Objective:To analyze the clinical features and diagnostic modalities of adult Meckel′s diverticulum.Methods:The clinical manifestations, diagnostic modalities, treatments and pathology of 40 adult patients with Meckel′s diverticulum admitted in Beijing Friendship Hospital, Capital Medical University from January 2013 to October 2023 were retrospectively analyzed.Results:There were 32 male cases (80.0%) and 8 female cases (20.0%) with male to female ratio of 4∶1 and a median age of 39 years. Patients with gastrointestinal bleeding, abdominal pain and asymptomatic patients accounted for 52.5% (21/40), 12.5%(5/40) and 35.0% (14/40), respectively. The average minimum hemoglobin was(67±14)g/L and 47.6% patients (10/21) received blood transfusion. The preoperative diagnostic rates of CT scan, angiography, Tc-99m pertechnetate scintigraphy and tagged red blood cell (TRBC) scan were 1/39, 0/7, 3/7 and 2/4, respectively. The diagnostic rates of capsule endoscopy and retrograde single balloon enteroscopy were 1/12 and 17/20 (85.0%). The distance between Meckel′s diverticulum and ileocecal valve was 20-170 cm. Histopathological examination revealed ectopic gastric mucosa and ectopic pancreatic tissue in 23.5% (7/34) and 5.9% (2/34) patients.Conclusions:Adult Meckel′s diverticulum is more common in male patients, often presenting with gastrointestinal bleeding as the initial symptom. Diagnosis is most commonly made through retrograde single balloon enteroscopy, and surgery is the recommended treatment method.

Objective:To standardize the management of auditory hallucination symptoms in inpatients with mental illness and develop an expert consensus on the management of auditory hallucinations in hospitalized psychiatric patients.Methods:From March 2023 to July 2023, the Mental Health Committee of the Chinese Nursing Association focused on the key issues in the management of auditory hallucinations symptoms in inpatients with mental illness, based on clinical practice, using literature analysis combined with the work experience of mental health experts, and formed the first draft of the expert consensus on the management of auditory hallucinations in inpatients with mental illness (hereinafter referred to as the consensus). Through 3 rounds of expert consultation and 3 rounds of expert demonstration meeting, the draft was adjusted, revised, and improved.Results:37 experts were included in the Delphi expert consultation, 1 male and 36 females with 39-67(51.48 ± 6.61) years old. The positive coefficients of experts in 3 rounds of Delphi expert consultations were all 100%, and the degrees of expert authority were 0.924, 0.938 and 0.949, respectively. The average importance value of each item was higher than 4.00, the variation coefficient of each item was less than 0.25. The Kendall harmony coefficient of the experts were 0.179, 0.195 and 0.198, respectively (all P<0.05). There were 15, 12, 12 experts in the first, seeond, third rounds of expert demonstration meeting. Finally, a consensus was reached on the recommendation of 4 parts, included auditory hallucination assessment, management format, symptom management implementation, and precautions. Conclusions:The consensus covers all parts of the management of auditory hallucination symptoms in hospitalized patients with mental disorders, which is practical and scientific. It is helpful to guide mental health professionals to standardize the management of auditory hallucination symptoms, improve the quality of nursing and ensure the safety of patients.

Objective:To evaluate the efficacy and safety of oral sulfate solution (OSS) for bowel preparation.Methods:A multi-center, randomized, single-blinded, positive-controlled and non-inferiority clinical study was conducted. Participants were randomized to receive two bottles of OSS or 4-liter polyethylene glycol (Ⅲ) (PEG) regimen. The primary indicator was efficacy for bowel preparation. Boston bowel preparation scale (BBPS) ≥2 scores in each segment was determined as effective. Secondary endpoints included subjects' compliance, colonoscopy bubble evaluation, time interval of defecation after medication, time interval of defecation type Ⅶ (Bristol stool classification), the number of defecation, and the positive rate of colonoscopy (detection rate of polyps, non-polyp eminence, ulcers, etc.) were also recorded. The safety was evaluated by the incidence of adverse events and severe adverse events.Results:A total of 240 subjects from 4 hospitals were enrolled in the study, with 120 subjects in the experimental group (the OSS group) and 120 subjects in the control group (the PEG group). The full analysis set (FAS) showed that the bowel preparation success rates were 92.44% (110/119) in the OSS group and 91.60% (109/119) in the PEG group ( χ2=0.058, P=0.809) . The total BBPS score and the scores of each bowel segment were all higher in the OSS group than those in the PEG group ( P<0.05) in both FAS and per protocol set (PPS) except the score of left colon in the FAS. The satisfaction rate of bubble evaluation in the OSS group was higher ( 95.80% VS 89.08%, P=0.025). The compliance, positive rate of colonoscopy and safety of the two groups were comparable. Conclusion:Compared with 4-liter PEG regimen, OSS regimen shows similar bowel preparation quality, superior anti-foaming effect with acceptable safety.

In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.
Humans ; Mice ; Animals ; Non-alcoholic Fatty Liver Disease/metabolism* ; NF-kappa B/metabolism* ; Organelle Biogenesis ; Retrospective Studies ; Mice, Inbred C57BL ; Obesity/metabolism* ; Liver ; Inflammation/metabolism* ; Body Weight ; Lipid Metabolism ; Lipids ; Diet, High-Fat/adverse effects*

Objective:To investigate the clinical features, characteristics under white-light endoscopy and endoscopic ultrasonography, and treatment strategies of gastritis cystica profunda (GCP) accompanied with or without neoplastic lesions.Methods:Clinical data of 35 patients, who were pathologically diagnosed as having GCP after endoscopic or surgical resection in Beijing Friendship Hospital, Capital Medical University from January 2015 to February 2021, were retrospectively collected, including 27 patients with neoplastic lesions. The demographic information, clinical manifestations, endoscopic features, treatment methods, and pathological results of GCP were summarized.Results:Thirty-five patients with GCP were 68.26±8.08 years old, and mostly male (80.00%, 28/35). The most common symptom was upper abdominal pain, accounting for 31.43% (11/35), and 25.71% (9/35) had no symptoms. Other symptoms included acid reflux, heartburn, abdominal distension, anemia, and choking sensation after eating. The most common site of GCP was cardia (51.43%, 18/35), and the main endoscopic manifestations of GCP were flat mucosal lesions (68.57%, 24/35), mainly 0-Ⅱa and 0-Ⅱa+Ⅱc type lesions, accounting for 66.67% (16/24). The second common endoscopic manifestation was polypoid eminence (20.00%, 7/35). Endoscopic ultrasonography was performed in 15 patients, with main manifestations of uniform hypoechoic with or without cystic echo (73.33%, 11/15). Among the GCP cases, 33 patients received endoscopic resection, and 2 received surgical treatment. The treatment processes were all successfully completed, and en-bloc resection was accomplished for all lesions receiving endoscopy, with the mean endoscopic operation time of 86.13 min. One patient suffered postoperative delayed bleeding after ESD which was stopped by endoscopic hemostasis. Final pathological results showed that the proportion of GCP complicated with neoplastic lesions was 77.14% (27/35), 68.57% (24/35) with early gastric cancer or precursor. Twenty-three cases achieved R0 resection. One case showed positive basal resection margin and vascular invasion, and recurrence happened in situ at the 5th month of follow-up, surgical resection was then performed. The endoscopic complete resection rate was 95.83% (23/24).Conclusion:GCP usually occurs in middle-aged and elderly male, often located in cardia, manifested mainly as flat mucosal lesions and polypoid changes. Endoscopic ultrasonography shows a high diagnostic value for GCP, and endoscopic treatment is safe and effective minimally invasive treatment for GCP.

Chemical constituents of n-butanol part of ethanol extract from the leaves of Cyclocarya paliurus (Batalin) Iljinskaja were studied.Eight glycosides were separated and purified by silica gel, MCI, ODS, Sephadex LH-20 column chromatography and semi-preparative high-performance liquid chromatography.Based on the physicochemical properties and spectral data, these compounds were 3-ethyl-4-methyl-pentyl ester-O-β-D-apiofuranosyl-(1→6)-β-D-glucopyranoside (1), juglanoside E (2), (4S)-α-terpineol-8-O-α-L-arabinofuranosyl-(1→6)-β-D-glucopyranoside (3), (4S)-α-terpineol-8-O-β-D-apiofuranosyl-(1→6)-β-D-glucopyranoside (4), eugenyl-O-β-D-apiofuranosyl-(1→6)-O-β-D-glucopyranoside (5), kaempferol-3-O-β-D-glucuronopyranosyl methylester (6), kaempferol-3-O-β-D-glucuronopyranoside (7), and quercetin-3-O-β-D-glucuronopyranoside (8).Among them, compound 1 was a new compound, and compounds 2-6 were isolated from the genus Cyclocarya for the first time.

Objective:To construct a Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression.Methods:Convenience sampling was used to select 25 experts from fields such as psychiatric nursing, psychiatric management, and rehabilitation treatment as the subject of the consultation. On the basis of literature review and clinical experience, the research group used the Delphi method to conduct two rounds of consultation with 25 experts, forming a Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression. The enthusiasm of experts was evaluated using the effective response rate of the questionnaires. The authority level of experts was assessed using an authority coefficient. The concentration of expert opinions was evaluated using the mean of item importance assignment and coefficient of variation. The degree of coordination of expert opinions was represented by the Kendall coordination coefficient.Results:The effective response rates of the two rounds of consultation questionnaires were all 100%, with expert authority coefficients of 0.890 and 0.904, and the Kendall coordination coefficients of expert opinions of 0.247 and 0.203 ( P<0.05) . The Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression was constructed, which included 10 dimensions and 38 items. Conclusions:The Discharge Preparation Service Demand Assessment Scale for Psychiatric Patients with Depression is scientific and reliable, which can provide a basis for clinical nurses to evaluate the discharge preparation service demands of psychiatric patients with depression.

Objective:To provide data support for the prevention and control of dengue fever in Henan Province by analyzing the molecular epidemiological and etiological characteristics of dengue fever outbreaks in Puyang in 2019.Methods:Blood samples were collected from all suspected cases of dengue fever. The antigen, antibody and nucleic acid of dengue virus (DENV) were detected. The E gene was amplified by viral nucleic acid extraction and sequenced. Phylogenetic tree was constructed to trace the source of infection. Results:A total of 61 local cases of dengue fever were reported, and no deaths were reported. Among them, 4 cases (72.13%) were positive for DENV NS1 antigen; 16(26.23%) cases were positive for specific IgM; 38(62.30%) cases were positive for specific IgG; 34 cases (54.10%) were positive for dengue nucleic acid testing. Ten dengue virus strains were isolated, all of which were dengue virus type 1(DENV-1). Sequence analysis of E gene suggested it belonged to the same clade as Henan201903 strain imported from Cambodia to Zhumadian, Henan in 2019, with the highest homology. Conclusions:The dengue fever epidemic in Henan Province was caused by DENV-1, which might be improted from Cambodia, Singapore, Myanmar and other Southeast Asian countries. Therefore, the surveillance of DENV in people returning from Southeast Asia should be strengthened.

Objective:To analyze the epidemiological and etiological characteristics of sever fever with thrombocytopenia syndrome (SFTS) cases in Henan province during 2017-2020.Methods:Descriptive epidemiology method was used to analyze the characteristics of SFTS cases in Henan during 2017-2020. Patients' sera in acute phase were collected and tested using real-time fluorescence RT-PCR. The S segment complete sequences of the isolated sever fever with thrombocytopenia syndrome virus (SFTSV) strains were amplified and homology analysis was performed to construct the phylogenetic tree.Results:A total of 1 767 SFTS cases, including 1 000 suspected cases and 767 confirmed cases, were reported in Henan during this period, and 11 cases, including 3 suspected cases and 8 confirmed cases died, the case fatality rate was 0.62% (11/1 767). The incidence decreased year by year. The cases were distributed in 28 counties of 6 cities, and 1 681 cases were reported in Xinyang, accounting for 95.13% (1 681/1 767) of the total. The cases mainly occurred from April to October, accounting for 96.10% (1 698/1 767) of the total. The incidence in males (0.38/100 000) was significantly lower than that in females (0.54/100 000) ( χ 2=54.855, P<0.001). Up to 93.44% (1 651/1 767) of the cases were aged between 40 and 84 years. Farmers accounted for 96.10% (1 698/1 767) of the total cases. One family cluster outbreak occurred in 4 years. A total of 1 110 samples were detected by Henan CDC, in which 435 were SFTS virus positive with an average positive rate of 39.19% (435/1 110). The differences in positive rates of SFTS virus among different years were significant ( χ2=25.405, P<0.001). The sequence homology of complete S segment of the 39 SFTS virus strains ranged from 94.76% to 99.82%. The genetic evolution analysis on the complete S segment of the 39 SFTS virus strains showed that 34 strains belonged to genotype A, 2 strains belonged to genotype B, and 3 strains belonged to genotype D. Conclusions:The incidence of SFTS in Henan was sporadic, and decreased year by year. SFTS had obvious regional and seasonal characteristics, and the area affected by SFTS expanded. The incidence of SFTS was high in elderly female farmers, and the positive rate of SFTS virus varied greatly in different years. The main type of SFTS virus in Henan was genotype A, but the etiological surveillance is still needed.

Drosophila neural development undergoes extensive chromatin remodeling and precise epigenetic regulation. However, the roles of chromatin remodeling in establishment and maintenance of cell identity during cell fate transition remain enigmatic. Here, we compared the changes in gene expression, as well as the dynamics of nucleosome positioning and key histone modifications between the four major neural cell types during Drosophila neural development. We find that the neural progenitors can be separated from the terminally differentiated cells based on their gene expression profiles, whereas nucleosome distribution in the flanking regions of transcription start sites fails to identify the relationships between the progenitors and the differentiated cells. H3K27me3 signal in promoters and enhancers can not only distinguish the progenitors from the differentiated cells but also identify the differentiation path of the neural stem cells (NSCs) to the intermediate progenitor cells to the glial cells. In contrast, H3K9ac signal fails to identify the differentiation path, although it activates distinct sets of genes with neuron-specific and glia-related functions during the differentiation of the NSCs into neurons and glia, respectively. Together, our study provides novel insights into the crucial roles of chromatin remodeling in determining cell type during Drosophila neural development.