Objective:To investigate the effect of tofacitinib on early atherosclerosis of patients with systemic lupus erythematosus and explore the possible relationship between lupus nephritis and early atherosclerosis of systemic lupus erythematosus.Methods:Sixteen 8-week-old female MRL/lpr mice with a body weight of 20~25 g were selected and randomly divided into the treatment group and placebo group, with 8 mice in each group. The treatment group diluted tofacitinib by normal saline, and given at a dose of 10 mg·kg -1·d -1, and the placebo group (starch tablets) administered the medication in the same way as the treatment group for a total of 8 weeks. The ELISA method was applied to detect serum anti-dsDNA antibody levels in the two groups of mice. Bradford method protein concentration was used to determine the level of urine protein in mice. Automatic biochemical analyzer was used to detect blood lipids, urea nitrogen, serum creatinine, complement C3, complement C4 levels. Western blotting was used to determine the protein expression levels of monocyte chemoattractant protein-1 (MCP-1), non-receptor protein tyrosine kinase family 1 (JAK1), signal transducer and activator of transcription 1 (STAT1) and signal transducer and activator of transcription 2 (STAT2) in aortic and kidney tissues. After the aortic arch section were prepared, oil red O was used to stain the sections, and the vascular plaque area and intimal thickness were evaluated by ImageJ software. The kidneys were dissected and stained with HE, and the active lesions of lupus nephritis were evaluated using the glomerular activity scoring system. SPSS 23.0 software was used for statistical analysis, in which the between-group comparison was performed using two independent samples t-test, and the correlation analysis was performed using the Spearman method. Results:①The serum anti-dsDNA antibody expression level in the treatment group [(5.2±1.0) U/ml] was lower than that in the placebo group [(6.9±1.2) U/ml], ( Z=-3.07, P=0.008), and the levels of complement C3 and complement C4 were higher than those in the placebo group [(293±10) mg/L vs. (260±19) mg/L, Z=2.72, P=0.017]; (16±6) mg/L vs. (8±9) mg/L, Z=3.78, P=0.006]. There was no significant difference in serum BUN and Scr between the treatment group and the placebo group [(10.6±0.7) mmol/L vs. (11.5±1.1) mmol/L, Z=-1.96, P=0.071; (17±5) μmol/L vs. (22±6) μmol/L, Z=-1.79, P=0.095]. ② Compared with the placebo group, the levels of LDL, TC and TG in the treatment group decreased [(0.83±0.15) mmol/L vs. (1.08±1.05) mmol/L, Z=-3.95, P=0.001; (2.90±0.08) mmol/L vs. (1.81±0.97) mmol/L, Z=-5.17, P=0.001; (1.10±0.08) mmol/L vs. (1.60±0.42) mmol/L, Z=-3.23, P=0.013], and HDL level increased [(2.02±0.99) mmol/L vs. (1.81±0.97) mmol/L, Z=4.42, P=0.001]. ③ Compared with the placebo group, the levels of aortic MCP-1, JAK1, STAT1 and STAT2 in the treatment group were reduced [(0.17±0.30) vs. (0.23±0.05), Z=-3.06, P=0.009; (0.83±0.09) vs. (1.05±0.19), Z=-3.07, P=0.008; (0.77±0.07) vs. (0.94±0.13), Z=-2.83, P=0.014; (0.70±0.07) vs. (0.82±0.09), Z=-2.83, P=0.013], the aortic plaque area and aortic intimal thickness were lower than those in the placebo group [(12±31) μm 2vs. (1 242±1 101) μm 2, Z=-3.12, P=0.016; (63±7) μm vs. (82.10±8.06) μm, Z=-5.13, P<0.001]. ④ Compared with the placebo group, the urine protein level and glomerulonephritis activity score in the treatment group were decreased [(0.08±0.03) mg/mL vs. (0.20±0.11) mg/mL, Z=-3.08, P=0.015; (1.79±0.38) vs. (2.79±0.14) points, Z=-7.08, P<0.001)], and renal tissue MCP-1, JAK1, STAT1.Compared with the placebo group, STAT2 levels were reduced [(0.364±0.040) vs. (0.425±0.021), Z=-3.85, P=0.003; (0.689±0.074) vs. (0.838±0.068), Z=-4.19, P=0.001; (0.508±0.070) vs. (0.646±0.019), Z=-2.85, P=0.015; (0.618±0.062) vs. (0.740±0.101), Z=-2.94, P=0.013. ⑤ The glomerular mobility scores of the two groups were positively correlated with LDL, TCHO, TG, aortic plaque area and aortic intimal thickness ( r=0.51, P=0.043; r=0.79, P<0.001; r=0.64, P=0.008; r=0.82, P<0.001; r=0.74, P=0.001), and negatively correlated with HDL ( r=-0.53, P=0.036). The urine protein levels in the two groups were positively correlated with LDL, TC, TG, aortic plaque area and aortic intimal thickness ( r=0.67, P=0.004; r=0.68, P=0.004; r=0.53, P=0.033; r=0.80, P<0.001; r=0.74, P=0.001), and negatively correlated with HDL ( r=-0.57, P=0.021). Conclusion:The severity of lupus nephritis is correlated with atherosclerosis and dyslipidemia in the early stage of systemic lupus erythematosus. Tofacitinib may reduce the degree of early arteriosclerosis and lupus nephritis in MRL/LPR mice, and reduce blood lipid levels, which may be effective in improving the prognosis of SLE and improving the survival rate of patients.

Orchitis is a common male genitourinary disorder that significantly impacts patients' life quality.Current treatment strategies have certain limitations and side effects.Ongoing therapeutic strategies focus on the interactions and regulatory networks among pathways and factors involved in the progression of orchitis.The targeted pharmacological agents include inflammatory pathways (p38MAPK, NF-κB, PI3K/Akt), cytokines (TNF-α, IL-6), and the nitric oxide synthase (NOS) system.However, these studies are currently at the animal research stage, and further clinical investigations are necessary to validate their efficacy and safety before clinical use.This article reviews the preclinical animal studies on new treatment methods of orchitis from the aspects of autoimmunity and exogenous microorganism induction, including ketotifen furmarate, aspirin, L-NAME, activin A, cortisol, melatonin, methane, long non-coding RNA MEG3, Abaloparatide, recombinant type Ⅰ interferon, and so on.

Objective To analyze the therapeutic effect of self-adhesive absorbent fiber dressing on su-perficial ulcer of stage 2 pressure injury.Methods Sixty patients with stage 2 pressure injury superficial ul-cers(71 sites)in the thoracic surgery ICU of this hospital from October 2020 to October 2023 were selected and divided into the control group(30 cases,36 sites)and experimental group(30 cases,35 sites)according to the random number table method.The control group was added with the exudation absorption dressing on the basis of conventional pressure injury therapy,while the experimental group was added the self-adhesive ab-sorbent fiber on the basis of conventional pressure injury therapy.After 3 weeks,the clinical efficacy,healing time,dressing change times and pain score were observed and compared between the two groups.Results The total effective rate of clinical treatment in the experimental group was 100.0％(30/30),which was significant-ly higher than 90.0％(27/30)in the control group.The cure time of the experimental group was(17.35±4.17)d,which was significantly shorter than(30.58±4.65)d of the control group.The number of dressing changes in the experimental group was(15.43±1.21)times,which was significantly lower than(53.24±3.43)times in the control group.The pain score of the experimental group was(2.33±1.45)points,which was significantly lower than(8.71±0.52)points of the control group.The above indicators had statistical differences between the two groups(P＜0.05).Conclusion The effect of self-adhesive absorbent fiber in the treatment of stage 2 pressure injury superficial ulcer is obvious,which could increase the clinical curative effect,shorten the healing time,reduce the times of dressing change and relieve the pain of the patients,it has good clinical application value.

Objective:To investigate the causal association between immune cell and different types of sepsis by using Mendelian randomization (MR) method, and to find the immune cell phenotypes causally associated with sepsis.Methods:Summary data for various circulating immune cell phenotypes were obtained from the GWAS catalog (GCST90001391-GCST90002121). Sepsis data were sourced from the UK Biobank database. Single nucleotide polymorphisms (SNP) were used as instrumental variables. The correlation threshold of P < 5×10 -6 was used to identify the strongly correlated instrumental variables, and the code was used to remove the linkage disequilibrium and the instrumental variables with F-value < 10. Inverse variance weighting (IVW) was used as the main research method to evaluate the stability and reliability of the results, including Cochran's Q test, MR-Egger regression and Leave one out. Reverse MR analysis was performed based on the immunophenotypic results of the removal of horizontal pleiotropy, and the immune cell phenotype with one-way causal association was obtained. Odds ratio ( OR) and 95% confidence interval (95% CI) were used to represent the effect value of the results. Results:CD16 on CD14 -CD16 + monocyte had horizontal pleiotropy in sepsis ( OR = 0.965?4, 95% CI was 0.933?5-0.998?3, P = 0.039?6). There were five immunophenotypes that had reverse causal associations with the types associated with sepsis. After excluding immune cell phenotypes with horizontal pleiotropy and reverse causation, a total of 42 immune cell phenotypes with sepsis, 36 immune cell phenotypes with sepsis (28-day death in critical care), 32 immune cell phenotypes with sepsis (critical care), 44 immune cell phenotypes with sepsis (28-day death), and 30 immune cell phenotypes had potential causal associations with sepsis (under 75 years old). After false discovery rate (FDR) correction, the correlations between BAFF-R on IgD - CD38br and sepsis (28-day death) were negative and strong ( OR = 0.737?8, 95% CI was 0.635?9-0.856?0, P = 6.05×10 -5, PFDR = 0.044?2). Conclusion:A variety of immune cell phenotypes may have a protective effect on sepsis, especially BAFF-R on IgD - CD38br expression is negatively correlated with sepsis (28-day death), which provides a new idea for immune modulation therapy in sepsis.

Objective To investigate the progress of two-dimensional echocardiographic parameters in patients with different severity of aortic stenosis.Methods A retrospective analysis was per-formed on 96 patients diagnosed with aortic stenosis with at least 2 times of transthoracic echo-cardiography(interval ≥1 year)in Department of Cardiology,Fourth Medical Center of Chinese PLA General Hospital from March 2017 to December 2023.According to aortic stenosis severity,they were divided into a mild group(72 cases),a moderate group(14 cases)and a severe group(10 cases).Peak pressure gradient(PPG)across aortic valve,Vmax,mean aortic valve pressure gradient(ΔPm),pulmonary artery systolic pressure(PASP)were collected,and the changes and annual progress of these echocardiographic parameters at baseline and before and after follow-up were analyzed.Results The values of IVST,LVPWT,Vmax,aortic valve PPG and ΔPm were sig-nificantly increased in the mild,moderate and severe stenosis groups in turn(P＜0.05,P＜0.01).The values of Vmax,PPG and ΔPm were significantly lower in the mild stenosis group than the moderate and severe stenosis groups,and the LVPWT value was obviously lower in the mild ste-nosis group than the severe stenosis group(P＜0.05).The aortic valve PPG and ΔPm values at follow-up were significantly higher than those before the follow-up in the three stenosis groups(P＜0.05,P＜0.01).After follow-up,the Vmax values in mild and moderate stenosis groups were notably higher than before(P＜0.01).The PASP value at follow-up was significantly higher than before in the severe stenosis group(P＜0.05).The annual progression rate of Vmax,PASP,LVEF were gradually increased in the mild,moderate,and severe stenosis groups(P＞0.05).The annual progression rate of ΔPm was gradually increased in the three groups in turn(2.30±1.77 mm Hg/year vs 2.40±1.18 mm Hg/year vs 6.08±1.70 mm Hg/year,P＜0.05).Conclusion As the severity of baseline aortic stenosis increases,obvious changes are observed in cardiac structure and function.Before and after follow-up,the serious the aortic stenosis severity is,the faster the annual progression rates of Vmax,PPG,LVEF and PASP are.

Objective To retrieve and evaluate relevant literatures on pain management for patients after hemorrhoidectomy and summarize the best evidence. Methods Based on the 6S evidence model, computer-based searches were conducted in relevant domestic and foreign databases for literatures related to pain after hemorrhoidectomy, including guidelines, expert consensus, systematic reviews, meta-analysis, and randomized controlled trial (RCT), from the establishment of the databases to March 12, 2023. The quality of evidence meeting the evaluation criteria was evaluated according to the corresponding literature evaluation criteria, and was summarized in combination with expert opinions. Results A total of 16 literatures were included (1 guideline, 6 expert consensus, 8 systematic reviews, and 1 RCT); the evidence included pain identification and assessment, drug management measures, traditional Chinese medicine therapy, and perioperative health education, eventually 21 pieces of evidence were extracted. Conclusion After hemorrhoidectomy, the most effective pain management plan should be developed based on the patient's condition and clinical status to relieve postoperative pain.

Objective To explore the application effect of pulmonary rehabilitation exercise health education program based on contemplation-action-maintenance (CAM) theory in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 90 COPD patients were selected as the study subjects and randomly divided into control group (n=45) and intervention group (n=45). A total of 5 patients were excluded, with 42 cases finally included in the intervention group and 43 cases in the control group. The control group received routine exercise health education, while the intervention group received pulmonary rehabilitation exercise health education based on the CAM theory. The Readiness for Hospital Discharge Scale (RHDS), Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3), Benefit Finding Scale (BFS), exercise adherence scale scores and exercise tolerance[6-minute walk test (6MWT)]were compared between the two groups. Results At discharge, the RHDS score of the intervention group was higher than that of the control group, with a statistically significant difference (P < 0.05). At discharge and at 1 month as well as 3 months after discharge, the BREQ-3 and BFS scores of the intervention group were higher than those of the control group, with statistically significant differences (P < 0.05). At 1 month and 3 months after discharge, the exercise adherence scale scores and 6MWT distances of the intervention group were higher or longer than those of the control group, with statistically significant differences (P < 0.05). Conclusion The pulmonary rehabilitation exercise health education program based on CAM theory can improve the discharge readiness and exercise motivation of COPD patients, enhance their awareness of disease benefit and exercise compliance, and improve the exercise endurance of patients.

Lysobacter harbors a plethora of cryptic biosynthetic gene clusters (BGCs), albeit only a limited number have been analyzed to date. In this study, we described the activation of a cryptic polyketide synthase (PKS)/nonribosomal peptide synthetase (NRPS) gene cluster (lsh) in Lysobacter sp. DSM 3655 through promoter engineering and heterologous expression in Streptomyces sp. S001. As a result of this methodology, we were able to isolate two novel linear lipopeptides, lysohexaenetides A (1) and B (2), from the recombinant strain S001-lsh. Furthermore, we proposed the biosynthetic pathway for lysohexaenetides and identified LshA as another example of entirely iterative bacterial PKSs. This study highlights the potential of heterologous expression systems in uncovering cryptic biosynthetic pathways in Lysobacter genomes, particularly in the absence of genetic manipulation tools.
Lysobacter/metabolism* ; Streptomyces/metabolism* ; Lipopeptides/metabolism* ; Polyketide Synthases/genetics* ; Multigene Family

Objective:To analyze the serum levels of integrin-associated proteins (CD47) in patients with rheumatoid arthritis (RA), and to explore its association with disease activity and bone destruction in RA.Methods:Serum and clinical data were collected from 65 RA patients and 25 healthy subjects. RA patients were grouped into low, moderate, and high bone erosion groups according to 7-joint ultrasonography score (US7). The levels of serum CD47, thrombospondin-1 (TSP-1) and receptor activator of nuclear factor-κB ligand (RANKL) were measured by enzyme-linked immunosorbnent assay (ELISA) in patients with RA and healthy subjects. The statistical analysis was carried out with independent t-test, analysis of variance, nonparametric rank sum test, pearson or Spearman correlation and logistic regression. Results:① The Serum levels of CD47, TSP-1, and RANKL were higher in the RA group than in the healthy controls ( P<0.01). ② In RA patients, serum CD47 level was positively correlated with disease course ( r=0.301, P<0.05), C-reactionprotein (CRP)( r=0.316, P<0.05), number of tender joints (TJC) ( r=0.254, P<0.05), number of swollen joints (SJC) ( r=0.316, P<0.05), disease activity score in 28 joints (DAS28) ( r=0.255, P<0.05), RANKL ( r=0.252, P<0.05) and TSP-1 ( r=0.260, P<0.05). Serum TSP-1 level was positively correlated with CRP ( r=0.299, P<0.05), TJC ( r=0.335, P<0.01), DAS28 ( r=0.315, P<0.05), RANKL ( r=0.305, P<0.05). ③ The disease course [ OR(95% CI)=1.048(1.033, 1.017)] and TSP-1 [ OR(95% CI)=1.013(1.000, 1.026)] were independently relevant factors affecting bone destruction. Conclusion:CD47 levels is significantly higher in RA patients than in healthy controls, and is associated with disease activity and bone destruction. CD47 may be involved in the bone destruction process of RA by acting on TSP-1.

Objective:To understand the research hotspots and development trends of oncology nurses at home and abroad from 2011 to 2020, so as to provide reference for related research.Methods:The articles related to oncology nurses at home and abroad from 2011 to 2020 were retrieved through China National Knowledge Infrastructure database, Web of Science database and PUBMED database, and the included literatures′ published journals, institutions and keywords were analyzed by using the online analysis of Statistical Analysis Toolkit for Informetrics3.2 and the software CiteSpace5.7.R1.Results:A total of 588 domestic and 738 foreign articles were included. Keywords analysis showed that domestic oncology nurse related research hotspots were occupational evaluation, hospice care, psychology and occupational protection. Oncology nurse at home and abroad research hotspots had both similarities and differences, different in fertility preservation, communication and so on.Conclusions:The domestic core journal forums of oncology nurse research are still too scattered, and there is a certain gap in the number of articles published between our country and other countries. China still needs to increase the research efforts in this field.