Objective : Mendelian randomization analysis was used to explore the causal relationship of T．gondii in- fection and the cyst distribution and inflammation in brain tissue by immunohistochemistry． Methods : Genome- wide association analysis data of T．gondii infection and encephalitis were obtained ，single nucleotide polymor- phisms (SNPs) were selected，Mendelian randomization analysis was conducted by inverse variance weighting，and the causal relationship between T．gondii infection and encephalitis was evaluated by OR value and 95% CI．Quality control was carried out by using heterogeneity test，horizontal multi-efficiency test and leave-one-out sensitivity test. Immunohistochemical staining was performed using brain sections of mice infected with tissue cysts of Wh6 strain for image analysis using Image J software. Results : A total of 29 SNPs were associated with toxoplasmic encephalitis. The results of IVW method suggested that T．gondii infection made encephalitis risk 0. 98 times higher ( OR = 0. 98， 95% CI = 0. 76 to 1. 27) ，indicating no causal relationship between the two．The quality control results suggested that the selected SNPs were stable and reliable．Toxoplasma cysts were distributed in various parts of the brain tis- sue． Conclusion T．gondii infection and encephalitis are related，but there is no sufficient evidence to prove the causal relationship between the two.

Objective To analyze the effect of nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model in patients with functional dyspepsia, in order to improve their psychological state and gastrointestinal motility, and provide reference for clinical nursing. Methods A total of 160 functional dyspepsia patients admitted to the First Affiliated Hospital of Xinxiang Medical College from December 2022 to June 2023 were chosen as the study subjects. They were randomly divided into control group and observation group, using a random number table method, with 80 cases in each group. Patients in control group were given routine nursing intervention, and patients in the observation group were treated nursing intervention based on IMB model. The psychological state, gastrointestinal motility andquality of life of the two groups were compared before and after intezrvention. Results After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in two groups were decreased, and the observation group was lower than that in the control group (P < 0.05). After intervention, the levels of gastrointestinal hormone nitric oxide (NO), serum motilin (MTL) andserum gastrin (GAS) in two groups were improved, and the levels of all indexes in the observation group were better than those in the control group (P < 0.05). After intervention, gastrointestinal quality of life index (GIQLI) of two groups was improved, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). Conclusion Nursing interventions based on the IMB model are beneficial for alleviating anxiety and depression in patients with functional dyspepsia, effectively enhancing gastrointestinal motility and vitality, and improving their quality of life.

Objective:To investigate the characteristics of regional brain functional centrality(DC)in patients with levodopa-induced dyskinesia(LID)and to explore the pathogenesis of LID.Methods:A total of 33 PD patients with LID(PD-LID), 41 PD patients without LID(PD-nLID)and 37 healthy controls from the First Affiliated Hospital of Nanjing Medical University were enrolled in this study.Differences in DC among the three groups were compared and the correlation between Z-DC values of the brain regions with differences and the scores of the involuntary movement scale(items 1-7)was analyzed.Results:Compared with Controls, PD-LID patients showed increased DC in the right amygdala(extending to the right globus pallidus)(MNI: x=30, y=-3, z=-18, t=4.00, P<0.05 after AlphaSim correction)and in the right postcentral gyrus(MNI: x=57, y=-9, z=39, t=-3.59; MNI: x=42, y=-33, z=57, t=-4.23, P<0.05 after AlphaSim correction)and reduced DC in the right superior parietal lobule(MNI: x=24, y=-51, z=72, t=-3.95, P<0.05 after AlphaSim correction).Compared with the PD-nLID group, the PD-LID group showed increased DC in the right globus pallidus(MNI: x=30, y=-12, z=-3, t=3.09, P<0.05 after AlphaSim correction).DC changes in the right globus pallidus were positively correlated with AIMS score( r=0.482, P=0.004). Conclusions:The enhancement of DC function in the right globus pallidus may be closely related to the onset and severity of LID.

Objective:This paper introduces the concepts of " patient-centered cell therapy research management model", to provide reference for domestic medical institutions which conduct cell therapy clinical trials.Methods:We reviewed and summarized the experiences of conducting cell therapy at Peking University Shenzhen Hospital, including challenges and response plans regarding to the technology assessment, ethical evaluation risks and regulatory compliance. According to which, this paper aims to explore the reflections and practical experience of establishing a patient-centered, multi-stakeholder shared decision-making research management system.Results:The " patient-centered cell therapy research management model" ensures the reliability of research results through multi-stakeholder engagement in decision-making and management, adequate technical evaluation, effective ethical review and harmonized scientific research management, which not only meets the urgent health needs of the patient, but also promotes the standardized development of emerging technologies.Conclusions:The " patient-centered cell therapy research management model" is tailored for the cell therapy research, it is important to promote its further assessment and applications.

Objective:To observe the characteristics of resting-state brain activity in Parkinson disease (PD) patients with peak-dose dyskinesia, and to explore its pathogenesis.Methods:From March 2017 to November 2019, totally 27 PD patients with peak-dose dyskinesia (dyskinetic group), and 29 PD patients without dyskinesia (non-dyskinetic group) treated in the First Affiliated Hospital of Nanjing Medical University and 27 healthy controls from the community were recruited.Resting-state functional magnetic resonance imaging (rs-fMRI) and clinical scale data were collected.SPSS 26.0 software and REST software were used for data analysis.The whole brain amplitude of low-frequency fluctuation (ALFF) values were compared among the three groups.Correlation analysis was performed between ALFF values of the significant brain regions and the scale scores.Finally, receiver operating characteristic (ROC) curve was used to evaluate the efficacy of ALFF values of significant brain regions in identifying three groups of subjects.Results:The peak-dose dyskinetic group showed decreased ALFF in right inferior frontal gyrus(MNI: x=36, y=21, z=30; x=36, y=18, z=30)and increased ALFF in right supplementary motor area (MNI: x=9, y=0, z=69; x=6, y=-3, z=72)(all P<0.05, Alphasim correction) compared with non-dyskinetic group and healthy controls.ALFF value in right inferior frontal gyrus was negatively correlated with unified dyskinesia rating scale (UDysRS) scores ( r=-0.47, P=0.018). The ALFF value of the right inferior frontal gyrus was more effective in identifying peak-dose dyskinetic patients from non-dyskinetic patients and healthy controls, and the area under the curve of right inferior frontal gyrus were 0.881 and 0.787 (both P<0.01), respectively. Conclusion:Abnormal spontaneous brain activity in right inferior frontal gyrus and right supplementary motor area can be the neurobiological basis of peak-dose dyskinesia in PD patients.The severity of peak-dose dyskinesia is associated with abnormal brain activity of right inferior frontal gyrus.The ALFF value of right inferior frontal gyrus is a potential imaging marker for identifying peak-dose dyskinetic patient.

Objective:To investigate the normal range of exhaled nitric oxide (FeNO) in 6-18-year-old children in China, so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods:A multi-center study was conducted on 5 949 children aged 6-18 (3 101 males and 2 848 females) in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association, FeNO was measured, and the relationship of FeNO with the sex, age, height, weight, body mass index and region was discussed.Results:The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb, and its 95% confidence interval (skewness distribution) was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb, respectively, and their 95% confidence intervals (skewness distribution) were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old, FeNO decreased with age, with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11, and FeNO of children aged 12-18 was significantly correlated with the gender, height, and region(all P<0.01). Conclusions:FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18, 16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old, the influence of age on FeNO should be considered, and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.

Objective: To analyze the influence of cognition on suicidal ideation in patients with major depressive disorder. Methods: A total of 108 inpatients with major depressive disorder from January 2017 to September 2018 in Beijing Huilongguan Hospital were enrolled.They were divided into suicidal ideation group (n=42) and non-suicidal ideation group (n=66) by the self-rating idea of suicide scale (SIOSS). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). The general situation was assessed by self-made general situation questionnaire.The related factors were analyzed by Logistic regression. Results: (1) The rate of suicidal ideation was 44.4% in patients with major depressive disorder.(2) The total score of RBANS and five-factor scores of RBANS in suicidal ideation group were lower than those in non-suicidal ideation group(total RBANS score(63.0±7.9) vs (73.8±7.7); immediate memory: (62.7±8.8) vs (70.8±7.6); visual span: (67.2±10.0) vs (72.7±9.8); speech function: (83.3±13.8) vs (91.5±4.5); attention: (85.3±11.9) vs (99.9±8.5); delayed memory: (53.5±7.7) vs (62.3±9.7), F=6.335-46.660, P<0.05). (3)Logistic regression showed, years of education were risk factors for suicidal ideation(β=0.289, P=0.013, OR=1.335, 95%CI=1.063-1.676), RBANS attention factor(β=-0.161, P=0.000, OR=0.851, 95%CI=0.778-0.931)and RBANS delayed memory factor score(β=-0.151, P=0.006, OR=0.860, 95%CI=0.772-0.957)were protective factors for suicidal ideation. Conclusion Cognitive function has an impact on suicide ideation of depressive patients, mainly attention and delayed memory are protective factors for suicide ideation.

Objective To compare the value of ultrasound guided and CT-guided percutaneous biopsy in diagnosis of chest lesions not blocked by bone nor lung.Methods A total of 244 patients with chest lesions not blocked by bone nor lung were collected and divided into ultrasound-guided group (n=114) or CT-guided group (n=130).The puncture success rate,biopsy success rate and the complication rate were compared between the two groups.Results The puncture success rate (98.25％ [112/ 114]) and biopsy success rate (96.49％ [110/114]) in ultrasound-guided group were higher than those in CT-guided group (86.92％ [113/130],79.23％ [103/130]),and the complication rate (3.51％ [4/114]) in ultrasound-guided group was lower than that in CT-guided group (16.92％ [22/130],all P＜0.01).Conclusion For chest lesions not blocked by bone nor lung,ultrasound is more secure and effective than CT for guiding percutaneous biopsy.

[Objective] To observe the effect of Jiedu Quyu Ziyin decoction on TLR4 signaling pathway in macrophages of MRL/lpr lupus mice. [Method] MRL/lpr lupus mice were divided into four groups:model group, prednisone group, Jiedu Quyu Ziyin decoction group(hereinafter referred to as:Chinese medicine group) and prednisone plus Chinese medicine group (hereinafter referred to as:combination of Chinese and western medicine group). The mice were gavaged with saline, prednisone, Jiedu Quyu Ziyin decoction and prednisone added Jiedu Quyu Ziyin decoction for 4 weeks. Macrophages of lung, peritoneal and spleen were collected and the expression of related genes was detected by RT-PCR. [Result] TLR4 mRNA in lung macrophages, and TLR4 protein in splenic macrophages increased significantly(P<0.05) after the treatment of prednisone. The increased TLR4 protein in splenic macrophages was significantly decreased by combining with Jiedu Quyu Ziyin decoction(P<0.05). Prednisone can significantly reduce the TLR4 downstream molecules such as MyD88, IFN-α, iNOS mRNA expression in lung and peritoneal macrophages(P<0.05). The decreased MyD88 mRNA in lung macrophages was increased significantly by combining with Jiedu Quyu Ziyin decoction(P<0.05). [Conclusion] TLR4 signaling pathway is changed in macrophages after glucocorticoid administration in MRL/lpr lupus mice. Jiedu Quyu Ziyin decoction can reduce the abnormal glucocorticoid-induced TLR4 protein expression.

Objective Tamm-Horsfall protein (THP) may play a role in kidney stone formation.The article aimed to conduct a preliminary study on the role of THP in kidney stone formation by investigating the changes of THP in rat urine, pathological changes of renal tissue and the formation of calcium salt crystals after establishing CNPs rat model of kidney stones.Methods Stone samples of 40 patients from February to June 2015 in our department were collected to establish the model of CNPs-induced kidney stone in rats and prepare CNPs suspension.48 SD rats were randomly divided into experimental group (group A) and blank control group (group B).Group A were injected with CNPs and the same amount of sterile saline injection in the group B.The urine of rats was collected after injection at 3h, 6h, 12h, 24h, 1w, 2w, 4w and 8w.ELISA were applied to detect THP levels in the urine.Then the rats were killed to take the kidney tissue.HE staining was used to investigate the pathological changes of the cells and evaluate the formation of the calcium salt crystals.Results THP levels in group A at 24h, 1w, 2w, 4w and 8w ([166.03±3.02], [173.50±1.78], [174.55±2.05], [176.54±2.45], [177.11±1.76]pg/mL) were significantly higher than that at 3h(165.89±2.23pg/mL)(P<0.05), which was the same case in comparison with those of group B ([157.65±2.22], [156.54±1.43], [159.45±3.21], [158.63±2.98], [157.33±2.05]pg/mL).Compared with the calcium salt crystal score at 6h (1 point), the scores at 3,6,12,24h (average score 2 points) increased.At 2w the score increased significantly to 3 points and reached the top score(6.7points) at 8w, which was of significant difference.The score of calcium salt crystals was in positive correlation with THP content (r=0.843,P<0.05).Conclusion THP in urine may contribute to the aggregation of calcium salt crystals and the formation of kidney stones.