Multivariable analysis identified intraoperative blood transfusion (OR: 2.12, 95% CI: 1.19–3.75, P=0.010) and interval to stoma closure > 120 days (OR: 2.05, 95%CI: 1.16-3.62, P = 0.013) as independent risk factors for development of pouchitis in UC patients undergoing TPC-IPAA. Conclusion:Surgical treatment of UC remains safe in the biologics era. Proactive strategies to reduce intraoperative blood transfusion and achieve timely stoma closure may reduce the risk of pouchitis in UC patients undergoing TPC-IPAA.

Objective:To explore the moderating and mediating roles of psychological resilience in the relationship between job satisfaction and depressive symptoms among petrochemical workers.Methods:In April 2022, a cluster sampling method was used to conduct a questionnaire survey among 1087 in-service employees of a petrochemical enterprise in Henan Province. A total of 861 questionnaires were recovered, including 857 valid ones, with an effective rate of 99.54%. Data on job satisfaction, psychological resilience, and depressive symptoms were collected using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Job Satisfaction Questionnaire, and Patient Health Questionnaire-9 (PHQ-9). Spearman rank correlation analysis was applied to analyze the relationships among the scores of job satisfaction, psychological resilience, and depressive symptoms. Hierarchical linear regression analysis was used to test the moderating effect of psychological resilience, and the Bootstrap method was employed to verify the mediating effect of psychological resilience.Results:The scores of job satisfaction, psychological resilience, and depressive symptoms among petrochemical workers were 36.00 (31.00, 36.00) points, 36.00 (30.00, 41.00) points, and 7.00 (3.00, 9.00) points. The detection rate of depressive symptoms was 65.7% (563/857). Results of Spearman rank correlation analysis showed that job satisfaction of petrochemical workers was positively correlated with psychological resilience ( rs=0.270, P<0.01) and negatively correlated with depressive symptoms ( rs=-0.386, P<0.01), psychological resilience was negatively correlated with depressive symptoms ( rs=-0.515, P<0.01). Results of hierarchical linear regression analysis indicated that psychological resilience had no moderating effect on the relationship between job satisfaction and depressive symptoms of petrochemical workers ( b=0.001, P>0.05). Results of the mediating effect test showed that psychological resilience played a partial mediating effect in the relationship between job satisfaction and depressive symptoms ( P<0.01), with a mediating effect value of -0.071 (95% CI: -0.125, -0.045), accounting for 20.16% of the total effect. Conclusion:Psychological resilience exerts a partial mediating effect rather than a moderating effect in the relationship between job satisfaction and depressive symptoms among petrochemical workers.

Objective:To explore the moderating and mediating roles of psychological resilience in the relationship between job satisfaction and depressive symptoms among petrochemical workers.Methods:In April 2022, a cluster sampling method was used to conduct a questionnaire survey among 1087 in-service employees of a petrochemical enterprise in Henan Province. A total of 861 questionnaires were recovered, including 857 valid ones, with an effective rate of 99.54%. Data on job satisfaction, psychological resilience, and depressive symptoms were collected using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Job Satisfaction Questionnaire, and Patient Health Questionnaire-9 (PHQ-9). Spearman rank correlation analysis was applied to analyze the relationships among the scores of job satisfaction, psychological resilience, and depressive symptoms. Hierarchical linear regression analysis was used to test the moderating effect of psychological resilience, and the Bootstrap method was employed to verify the mediating effect of psychological resilience.Results:The scores of job satisfaction, psychological resilience, and depressive symptoms among petrochemical workers were 36.00 (31.00, 36.00) points, 36.00 (30.00, 41.00) points, and 7.00 (3.00, 9.00) points. The detection rate of depressive symptoms was 65.7% (563/857). Results of Spearman rank correlation analysis showed that job satisfaction of petrochemical workers was positively correlated with psychological resilience ( rs=0.270, P<0.01) and negatively correlated with depressive symptoms ( rs=-0.386, P<0.01), psychological resilience was negatively correlated with depressive symptoms ( rs=-0.515, P<0.01). Results of hierarchical linear regression analysis indicated that psychological resilience had no moderating effect on the relationship between job satisfaction and depressive symptoms of petrochemical workers ( b=0.001, P>0.05). Results of the mediating effect test showed that psychological resilience played a partial mediating effect in the relationship between job satisfaction and depressive symptoms ( P<0.01), with a mediating effect value of -0.071 (95% CI: -0.125, -0.045), accounting for 20.16% of the total effect. Conclusion:Psychological resilience exerts a partial mediating effect rather than a moderating effect in the relationship between job satisfaction and depressive symptoms among petrochemical workers.

Objective:To investigate the clinical characteristics, postoperative complications, and risk factors for pouchitis in surgical patients with ulcerative colitis (UC).Methods:This was a retrospective observational study. The clinical data of 336 UC patients who had undergone surgical treatment at the Inflammatory Bowel Disease Center of the Department of General Surgery, Jinling Hospital Affiliated to Nanjing University Medical School from February 2014 to February 2024 were enrolled. The study patients were stratified into 2014-2019 ( n = 158) and 2020–2024 groups ( n = 178), these being the periods before and after biologics were covered for treatment of UC by national insurance in China in 2020. Clinical characteristics and surgical complications were analyzed and compared between the 2014-2019 and 2020-2024 groups. Multivariable logistic regression was performed to identify the risk factors associated with pouchitis in UC patients undergoing total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA). Results:The study cohort comprised 336 UC patients, 193 (57.4%) of whom were men. The median preoperative disease course was 48.0 months and the mean age at colectomy was 46.4±15.4 years. TPC-IPAA had been performed on 275 patients (81.8%), 129 in the 2014-2019 group and 146 in the 2020-2024 group. Sixty-one patients had undergone total or subtotal colectomy, 29 in the 2014-2019 group and 32 in the 2020-2024 group. 262 (78.0%) UC patients underwent surgery due to medical refractory. Ninety-nine (29.5%) had used biopharmaceuticals within 2 months prior to surgery, 63 (18.8%) of them having received infliximab. A smaller proportion of patients had undergone surgery for UC that was refractory to medications in the 2020–2024 group than in the 2014–2019 group (73.0% [130/178] vs. 83.5% [132/158], χ 2=5.384, P=0.020), the patients were older at colectomy (48.0±15.4 years vs. 44.6±15.2 years, t=-2.008, P=0.045), the body mass index was higher (20.2±3.1 kg/m 2 vs. 19.4±3.2 kg/m 2, t=-2.201, P=0.028), the Mayo score prior to surgery was lower ( M[ Q1, Q3]: 11.0 [9.2, 12.0 points] vs. 12.0 [11.0, 12.0) points, Z=-4.242, P=0.001), the rate of Charlson Comorbidity Index ≥ 3 scores was higher (27.0% [48/178] vs. 17.1% [27/158], χ 2=5.384, P=0.020), a greater percentage of patients had received biologics prior to surgery (41.0% [73/178) vs. 16.5% [26/158], χ 2=24.285, P<0.001), and intraoperative blood loss was greater ( M[ Q1, Q3]: 100.0 [100.0, 150.0] ml vs. 50.0 [30.0, 100.0] ml, Z=-7.054, P<0.001) despite the operation time being shorter (253.8±74.6 minutes vs. 315.2±96.8 minutes, t=6.265, P<0.001). Among the 275 patients undergoing TPC-IPAA, 95 (34.6%) had early complications (within 30 days after surgery), 20 (7.3%) of which were Clavien-Dindo Grade III–IV complications. Among these patients, 50 (18.2%) had ileus or small bowel obstruction, 11 in the 2014-2019 group and 39 in the 2020-2024 group; this difference is statistically significant (χ 2=15.225, P<0.001). Ninety-one patients (33.1%) had late complications (more than 30 days after surgery), 75 (27.3%) being pouchitis (36 in the 2014-2019 group and 39 in the 2020-2024 group); this difference is not statistically significant (χ 2=0.049, P=0.824). Five patients (1.8%) had undergone pouch excision with permanent ileostomy. Among the 61 patients who had undergone total or subtotal colectomy, 26 (42.6%) developed early postoperative complications, including 10 (16.4%) Clavien-Dindo Grade III-IV complications and one death (1.6%), the last being attributable to multiorgan dysfunction. Three patients (4.9%) had late complications; the difference in incidence of postoperative complications between the 2014-2019 and 2020-2024 groups is not statistically significant (both P>0.05). Multivariable analysis identified intraoperative blood transfusion (OR: 2.12, 95% CI: 1.19–3.75, P=0.010) and interval to stoma closure > 120 days (OR: 2.05, 95%CI: 1.16-3.62, P = 0.013) as independent risk factors for development of pouchitis in UC patients undergoing TPC-IPAA. Conclusion:Surgical treatment of UC remains safe in the biologics era. Proactive strategies to reduce intraoperative blood transfusion and achieve timely stoma closure may reduce the risk of pouchitis in UC patients undergoing TPC-IPAA.

The complex pathophysiological mechanisms between diabetes mellitus and cardiovascular diseases have not yet been fully elucidated， becoming one of the challenges in clinical care. Glucagon-like peptide-1 receptor agonist （GLP1-RA） and sodium glucose cotransporter-2 inhibitors （SGLT2） are clinically used to reduce the cardiovascular risk of patients with diabetes mellitus. Traditional Chinese medicine has diverse biological activities and unique advantages in the treatment of chronic complex diseases due to its multi-component and multi-target effects. Based on recent reports， this paper reviewed the common risk factors of diabetes mellitus and cardiovascular diseases （e.g.， hyperglycemia， insulin resistance， and inflammation）， related targets such as apolipoprotein C-Ⅲ （APOC3）， S100 calcium-binding protein A8/A9 （S100A8/A9）， growth/differentiation factor-15 （GDF-15）， and NACHT， LRR， and PYD domains-containing protein 3 （NLRP3）， advanced glycation end products， insulin resistance， endothelial dysfunction， endoplasmic reticulum stress， mitochondrial dysfunction， and intestinal flora disorder. In addition， this paper summarized the research progress in the treatment of cardiovascular diseases in diabetes mellitus with the active ingredients （e.g.， baicalein， puerarin， curcumin， notoginsenoside， and tanshinone Ⅱ_A）， single herbal medicines （e.g.， Astragali Radix， Ginseng Radix et Rhizoma， Sophorae Flavescentis Radix， Cinnamomi Cortex， and Corni Fructus）， and compound formulas （e.g.， Buzang Tongluo Fang， Yiqi Yangyin Huoxue Fang， Shenqi Fang， Huangqisan， Danggui Buxue Tang， and Liuwei Dihuang Wan） of traditional Chinese medicine. Traditional Chinese medicine mainly treats cardiovascular diseases in diabetes mellitus by reducing inflammation and oxidative stress， ameliorating dyslipidemia and insulin resistance， protecting islet β cell function， repairing endothelial damage， inhibiting smooth muscle cell proliferation， foam cell formation， macrophage polarization， and cardiac hypertrophy and fibrosis， and regulating intestinal flora disorder. These processes involve insulin receptor substrate/ phosphatidylinositol 3-kinase/protein kinase B （IRS/PI3K/Akt）， peroxisome proliferator-activated receptor α/γ （PPAR α/γ）， nuclear factor-kappa B （NF-κB）， adenosine 5′-monophosphate （AMP）-activated protein kinase （AMPK）， hypoxia-inducible factor-1-BCH domain-containing protein （HIF-1-BNIP）， vascular endothelial growth factor/hypoxia-inducible factor-1α （VEGF/HIF-1α） and other signaling pathways. This review is expected to provide a theoretical basis and reference for the treatment of cardiovascular diseases in diabetes mellitus with traditional Chinese medicine.

Objective:To analyze the different clinicopathological features of intrahepatic cholangiocarcinoma with and without viral hepatitis.Methods:The clinicopathological data of 79 intrahepatic cholangiocarcinoma cases from Mar 2012 to Sep 2018 at Henan Provincial People's Hospital were retrospectively analyzed.Results:Twenty-five of the 79 patients with intrahepatic cholangiocarcinoma were accompanied by viral hepatitis. Those with viral hepatitis had a lower mean age at onset than those without [(53±11) years vs. (60±11) years, P=0.011], higher proportion of male patients (80% vs. 52%, P=0.017), higher AFP positive rate (40% vs. 19%, P=0.041), lower CA19-9 positive rate (48% vs. 72%, P=0.036), tend to occur in the right liver lobe (76% vs. 44%, P=0.009), a lower rate of bile duct invasion (16% vs. 41%, P=0.03), and were more likely to be mass type (mass type proportion 96% vs. 72%, P=0.032). Conclusions:Viral hepatitis is common in intrahepatic cholangiocarcinoma. Intrahepatic cholangiocarcinoma with and without viral hepatitis differ in clinicopathology. Intrahepatic cholangiocarcinoma with viral hepatitis is more likely to have the characteristics of hepatocellular carcinoma, while intrahepatic cholangiocarcinoma without viral hepatitis is more likely to have the characteristics of cholangiocarcinoma.

Objective:To investigate the influences and mechanism of berberine on wound healing of full-thickness skin defects in diabetic mice.Methods:The experimental research method was adopted. Mouse dermal fibroblasts (MDF) conventional-glucose complete medium (hereinafter referred to as conventional medium) were prepared with final mass concentrations of berberine of 0 (no berberine), 1.25, 2.50, 5.00, 10.00, 20.00, 40.00, 80.00, and 160.00 μg/mL, respectively. Primary MDF were cultured using conventional medium and MDF high-glucose (30 mmol/L glucose) complete medium (hereinafter referred to as high-glucose medium), and the 3 rd to 6 th passage cells were collected for the following experiments. Cells cultured in conventional medium were taken and subjected to starvation treatment for 12 hours, and then cultured in conventional media containing different concentrations of berberine for 48 hours to screen out the optimal working concentration of berberine using the cell counting kit 8 (CCK-8), the sample number was 6, and the selected optimal berberine concentration was used for subsequent cell culture experiments. Cells cultured in 2 media were taken, of which the cells cultured in conventional medium were included to the normal control group; cells cultured in high-glucose medium were divided into high-glucose alone group and high-glucose+berberine group according to the random number table (the same grouping method below). After 48 h of cultivation, cell viability was detected by CCK-8, cell migration capacity was evaluated by scratch test and Transwell assays, and mRNA and protein expression levels of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor-β 1 (TGF-β 1), matrix metalloproteinase 9 (MMP-9), and cysteine aspartic acid specific protease (caspase-3) in the cells were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction and Western blotting, respectively, and the sample numbers of the aforementioned experiments were 6, 3, 9, 3, and 6, respectively. Fifteen 8-week-old male BALB/c mice were used to establish diabetic mouse model, then full-thickness skin defect wounds on their backs were made and divided into diabetes alone group, diabetes+low-concentration berberine group (25 μg/mL), and diabetes+high-concentration berberine group (75 μg/mL) for corresponding treatments, with 5 mice in each group. The wound areas were measured using ImageJ software on post injury day (PID) 0 (immediately), 3, 7, 14, and 21. On PID 21, histological changes and collagen formation in the wound tissue were detected by hematoxylin-eosin and Masson staining, respectively, protein expression and mRNA levels of MMP-9, PDGF, TGF-β 1, VEGF, CD31, and caspase-3 in the wound tissue were detected by immunohistochemistry and real-time fluorescence quantitative reverse transcription polymerase chain reaction, respectively, the sample number of animal experiments was all 5. Data were statistically analyzed with one-way analysis of variance, independent sample t-test, Tukey's test, and factorial design analysis of variance. Results:After 48 hours of cultivation, the cell viability was the highest when the mass concentration of berberine was 20.00 μg/mL. After 48 h of cultivation, compared with that in normal control group, cell viability in both high-glucose alone group and high-glucose+berberine group reduced significantly ( P<0.05); compared with that in high-glucose alone group, the cell viability in high-glucose+berberine group was significantly enhanced ( P<0.05). After 48 h of cultivation, scratch test results showed that, the cell migration rates in 24 h in both high-glucose alone group and high-glucose+berberine group were significantly decreased than that in normal control group ( P<0.05); compared with that in high-glucose alone group, the cell migration rate in 24 h in high-glucose+berberine group was significantly enhanced ( P<0.05). After 48 h of cultivation, the results of Transwell experiments showed that, compared with (141±7) of cells migrating in 24 h in normal control group, the number of cells migrating in 24 h in high-glucose alone group and high-glucose+berberine group were 28±3 and 86±6, respectively, which were significantly decreased ( P<0.05); compared with that in high-glucose alone group, the number of cells migration in 24 h in high-glucose+berberine group was significantly increased ( P<0.05). After 48 h of cultivation, compared with those in normal control group, the mRNA levels of PDGF, VEGF, TGF-β 1, and MMP-9 of cells in high-glucose alone group and high-glucose+berberine group were significantly decreased ( P<0.05), the mRNA levels of caspase-3 were significantly increased ( P<0.05); compared with those in high-glucose alone group, the mRNA levels of PDGF, VEGF, TGF-β 1, and MMP-9 of cells in high-glucose+berberine group were significantly increased ( P<0.05), the mRNA expression level of caspase-3 was significantly decreased ( P<0.05). After 48 h of cultivation, compared with those in normal control group, the protein expression levels of PDGF, VEGF, TGF-β 1, and MMP-9 of cells in high-glucose group and high-glucose+berberine group were significantly decreased ( P<0.05), the protein expression levels of caspase-3 were significantly increased ( P<0.05); compared with those in high-glucose alone group, the protein expression levels of PDGF, VEGF, TGF-β 1, and MMP-9 of cells in high-glucose+berberine group were significantly increased ( P<0.05), and the protein expression level of caspase-3 was significantly decreased ( P<0.05). Compared with those in diabetes alone group, the wound areas of mice in diabetes+low-concentration berberine group on PID 14 and 21 and in diabetes+high-concentration berberine group on PID 3, 7, 14, and 21 were significantly decreased ( P<0.05); compared with that in diabetes+low-concentration berberine group, the wound area in diabetes+high-concentration berberine group was significantly decreased on PID 3, 7, 14, and 21 ( P<0.05). On PID 21, the wound of mice in diabetes alone group was not epithelialized with a large number of inflammatory cells and granulation tissue in the dermis; most of the wound tissue of mice in diabetes+low-concentration berberine group was already epithelialized, although there was a large number of inflammatory cells in the dermis; and most of the wound tissue of mice in diabetes+high-concentration berberine group had completed epithelialization with a small number of hair follicles and inflammatory cells in the dermis. On PID 21, compared with that in diabetes alone group, the collagen area of wound of mice in diabetes+low-concentration berberine group and diabetes+high-concentration berberine group was significantly increased ( P<0.05); compared with that in diabetes+low-concentration berberine group, the collagen area of wound of mice in diabetes+high-concentration berberine group was significantly increased ( P<0.05). On PID 21, compared with those in diabetes alone group, the protein expression levels of MMP-9, PDGF, TGF-β 1, VEGF, and CD31 in wound tissue of mice in diabetes+low-concentration berberine group and diabetes+high-concentration berberine group were significantly increased ( P<0.05), the protein expression levels of caspase-3 were significantly decreased ( P<0.05); compared with those in diabetes+low-concentration berberine group, the protein expression levels of MMP-9, PDGF, TGF-β 1, VEGF, and CD31 in wound tissue of mice in diabetes+high-concentration berberine group were significantly increased ( P<0.05), the protein expression level of caspase-3 was significantly decreased ( P<0.05). On PID 21, compared with those in diabetes alone group, the mRNA levels of MMP-9, PDGF, TGF-β 1, VEGF, and CD31 in wound tissue of mice in diabetes+low-concentration berberine group and diabetes+high-concentration berberine group were significantly increased ( P<0.05), the mRNA levels of caspase-3 were significantly decreased ( P<0.05); compared with those in diabetes+low-concentration berberine group, the mRNA levels of MMP-9, PDGF, TGF-β 1, VEGF, and CD31 in wound tissue of mice in diabetes+high-concentration berberine group were significantly increased ( P<0.05), the mRNA level of caspase-3 was significantly decreased ( P<0.05). Conclusions:Berberine can promote the proliferation and migration of MDF and the healing of full-thickness skin defect wounds of mice in diabetic mice by up-regulating the expression of biofactors including MMP-9, PDGF, TGF-β 1, and VEGF, and down-regulating the expression of caspase-3, a pro-apoptotic factor in wound tissue of mice.

Objective    To identify the risk factors of postoperative blood loss among pediatric patients following corrective operation of tetralogy of Fallot (TOF) and to develop nomogram predicting the risk of postoperative blood loss. Methods    A retrospective case-control study was conducted in pediatric TOF patients who underwent corrective operation in our hospital from November 2018 to June 2019. And the clinical data from each enrolled patient were gathered and analyzed. Clinically significant postoperative blood loss was defined as drainage volume from chest tube ≥ 16 mL/kg during the first 24 h after surgery, which corresponded to the 75th percentile of the blood loss in our population. The primary outcome was to determine the independent predictors of postoperative blood loss by the least absolute shrinkage and selection operator (LASSO) regression, univariate and multivariate logistic regression analysis. On the basis of the independent predictors of postoperative bleeding, nomogram was developed and its discrimination and calibration were estimated. Results    A total of 105 children were selected (67 males and 38 females aged 3-72 months). The drainage volume from chest tube in the bleeding group was significantly higher than that in the non-bleeding group during the first 24 h (P<0.000 1). Multivariate logistic regression analysis showed that low body weight (OR=0.538, 95%CI 0.369-0.787, P=0.001), high preoperative hemoglobin concentration (OR=1.036, 95%CI 1.008-1.066, P=0.013) and prolonged intraoperative aortic cross clamp time (OR=1.022, 95%CI 1.000-1.044, P=0.048) were independent risk factors for postoperative blood loss. In the internal validation, the model displayed good discrimination with a C-index of 0.835 (95%CI 0.745-0.926) and high quality of calibration plots in nomogram models was noticed. Conclusion    The nomogram demonstrated good discrimination and calibration in estimating the risk of postoperative blood loss among pediatric patients following corrective operation of TOF.