ObjectiveTo investigate the immunological characteristics of the patients with aplastic anemia （AA） and elevated hemogram parameters treated with Yiqi Yangxue prescription combined with Western medicine and the predictive effects of immunological indexes on elevated hemogram parameters， thus providing a reference for the prediction of the treatment efficacy and the adjustment of the treatment regimen. MethodA retrospective study was conducted， involving 77 AA patients treated with Yiqi Yangxue prescription combined with Western medicine for 6 months in 19 medical institutions including Xiyuan Hospital， China Academy of Chinese Medical Sciences from September 2018 to March 2021. The patients were assigned into two groups according to the elevations in hemogram parameters ［including hemoglobin （HGB）， white blood cell count （WBC）， platelet （PLT）， and absolute neutrophil count （ANC）］ after 6 months of treatment. One group had the elevation <50%， and the other group had the elevation ≥50% compared with the baseline. The clinical and immunological characteristics were compared between the two groups. Result① Compared with the group with HGB elevation<50%， the group with HGB elevation≥50% showed elevated level of CD3⁺ human leukocyte antigen-DR （HLA-DR）⁺ and increased proportion of patients with T-helper cell type 2 （Th2）<5%， CD8⁺≥50%， and CD3⁺HLA-DR⁺≥9% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD8⁺≥50% before treatment was the independent influencing factor for HGB elevation ≥50% ［odds ratio （OR）=12.000， 95% confidence interval （CI） 2.218， 64.928， P<0.01］. ② Compared with the group with WBC elevation<50%， the group with WBC elevation≥50% showed increased proportion of patients with CD3⁺HLA-DR⁺<6% and T-box transcription factor （T-bet）≥200% before treatment （P<0.05）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<6% （OR=2.998， 95%CI 1.036， 8.680， P<0.05） and T-bet≥200% （OR=3.634， 95%CI 1.076， 12.273， P<0.05） before treatment were independent influencing factors for WBC elevation≥50%. ③ Compared with the group with PLT elevation<50%， the group with PLT elevation≥50% presented lowered Th1 and CD3⁺HLA-DR⁺ levels and increased proportion of patients with Th1<12%， CD4⁺≥6%， and CD3⁺HLA-DR⁺<5% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<5% before treatment was the independent influencing factor for PLT elevation≥50% （OR=16.190， 95%CI of 3.430 to 76.434， P<0.01）. ④ Compared with the group with ANC elevation<50%， the group with ANC elevation≥50% showed no significant changes in the hemogram parameters before treatment. ConclusionAs for the AA patients with rapid elevation in HGB， Yiqi Yangxue prescription combined with Western medicine demonstrate significant effects in the patients with Th2<5% and CD3⁺HLA-DR⁺≥9%， especially those with CD8⁺≥50%. As for the AA patients with rapid elevation in WBC， the therapy was particularly effective in the patients with CD3⁺HLA-DR⁺<6% and T-bet≥200%. As for the AA patients with rapid growth in PLT， the therapy was particularly effective in the patients with Th1<12% and CD4⁺≥6%， especially those with CD3⁺HLA-DR⁺<5%.

Objective To investigate the impact of influence of personality traits of nurses as second victim and negative experience of nurses in adverse event and explore the intermediary roles of stress perception in influencing mechanism of negative experience.Methods Between March and April 2023,a convenience sampling method was employed to select 560 nurses from 3 general hospitals in Taiyuan City to conduct the study.The selected nurse all had experienced adverse events within last 3 months.The survey employed a general information questionnaire,Chinese big five personality questionnaire,second victim experience and support scale and Chinese version of stress perception scale.Pearson's correlation analysis was conducted to explore the correlation between the personality traits of nurses as second victim(specifically neuroticism),negative experiences and stress perception.The mediating role of stress perception between the neuroticism of nurses as second victim and negative experiences of nurses was analysed using PROCESS plug-in with the Bootstrap method.Results All of 560 distributed questionnaires were recovered,with a 100.00%of response rate.Personality traits of nurses as second victim were ranked in descending order with rigor,agreeableness,openness,neuroticism and extroversion.Both negative experiences and stress perception had higher scores(40.25±10.64 and 30.25±5.98,respectively).Neurotic personality in nurses as second victim was positively correlated with negative experience(r=0.528,P＜0.01)and stress perception(r=0.594,P＜0.01).Negative experiences showed a positive correlation with stress perception(r=0.339,P＜0.01).Neurotic personality of nurses as second victim had a significant direct impact on negative experiences[β=0.519,95%CI:0.318-0.720].As one of the stress perception dimensions,tension played a partial mediating role between neurotic personality in nurses as second victim and negative experience[β=0.148,95%CI:0.006-0.300],and a mediating effect percentage of 22.70%.Conclusions The neurotic personality of nurses as second victim can directly affect the negative experiences,either independently or in conjunction with tension.Nursing managers and nurses as second victims can reduce the negative experiences in adverse events by addressing higher neurotic personality and alleviating tension.

Objective:To investigate the effect of low-dose ketamine on neuroinflammation and microcirculation in mice with traumatic brain injury (TBI).Methods:Sixty adult male C57BL/6 mice, weighing 22-28 g, were randomly divided into sham-operated group, TBI group, Sham+ketamine group, and TBI+ketamine group ( n=15). A controlled cortical impingement (CCI) method was used to establish TBI models in the later 2 groups. Sham+ketamine group and TBI+ketamine group were intraperitoneally injected with 30 mg/kg ketamine once daily for 3 d at 30 min after TBI; sham-operated group and TBI group were intraperitoneally injected same amount of saline at the same time points. Cerebral cortical blood flow in 6 mice from each group was measured by laser speckle contrast imaging (LSCI) before, immediately after, 30 min after, 1 d after and 3 d after modeling, respectively. Three d after modeling, immunohistochemical staining and immunofluorescent double label staining were used to detect the nuclear translocation of microglia markers, ionized calcin-antibody-1 (Iba-1) and nuclear factor (NF)-κB p65 in damaged cortical brain tissues in 6 mice from each group. The remaining 3 mice in each group were sacrificed and tissue plasma was extracted 3 d after modeling; levels of NF-κB p65, phosphorylated (p)-NF-κB p65, p-IκB and inducible nitric oxide synthase (iNOS) in cortical brain tissues were detected by Western blotting. Expressions of tumor necrosis factor-α (TNF-α), interleukin-1-β (IL-1β) and interleukin-6 (IL-6), iNOS, reactive oxygen species (ROS) and reactive nitrogen species (RNS) in cortical brain tissues were detected by ELISA. Results:LSCI indicated that, 3 d after modeling, relative blood flow in local cerebral microcirculation of TBI+ketamine group was significantly increased compared with that of TBI group ( P<0.05). Immunohistochemical staining indicated that compared with the sham-operated group and Sham+ketamine group, the TBI group and TBI+ketamine group had significantly increased number of Iba-1 positive cells in the cerebral cortex ( P<0.05); compared with the TBI group, the TBI+ketamine group had significantly decreased number of Iba-1 positive cells ( P<0.05). ELISA indicated that compared with the sham-operated group and Sham+ketamine group, the TBI group and TBI+ketamine group had significantly increased expressions of TNF-α, IL-1β, IL-6, iNOS, ROS and RNS in damaged cortical brain tissues ( P<0.05); compared with the TBI group, the TBI+ ketamine group had significantly decreased expressions of TNF-α, IL-1β, IL-6, iNOS, ROS and RNS in damaged cortical brain tissues ( P<0.05). Immunofluorescent double label staining indicated obviously inhibited NF-κB p65 nuclear translocation in TBI+ketamine group when it was compared with TBI group. Western blotting indicated that compared with the sham-operated group and Sham+ketamine group, the TBI+ketamine group had significantly increased iNOS, NF-κB p65, p-NF-κB p65 and P-IκB protein expressions in damaged cortical brain tissues ( P<0.05); compared with the TBI group, the TBI+ketamine group had significantly decreased protein expressions of iNOS, NF-κB p65, p-NF-κB p65 and p-IκB in damaged cortical brain tissues ( P<0.05). Conclusion:Low-dose ketamine reduces neuroinflammation and improves cerebral microcirculatory blood flow after open TBI, whose mechanism may be related to inhibition of microglia NF-κB/iNOS pathway.

Objective This study aimed to investigate the glycosyltransferase gene DsUGT11 involved in the biosynthesis of flavonoids in Desmodium styracifolia,and to analyze the function of its encoding protein by bioinformatic tools,gene cloning,prokaryotic expression,and other technologies.Methods The sequence characteristics and potential biological functions of DsUGT11 were analyzed and predicted by bioinformatics analysis,respectively.Total RNA was extracted from fresh leaves and reverse transcribed into cDNA,from which DsUGT11 gene was successfully amplified and cloned.Heterologous expressed protein was induced and purified,followed by functional characterization using enzymatic reaction in vitro.Results A candidate glycosyltransferase gene,designated as DsUGT11,was identified from the transcriptome data of D.styracifolia.The length of the open reading frame of DsUGT11 is 1426 bp,and the molecular weight of its encoding protein is expected to be 52.14 KDa.By bioinformatic analysis,DsUGT11 was found to harvest a conserved motif of"PSPG"that is unique to the UGT family.Moreover,DsUGT11 was successfully amplified and cloned using the prokaryotic expression vector pMALc5X.Recombinant protein was induced and purified subsequently.Next,the purified protein was used to perform the enzymatic reaction in vitro,the result of which suggested that DsUGT11 was able to catalyze the conversion of 2-OH-naringenin and UDP-glucose into three different compounds,one of which was authenticated as apigenin-7-O-β-D-glucoside(also known as Apigetrin),with two others unknown.Conclusion In this study,the DsUGT11 gene was identified and cloned,whose encoding protein is a flavone-oxyglycosyltransferase catalyzing the conversion of 2-OH-naringenin and UDP-glucose into three different compounds including Apigetrin.

Ischemic stroke is one of the important causes of disability and death among middle-aged and elderly people in China,and there are many complicated problems from diagnosis to treatment.At present,vascular recanalization has become the most important treatment for ischemic stroke.However,the prognosis of patients is still not ideal after vascular recanalization treatment alone.At the same time,the therapeutic effect of neuroprotective drugs targeting a single target is still not significant.Annexin A5 has many biological functions,such as anticoagulation,anti-inflammation,protection of neuron survival and so on,and can be used for neuroprotective therapy such as reducing reperfusion injury after cerebral vascular recanalization.Annexin A5 can be used in the diagnosis of stroke and the construction of targeted vectors because of its close binding with phosphatidylserine.The authors summarized the multiple functions of Annexin A5,and analyzes its possible effects on ischemic stroke,so as to provide reference for the follow-up study.

infC gene encodes the translation initiation factor IF3 in bovine Pasteuella multocida,but it whether or not regulation to the virulence and cross-protection in P.multocida is still not well understood.In this study,the infC gene mutant(△infC)derived from bovine P.multocida type A strain CQ2 was constructed using by homologous recombination method.Compared with wild strain,the △infC showed significant increasing in biofilm formation,but the capsule produc-tion,virulence and bacterial loading in organs were significant decreased,and the IL-1β secretion of mouse peritoneal macrophage increased.Along with the infC gene deletion,the expression of genes related to capsule synthesis and LPS synthesis and transport were significantly down-regulated,while that of genes related to biofilm synthesis and outer membrane protein were significantly up-regulated.The inactivated vaccines of wild type and mutant were prepared and mice were immu-nized twice then challenged with wild type strains,respectively.The immuno-protection rate of△in fC inactivated vaccine against bovine P.multocida type A,B and F were 100.0％,83.3％and 0.0％,respectively,and the immuno-protection rate that against rabbit type P.multocida was 33.3％.The results indicated that infC gene could affect the virulence of P.multocida by regula-ting the production of capsule and the expressions of virulence related factors,and the deletion of infC gene conferred a certain cross-protection property of strains.This study provided a certain foundation for the development of P.multocida vaccine.

Objective To investigate the effect of intestinal flora on the efficacy of polyethylene glycol losenatide(PEX168)in mice with type 2 diabetes mellitus(T2DM).Methods A total of 50 healthy male C57BL/6 mice were fed with a high-fat diet combined with STZ to establish a T2DM mouse model.Among them,40 were successfully modeled and divided into T2DM group(n=10)and PEX168 group(n=30).PEX168 group was further divided into two sub groups according to HbA1c:ideal group(IE subgroup,HbA1c≤6.5%,n=12)and unsatisfactory group(NE subgroup,HbA1c>6.5%,n=12).IE subgroup was fecal donor,NE subgroup was recipientand further divided into fecal bacteria transplantation subgroup(FMT,n=5)and Sham subgroup(Sham,n=5).Fecal bacteria transplantation(FMT)was used to transfer fecal bacteria from IE group to FMT group.Body weight,food intake and blood glucose were measured every 2 weeks in all the groups.FPG,FIns,HbA1c and insulin resistance index(HOMA-IR)were compared on the 7th day after 10 weeks of intervention in all the groups.Results FPG and body weight were lower at the 4th,6th,8th and 10th week(P<0.05),and food intake was lower in PEX168 group than in T2DM group at the 2nd,4th,6th,8th and 10th week(P<0.05).At the 4th,6th,8th and 10th week after administration,the FPG and body weight were lower in IE subgroup than in NE subgroup(P<0.05),and the food intake was lower at the 0th,4th,8th and 10th week after administration than in NE subgroup(P<0.05).The FBG,body weight and food intake were lower in FMT subgroup than in Sham subgroup at 4,6 and 8 weeks(P<0.05).The FPG,HbA1c,2 hPG,FIns and HOMA-IR were lowerin PEX168 group after treatment than in PEX168 group before treatment and T2DM group after treatment(P<0.05).FPG,HbA1c,FIns,2 hPG and HOMA-IR were lower in IE subgroup after treatment than in IE subgroup before treatment and NE subgroup after treatment(P<0.05).FPG,HbA1c,FIns,2 hPG and HOMA-IR were lower in FMT subgroup after treatment than in FMT subgroup before treatment and Sham subgroup after treatment(P<0.05).Conclusions Differences in intestinal flora between individuals affect the efficacy of PEX168.FMT treatment can improve the composition of intestinal flora and affect the efficacy of PEX168.

Objective:To explore the clinical effects of early rehabilitation treatment after repair surgery of skin and soft tissue defects accompanied by extensor tendon injury on the back of hand.Methods:This study was a retrospective non-randomized controlled study. From February 2015 to February 2023, 24 patients (15 males and 9 females, aged 12-55 years) with skin and soft tissue defects accompanied by extensor tendon injury on the back of hand, who met the inclusion criteria and were repaired with flap transplantation and tendon grafting or tendon anastomosis, were admitted to the First Affiliated Hospital of Air Force Medical University. According to different intervention time for postoperative rehabilitation treatment of patients, the patients were divided into conventional rehabilitation group and early rehabilitation group, with 12 cases in each group. Patients in early rehabilitation group received rehabilitation treatment immediately after surgery under the rehabilitation guidance of specialized rehabilitation physicians based on the characteristics of different postoperative periods. Patients in conventional rehabilitation group began rehabilitation treatment from the third week after surgery, and their rehabilitation treatment was the same as that of patients in early rehabilitation group from the second week after surgery. The patients in 2 groups were treated in the hospital until the sixth week after surgery. The occurrence of flap vascular crisis and tendon rupture were observed within 6 weeks after surgery. After 6 weeks of surgery, the manual muscle test was used to measure the pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, and grip force of the affected hand; the total action motion method was used to evaluate the finger joint range of motion of the affected hand, and the excellent and good ratio was calculated; the Carroll upper extremity function test was used to score and rate the function of the affected hand.Results:Within 6 weeks after surgery, only 1 patient in conventional rehabilitation group suffered from venous crisis, and the flap survived after the second surgical exploration and anastomosis of blood vessels; there was no occurrence of tendon rupture in patients of 2 groups. After 6 weeks of surgery, there were no statistically significant differences in pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, or grip force of the affected hand between the two groups of patients ( P>0.05); the excellent and good ratio of the finger joint range of motion of the affected hand of patients in early rehabilitation group was 11/12, which was higher than 7/12 in conventional rehabilitation group, but there was no statistically significant difference ( P>0.05); the affected hand function score of patients in early rehabilitation group was 90±6, which was significantly higher than 83±8 in conventional rehabilitation group ( t=2.41, P<0.05); the function rating of the affected hand of patients in early rehabilitation group was obviously better than that in conventional rehabilitation group ( Z=2.04, P<0.05). Conclusions:Early rehabilitation treatment for patients with skin and soft tissue defects accompanied by extensor tendon injury on the back of hand after repair surgery can improve hand function, but it would not increase surgery related complications, which is worthy of clinical promotion and application.

Background::Scleroderma is characterized by inflammation and fibrosis, predominantly occurring in the skin and extending to various parts of the body. The pathophysiology of scleroderma is multifaceted, with the current understanding including endothelial damage, inflammatory cell infiltration, and fibroblast activation in its progression. Nonetheless, the mechanism of cellular interactions and the precise spatial distribution of these cellular events within the fibrotic tissues remain elusive, highlighting a critical gap in our comprehensive understanding of scleroderma’s pathogenesis.Methods::In this study, we administered bleomycin intradermally to the dorsal skin of four individual murine models. Subsequently, skin tissues were harvested at predetermined intervals for comprehensive spatial transcriptomic analysis to determine the spatial dynamics influencing scleroderma pathogenesis. To validate the possible results from bioinformatic analysis, further in vitro and in vivo experiments were conducted. Results::Analysis of the spatial transcriptome revealed significant alterations in cell clusters during the progression of scleroderma. Gene Ontology analysis identified disruptions in lipid metabolism as the disease advanced. Pseudotime analysis provided evidence for a phenotypic transition from adipocytes to fibroblasts. In vitro studies demonstrated increased expression of Col1a1 and α-SMA as the disease progressed. These fibroblasts have been identified as key contributors to the increasing inflammation. Co-culturing TGF-β induced adipocytes with RAW264.7 cells resulted in overexpression of pro-inflammatory cytokines in the RAW264.7 cells. Both in vitro and in vivo experiments confirmed adipocyte loss and fibroblast formation, with transformed fibroblasts showing pronounced pro-inflammatory characteristics, highlighting their crucial role in the disease mechanism. Conclusions::Our study showed the spatial distribution and dynamic alterations of various cell types during scleroderma progression. Crucially, we identified the transformation of adipocytes into fibroblasts as a key factor promoting disease advancement. These emergent fibroblasts intensify inflammation, indicating that research on these cell clusters could reveal key scleroderma mechanisms and guide future therapies.

Objective:This study aims to investigate the expression levels of α-synuclein(α-synuclein)and apolipoprotein A-1(ApoA1)in elderly patients with cerebral small vessel disease(CSVD)and their association with cognitive function.Methods:A total of 176 elderly patients diagnosed with CSVD and admitted to Huludao Central Hospital between September 2022 and February 2024 were retrospectively selected as research subjects.Based on their cognitive function at the time of admission, patients were categorized into a disorder group comprising 71 cases and a normal group consisting of 105 cases.General information was collected from the patients, and the serum expression levels of α-synuclein and ApoA1 were measured.Pearson correlation analysis was employed to assess the relationship between the expression levels of α-synuclein and ApoA1 and the Montreal Cognitive Assessment(MoCA)scores.Furthermore, multi-factor logistic regression analysis was conducted to identify influencing factors, and receiver operating characteristic(ROC)curves were generated to evaluate the diagnostic value of serum levels.Results:Patients in the disorder group were older than those in the normal group.Additionally, the MoCA score and serum α-synuclein levels were significantly higher in the disorder group, while ApoA1 levels were lower(all P<0.05).Pearson correlation analysis indicated that the MoCA score was negatively correlated with α-synuclein expression and positively correlated with ApoA1 expression(all P<0.05).Multivariate logistic regression analysis revealed that age, smoking history, and α-synuclein levels are risk factors for cognitive dysfunction in patients with CSVD, whereas ApoA1 is identified as a protective factor for cognitive function in this population.Furthermore, ROC curve analysis demonstrated that serum α-synuclein and ApoA1 levels possess diagnostic value for cognitive dysfunction in patients.The area under the curve(AUC)for the combined predictions was 0.836, with sensitivity and specificity rates of 76.14% and 78.14%, respectively. Conclusions:Elderly patients with CSVD and cognitive dysfunction exhibit abnormally high levels of α-synuclein and abnormally low levels of ApoA1.Both factors are influential in the context of cognitive dysfunction among elderly patients with CSVD and contribute to improved diagnostic efficiency.