Objective:This study identifies independent predictive indicators to distinguish autoimmune gastritis from Helicobacter pylori ( H. pylori)-induced atrophic gastritis and validates their diagnostic performance to compare laboratory indicators of autoimmune gastritis and H. pylori-induced atrophic gastritis. Methods:A retrospective comparison of laboratory examination indicators was conducted for chronic atrophic gastritis patients with involvement of the gastric fundus and corpus, who were followed up at the Department of Gastroenterology, Xijing Hospital, from January 2014 to September 2024. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff points and corresponding diagnostic thresholds. In addition, multivariate logistic regression analysis was conducted to identify independent predictive indicators for autoimmune gastritis, with further assessment in a validation cohort.Results:A total of 139 patients with autoimmune gastritis and 209 patients with H. pylori-induced atrophic gastritis were included. Pepsinogen (PG) Ⅰ levels and the PG Ⅰ/PG Ⅱ ratio in patients with autoimmune gastritis were significantly lower than in those with H. pylori-induced atrophic gastritis [11.0 (4.8, 22.5) vs. 41.8 (32.2, 59.9) μg/L, U=722.00, P<0.001; 1.24 (0.75, 3.54) vs. 5.76 (4.31, 7.12), U=817.00, P<0.001], while gastrin levels were significantly higher [375 (84, 738) vs. 49 (35, 81) ng/L, U=378.00, P<0.001]. PG Ⅰ was identified as an independent predictive variable, with an area under the ROC curve of 0.847 (95% CI 0.791-0.904), sensitivity of 77.6%, specificity of 91.8%, positive predictive value of 80.5%, and negative predictive value of 90.5%. Conclusions:Significant differences in laboratory indicators were observed between autoimmune gastritis and H. pylori-induced atrophic gastritis in chronic atrophic gastritis involving gastric fundus and corpus. Besides, PG Ⅰ demonstrated good diagnostic performance in identifying autoimmune gastritis and can effectively differentiate between different types of atrophic gastritis.

Objective To investigate the effect and mechanism of melatonin in alleviating hypoxia-induced apoptosis in ovarian gra-nulosa cells.Methods Rat ovarian granulosa cells were isolated and divided into normoxic,hypoxic,and melatonin groups.Hypoxia-induced injury models were established in the hypoxic and melatonin groups,and granulosa cells in the melatonin group were treated with melatonin.A total of 24 rats were randomized into the control,model,and intervention groups(n=8 per group).Rat models of declining ovarian function induced by long-term hypoxia were established in the model and intervention groups.The rats in the intervention group were intraperitoneally injected with melatonin.Cell proliferation was measured using a CCK-8 assay,and lactate secretion and HIF-1αprotein with a specific kit,respectively.The levels of estradiol and progesterone in the cell supernatant and rat serum were detected using ELISA.Granulosa cell apoptosis was detected by flow cytometry,ovarian morphology by HE staining,and Bax and caspase-3 expression by Western blotting.Results Compared with the normoxic group,the hypoxic group exhibited decreased granulosa cell proliferation,increased apoptosis,elevated lactate and HIF-1α levels,and reduced estradiol and progesterone levels(P＜0.05).Compared with hypoxic group,these changes were significantly reversed in the molatonin group(P＜0.05).Compared with the control group,the model group showed increased lactate,HIF-1α,Bax,and caspase-3 levels,decreased estradiol and progesterone levels,and reduced follicles.Compared with the model group,all the indicators were ameliorated in the intervention group(P＜0.05).Conclusion Melatonin alleviated hypoxia-induced granulosa cell apoptosis and promoted the recovery of ovarian function.

Objective To investigate the effect and mechanism of melatonin in alleviating hypoxia-induced apoptosis in ovarian gra-nulosa cells.Methods Rat ovarian granulosa cells were isolated and divided into normoxic,hypoxic,and melatonin groups.Hypoxia-induced injury models were established in the hypoxic and melatonin groups,and granulosa cells in the melatonin group were treated with melatonin.A total of 24 rats were randomized into the control,model,and intervention groups(n=8 per group).Rat models of declining ovarian function induced by long-term hypoxia were established in the model and intervention groups.The rats in the intervention group were intraperitoneally injected with melatonin.Cell proliferation was measured using a CCK-8 assay,and lactate secretion and HIF-1αprotein with a specific kit,respectively.The levels of estradiol and progesterone in the cell supernatant and rat serum were detected using ELISA.Granulosa cell apoptosis was detected by flow cytometry,ovarian morphology by HE staining,and Bax and caspase-3 expression by Western blotting.Results Compared with the normoxic group,the hypoxic group exhibited decreased granulosa cell proliferation,increased apoptosis,elevated lactate and HIF-1α levels,and reduced estradiol and progesterone levels(P＜0.05).Compared with hypoxic group,these changes were significantly reversed in the molatonin group(P＜0.05).Compared with the control group,the model group showed increased lactate,HIF-1α,Bax,and caspase-3 levels,decreased estradiol and progesterone levels,and reduced follicles.Compared with the model group,all the indicators were ameliorated in the intervention group(P＜0.05).Conclusion Melatonin alleviated hypoxia-induced granulosa cell apoptosis and promoted the recovery of ovarian function.

Objective:This study identifies independent predictive indicators to distinguish autoimmune gastritis from Helicobacter pylori ( H. pylori)-induced atrophic gastritis and validates their diagnostic performance to compare laboratory indicators of autoimmune gastritis and H. pylori-induced atrophic gastritis. Methods:A retrospective comparison of laboratory examination indicators was conducted for chronic atrophic gastritis patients with involvement of the gastric fundus and corpus, who were followed up at the Department of Gastroenterology, Xijing Hospital, from January 2014 to September 2024. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff points and corresponding diagnostic thresholds. In addition, multivariate logistic regression analysis was conducted to identify independent predictive indicators for autoimmune gastritis, with further assessment in a validation cohort.Results:A total of 139 patients with autoimmune gastritis and 209 patients with H. pylori-induced atrophic gastritis were included. Pepsinogen (PG) Ⅰ levels and the PG Ⅰ/PG Ⅱ ratio in patients with autoimmune gastritis were significantly lower than in those with H. pylori-induced atrophic gastritis [11.0 (4.8, 22.5) vs. 41.8 (32.2, 59.9) μg/L, U=722.00, P<0.001; 1.24 (0.75, 3.54) vs. 5.76 (4.31, 7.12), U=817.00, P<0.001], while gastrin levels were significantly higher [375 (84, 738) vs. 49 (35, 81) ng/L, U=378.00, P<0.001]. PG Ⅰ was identified as an independent predictive variable, with an area under the ROC curve of 0.847 (95% CI 0.791-0.904), sensitivity of 77.6%, specificity of 91.8%, positive predictive value of 80.5%, and negative predictive value of 90.5%. Conclusions:Significant differences in laboratory indicators were observed between autoimmune gastritis and H. pylori-induced atrophic gastritis in chronic atrophic gastritis involving gastric fundus and corpus. Besides, PG Ⅰ demonstrated good diagnostic performance in identifying autoimmune gastritis and can effectively differentiate between different types of atrophic gastritis.

Anaplastic thyroid carcinoma(ATC)is the most aggressive malignancy with poor prognosis.The pathogenesis of ATC is complex,and there is no effective treatment at present.In recent years,with the deep understanding of the genetic(such as BRAF V600E,TP53,TERT,PIK3CA mutations,etc.)and epigenetic(such as histone methylation,histone deacetylation,microRNA regulatory pathways,etc.)changes driving ATC,molecular targeted therapy has brought new hope to ATC patients.This article reviews the molecular mechanisms of ATC and the latest achievements in targeted therapy and other therapies.

Objective:To explore the relationship between psychological resilience,professional identity and employment pressure of nursing students with different educational levels,and analyze its influencing factors.Methods:A total of 208 nursing students with different educational levels were investigated by using the general information questionnaire,the employment pressure questionnaire of nursing students,the psychological resilience scale and the professional identity questionnaire.The correlation among psychological resilience,professional identity and employment stress was analyzed by Pearson correlation analysis.Results:The total score of professional identity,psychological resilience,and employment stress was(54.46±12.34),(57.62±18.66),and(98.30±20.25),respectively.There was no significant difference in professional identity score and psychological resilience score among nursing students with different educational levels(P＞0.05).There was no significant difference in the employment stress scores between nursing students upgrading from a junior college and undergraduate and junior college nursing students(P＞0.05),while the employment stress score of junior college nursing students were significantly higher than that of undergraduate nursing students(P＜0.05).Pearson correlation analysis showed that the total score of employment stress was positively correlated with the total score of psychological resilience(r=0.252),and the total score of professional identity(r=0.312)(P＜0.01).Conclusions:The psychological resilience of nursing students is at the average level,professional identity is low,and the employment pressure of junior college nursing students is higher than that of undergraduates.Targeted interventions should be developed to improve the psychological resilience and professional identity of nursing students,and reduce the employment pressure level of junior college nursing students.

Objective:This study introduces a novel approach utilizing a self-made drug delivery cannula implanted into the cerebellomedullary cistern(CMC)of rats to allow repeated administrations in conscious subjects.Methods:A self-made medication cannula is inserted through a drilled hole at the midpoint of the occipital crest of the rat's skull,de-scending along the inner wall of the occipital bone until reaching the CMC,and securing it in place with skull screws and self-curing resin.Lipopolysaccharide(LPS)is injected into the CMC to induce neuroinflammation,and the feasibility of this method is assessed using X-ray imaging,behavioral testing,and immunofluorescence staining.Results:The place-ment of the brain cannula was confirmed using X-ray film and pontamine sky blue staining.Rats in the LPS group exhib-ited a lower facial mechanical pain threshold compared to the Control group(P＜0.001),along with reduced residence time in the open field center(P＜0.01).Immunofluorescence staining revealed LPS-induced activation of caudal spinal trigeminal nucleus(SpVc)microglia.Conclusion:This method proves to be suitable for multiple administrations to the cerebellomedullary cistern of conscious rats,enabling the study of the SpVc's role in pain modulation.

The annual incidence of neurodegenerative disease has been increasing with the aging of the global population,seriously affecting the quality of life of elderly patients and imposing a heavy burden on society.Glycyrrhetinic acid,which inhibits neuroinflammation and protects neurons,is one of the main active ingredients of the traditional Chinese medicine Glycyrrhiza glabra.Increasing numbers of studies are focusing on the mechanism of action of glycyrrhetinic acid and its derivatives in neurodegenerative disease.This review summarizes studies on the effects and mechanisms of action of glycyrrhetinic acid and its derivatives in Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,multiple sclerosis,and cerebellar atrophy.Additionally,the future applications of glycyrrhetinic acid and its derivatives in neurodegenerative disorders are discussed.

Objective:To explore the current status and influencing factors of meaning in life among postoperative lung cancer patients, providing reference and guidance for the development of nursing interventions.Methods:From January to March 2023, convenience sampling was used to select 170 lung cancer patients with surgery in Department of Chest Surgery of the Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College as the study subject. The patients were surveyed using the General Information Questionnaire, Chinese version of Meaning in Life Questionnaire (C-MLQ), and the Cancer Fatigue Scale (CFS) .Results:The score of meaning in life among postoperative lung cancer patients was (45.71±5.90). Hierarchical linear regression analysis showed that living alone, educational level, and cancer-related fatigue were the influencing factors on the meaning in life among postoperative lung cancer patients ( P<0.05) . Conclusions:The meaning in life of postoperative lung cancer patients is at a moderate level. Medical and nursing staff should focus on patients who live alone and have a low level of education, and can also improve their meaning in life by alleviating cancer-related fatigue.

Objective:To evaluate the efficacy of dexmedetomidine for patient-controlled sleep regulation in improving postoperative sleep disorders in patients with gastrointestinal tumors.Methods:One hundred and fifty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 40-80 yr, with a preoperative Pittsburgh Sleep Quality Index (PSQI) score of ≤7 and a PSQI score of >7 on the 1st day after surgery, undergoing elective laparoscopic resection of gastrointestinal tumors from May 2023 to December 2023 in the Affiliated Changzhou No. 2 People′s Hospital of Nanjing Medical University, were divided into 3 groups ( n=50 each) using a random number table method: normal saline group and dexmedetomidine via different routes of administration groups (DEX1 group, DEX2 group). After the routine use of 48 h postoperative analgesia, dexmedetomidine 400 μg and atropine 1 mg in 100 ml of normal saline were added to the analgesic pump in DEX1 and DEX2 groups, DEX1 group received a background infusion at a rate of 2.5 ml/h, and after an initial dose of 6 ml, the patient-controlled analgesia (PCA) pump was programmed to deliver 4 ml with a lockout interval of 10 min and background infusion at 0.5 ml/h in DEX2 group. In NS group, normal saline was added to the PCA pump, and the methed of petient-controlled administration was the same as those previously described in DEX2 group. PSQI scores were recorded at days 1, 3 and 7 and 1 month postoperatively, and visual analogue scale scores were recorded on postoperative days 1, 3 and 7. Personal Health Questionnaire Depression Scale scores were assessed and the polysomnogram was monitored on the preoperative day 1, and 15-item Quality of Recovery (QoR-15) scale scores were assessed on postoperative day 7. The duration of PACU stay, consumption of anesthetic drugs, the total pressing times of PCA within 48 h, consumption of analgesic drugs and lenth of hospital stay were recorded. Results:Compared with NS group, the sleep stage N1 ratio and arousal index were significantly decreased and the sleep stage N2 ratio and sleep efficiency were increased on postoperative days 3 and 7, PSQI scores at days 3 and 7 and 1 month after operation and VAS score at postoperative day 7 were decreased, the length of hospital stay was shortened in DEX1 and DEX2 groups, and QoR-15 scale scores were significantly increased in DEX2 group ( P<0.05). Compared with DEX1 group, the sleep stage N3 ratio was significantly increased, PSQI scores were decreased on postoperative days 3 and 7, and QoR-15 scale scores were increased in DEX2 group ( P<0.05). Multivariate logistic regression analysis showed that dexmedetomidine for patient-controlled sleep regulation was a protective factor against postoperative sleep disturbances ( P<0.05). Conclusions:For the patients with postoperative sleep disorders following surgery for gastrointestinal tumors, self-controlled administration of dexmedetomidine for 3 consecutive days after surgery improves the sleep structure, raises the subjective sleep quality and promotes the postoperative recovery.