BACKGROUND:The in vitro construction of intestinal smooth muscle layer,as an important component of the intestinal wall,has attracted much attention in the bionic construction of tissue-engineered intestinal canal. OBJECTIVE:To explore the effects of cyclic mechanical stretching on the growth activity of intestinal smooth muscle cells and the expression of functional genes within collagen strips. METHODS:The collagen band culture system of intestinal smooth muscle cells was constructed using a self-designed collagen strip stretching culture device with self-made rat tail collagen as a scaffold and primary rat intestinal smooth muscle cells as seed cells.EthD-1/Calcein-AM cell activity staining,magenta staining,cytoskeleton-Ki67 immunofluorescence staining were used to observe the growth activity and proliferation of the cells,and quantitative RT-PCR was used to detect the expression of desmin,α-sma,and vimentin functional genes. RESULTS AND CONCLUSION:The collagen band culture system of intestinal smooth muscle cells was successfully constructed,and intestinal smooth muscle cells in the band had good cell activity.The number of Ki67 positive cells increased and desmin,α-sma and vimentin were significantly overexpressed under cyclic stretching and dynamic culture conditions(P＜0.001).To conclude,mechanical stimulation is beneficial to maintain the growth phenotype of smooth muscle cells and promote their functional differentiation during three-dimensional culture in vitro.

Objective To explore the influencing factors of medication experience in patients with schizophrenia based on benefit-risk perception.Methods Patients with stable schizophrenia who were hospitalized in 2 tertiary psychiatric hospitals in Heilongjiang Province from September to December 2023 were selected by convenience sampling method.A convergent mixed method was adopted.In quantitative study,data of 400 patients were collected by general situation questionnaire,Subjective Well-being Under Neuroleptic Treatment Scale,the Living with Medicines Questionnaire,Beliefs about Medication Questionnaire,Positive and Negative Syndrome Scale.Binary logistic regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia.15 patients with adverse medication experience in quantitative study were selected for qualitative study,and the interview data were sorted and analyzed according to the topic frame analysis method.Results Quantitative results:medication burden,medication beliefs,and psychiatric symptoms of patients with schizophrenia were influential factors of medication experience(P<0.05).Qualitative results:the medication experience of schizophrenia patients includes 4 themes,namely perceived necessity of medication,perceived benefit of medication,perceived risk of medication,and the need for multi-party cooperation to improve the medication experience.The results of quantitative and qualitative research are complementary in terms of perceived benefit,consistent in terms of perceived risk,and expansive in terms of perceived value.Conclusion Psychiatric nurses can reduce patients'perceived risk of medication,enhance the perceived benefit of medication,and then improve patients'adverse medication experience and promote mental rehabilitation.

Objective:To systematically review the factors related to the aggressive behavior of hospitalized patients with schizophrenia in China.Methods:CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Cochrane Library,and Embase databases were searched to collect case-control studies on factors related to aggression in hospitalized patients with schizophrenia in China from its inception to June 2023.Analysis was per-formed using ReviewManager 5.3 to calculate pooled OR(95％CI)values.Results:Thirty-three studies were in-cluded.Medical staff coercive measures(OR=3.86,95％CI:2.75-5.43),unemployment(OR=1.44,95％CI:1.14-1.81),positive family history(OR=2.97,95％CI:2.29-3.87),poor medication compliance(OR=4.37,95％CI:3.36-5.69),young age(OR=3.13,95％CI:2.66-3.69),involuntary hospitalization(OR=3.34,95％CI:2.81-3.97),depression(OR=2.11,95％CI:1.68-2.66),emotional abuse(OR=1.13,95％CI:1.04-1.23),male(OR=2.70,95％CI:2.20-3.31),delusions(OR=2.14,95％CI:1.69-2.71),auditory hallucina-tions(OR=2.23,95％CI:1.70-2.94),and major life events(OR=3.21,95％CI:1.90-5.42)and previous history of aggressive behavior(OR=2.20,95％CI:2.06-2.34)were risk factors associated with aggressive be-havior in Chinese patients with schizophrenia,and social support(OR=0.46,95％CI:0.31-0.67)was a protec-tive factor.Conclusion:There are various factors related to aggressive behavior in hospitalized Chinese patients with schizophrenia,and medical staff should identify high-risk groups early according to the relevant factors,and effec-tively intervene in controllable factors to reduce the occurrence of aggressive behavior.

Objective:To assess the understanding level of Family Resilience Scale for Schizophrenic Patients among respondents using cognitive interviews and revise the items accordingly.Methods:Using the purposive sampling method, two cognitive interviews were conducted on schizophrenia patients admitted to Chifeng An Ding Hospital from April to June 2023. A Question Appraisal System (QAS-99) was used to encode the interview data to find the problems existing in the scale structure, and at the same time, the scale items were revised based on expert opinions.Results:The first round of cognitive interviews showed ten questions, mainly focusing on "clarification"questions. The results of the second round of cognitive interviews showed that all respondents could correctly understand the scale items revised by the first round of lognitive interviews, and no further revision was required. The final Family Resilience Scale for Schizophrenic Patients included 24 items.Conclusions:Cognitive interviews can help to find and solve the differences in the understanding of items between researchers and interviewees in the compilation of the Family Resilience Scale for Schizophrenic Patients so as to improve the accuracy and reliability of the scale.

Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group. Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors. Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson χ² and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence. Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；P<0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P<0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P<0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485，P<0.05). Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.

We retrospectively analyzed the clinical data of seven patients (four men and three women) with primary hyperoxaluria (PH) type 1 (PH1) in the Department of Nephrology of Zhongda Hospital, Southeast University from January 2018 to October 2023. The mean age at disease onset was 32.1 (range: 26-42) years. The mean age at diagnosis was 40.6 (range: 28-51) years. All patients initially had kidney stones, and three patients were found to have renal insufficiency at the time of disease onset. Among them, two patients underwent hemodialysis immediately. Symptoms at the first visit included bone pain ( n=7), joint pain or deformity ( n=5), fatigue ( n=5), hypotension ( n=3), and subcutaneous nodules ( n=2). Four patients had a family history of PH. All patients had varying degrees of anemia (60-114 g/L), significant hypoalbuminemia (16.5-32.1 g/L), and hypercoagulable state (D-dimer: 2 230-12 781 μg/L). Seven patients received maintenance hemodialysis; their mean age was 37.7 (range: 26-50) years. The mean duration from disease onset to hemodialysis was 5.6 (range: 0-20) years. Five patients repeatedly experienced dialysis access dysfunction. Three patients underwent kidney transplantation before a diagnosis was made, and all transplanted kidneys lost function due to oxalate deposition. The mean follow-up duration was 14.43 (range: 4-38) months. Unfortunately, one patient died. All seven patients underwent computed tomography of the abdomen. All patients suffered skeletal abnormalities, bilateral nephrolithiasis, and nephrocalcinosis. Six patients carried AGXT gene mutations, including four compound heterozygous mutations and two pure homozygous mutations.The mutation sites included: c.823-824dup.AG (p.S275Rfs*38)(exon 8), c.815-816ins.GA (p.S275Rfs*38)(exon 8), c.595G>A (p.G199S) (exon 5), c.32C>G (p.P11R) (exon 1), and c.638C>T (p.A213V)(exon 6). According to the American College of Medical Genetics and Genomics guidelines, two loci were identified as likely pathogenic variants, seven were identified as pathogenic variants, and one locus was identified as having uncertain significance. In addition, patients 1 and 4 underwent skin biopsy, patient 2 underwent renal transplant biopsy, and patient 3 underwent bone marrow biopsy. Interestingly, significant oxalate deposition was found in the tissues. Therefore, PH1 is a rare autosomal recessive inherited disease. This study not only enhanced the understanding of the clinical characteristics of PH1 patients but also had great significance in early diagnosis and treatment of the disease.

The paper reports a rarely case of hemophagocytic syndrome complicated with thrombotic microangiopathy, first presented with fever of unknown origin. A 37-year-old female patient mainly presented with fever, hemolytic anemia, thrombocytopenia, and progressive decline in renal function. After infusion of fresh frozen plasma and high dose of glucocorticoid after double plasma exchange, the patient showed good prognosis, no further fever or hemolysis occurred, recovered platelet and renal function. After acute episode phase, kidney biopsy was performed and acute tubular necrosis was diagnosed. During the follow-up period, the disease did not recur, and the renal function was normal.

Objective:To the molecular mechanism of Yinjiushu in the treatment of non-alcoholic fatty liver disease (NAFLD) by network pharmacology based on the theory of homology of medicine and food; To conduct experimental verification.Methods:The active components and targets of the Yinjiushu were screened through the TCMSP platform. Cytoscape 3.7.2 was used to construct the "Chinese materia medica-component-target" network of Yinjiushu. The potential targets of NAFLD were obtained by using TTD, GeneCards database and DisGeNET database, and the intersection targets of Yinjiushu and NAFLD were obtained by mapping targets with Venn diagram. The high confidence interaction relationship of intersection targets was obtained in STRING database, and the core targets of Yinjiushu in treating NAFLD were screened out. GO function and KEGG pathway enrichment of common targets were analyzed by David database, and the above results were further verified by animal experiments. The rats were divided into blank group, model group, Western medicine group and Yinjiushu high-, medium- and low-dosage groups according to random number table method, with 8 rats in each group. Except the blank group, rats in other groups were fed with high-fat diet to prepare NAFLD model. Each group was given corresponding drugs for intervention. The rats were weighed regularly. The serum contents of GPT, GOT, TC, TG, IL-6, TNF-α, MPO of rats were detected by ELISA. The liver index was calculated. The degree of fatty degeneration of hepatocytes was observed by HE. The expressions of CAT, NOS3, SOD, PI3K, p-Akt, Akt protein were detected by Western blot.Results:A total of 8 418 NAFLD-related targets, 118 kinds of active components from Yinjiushu, and 137 targets acting on NAFLD were screened. The core targets included IL-6, TNF, VEGFA, TP53, JUN, CAT, NOS3, SOD, etc. 20 related signaling pathways were screened from KEGG enrichment pathway, among which PI3K/Akt pathway, calcium ion pathway, cAMP pathway and TNF pathway may play key roles in the treatment. Yinjiushu was closely related to inflammatory reaction, oxidative stress, angiogenesis, autophagy, cell proliferation, differentiation, metabolism, apoptosis, etc., or it could treat NAFLD by promoting cell apoptosis, inhibiting cell proliferation, inhibiting cell migration, etc. The animal experiment proved that Yinjiushu could reduce the body weight, wet liver weight and liver-body ratio of NAFLD rats, reduce some liver function and blood lipid indexes (GPT, GOT, TG, TC), down-regulate serum IL-6, TNF-α and MPO, up-regulate the expression of CAT, NOS3 and SOD in hepatocytes, and activate the expression of PI3K/Akt key protein.Conclusion:Yinjiushu can play a role in treating NAFLD by inhibiting the release of inflammatory mediators, improving lipid metabolism disorder of hepatocytes, repairing oxidative stress injury and promoting the recovery of liver function.

Objective:To evaluate the clinical efficacy and safety of Blinatumomab on the treatment of refractory or relapsed precursor B-cell acute lymphoblastic leukemia (R/R BCP-ALL) in children.Methods:Clinical data of children with R/R BCP-ALL treated with Blinatumomab in the Department of Hematology, Children′s Hospital of Soochow University, from August 2021 to June 2022 were retrospectively analyzed.Children were divided into<45 kg group and ≥45 kg group according to their weight at admission.They were treated with different dosages of Blinatumomab, and bone marrow remission was assessed at about 15 days.Clinical indicators and adverse events during the treatment period were recorded.The rank sum test of two independent samples were used to compare the differences between groups.The Fisher′ s test was used for comparing categorical variables. Results:Among the 16 children with R/R BCP-ALL, 12 cases (75%) achieved complete response (CR) and minimal residual lesion (MRD) turned negative at about 14 days.Among them, 5 out of 9 children with bone marrow primitive naive cell ratio≥0.5 achieved CR, and 7/7 children with bone marrow primitive naive cell ratio<0.5 achieved CR.The peak value of interleukin-6 (IL-6) in children with CR was significantly higher than those without CR ( Z=2.50, P=0.012). Twelve cases achieved CR on bone marrow assessment around day 15, and 3 cases who did not achieve CR remained in remission on day 28, with an efficacy prediction accuracy of 93.8%(15/16). Adverse events included fever, neutropenia, hypokalemia, abnormal liver function, hypocalcemia, edema, rash, hypertension, myocardial damage, abdominal pain, hypotension, and cytokine release syndrome, which were all grade 1.Neurotoxicity and death were not reported. Conclusions:The remission rate of R/R BCP-ALL in children treated with Blinatumomab was high, especially in patients with a low tumor load.The toxicity and adverse events of Blinatumomab treatment are minor and controllable.Day 15 is the optimal time point to evaluate the efficacy of Blinatumomab on children with R/R BCP-ALL, and a higher IL-6 peak can be served as a predictor of its efficacy.

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome and a common cause of liver cirrhosis and cancer. Akkermansia muciniphila (A. muciniphila) is a next-generation probiotic that has been reported to improve metabolic disorders. Emerging evidence indicates the therapeutic potential of A. muciniphila for NAFLD, especially in the inflammatory stage, nonalcoholic steatohepatitis. Here, the current knowledge on the role of A. muciniphila in the progression of NAFLD was summarized. A. muciniphila abundancy is decreased in animals and humans with NAFLD. The recovery of A. muciniphila presented benefits in preventing hepatic fat accumulation and inflammation in NAFLD. The details of how microbes regulate hepatic immunity and lipid accumulation in NAFLD were further discussed. The modulation mechanisms by which A. muciniphila acts to improve hepatic inflammation are mainly attributed to the alleviation of inflammatory cytokines and LPS signals and the downregulation of microbiota-related innate immune cells (such as macrophages). This review provides insights into the roles of A. muciniphila in NAFLD, thereby providing a blueprint to facilitate clinical therapeutic applications.
Humans ; Animals ; Non-alcoholic Fatty Liver Disease/therapy* ; Liver Cirrhosis ; Inflammation