ObjectiveTo explore the mechanism by which Buyang Huanwutang regulates the glutathione peroxidase 4 （GPX4）-acyl-CoA synthetase long-chain family member 4 （ACSL4） axis to inhibit ferroptosis and promote neurological functional recovery after spinal cord injury （SCI）. MethodsNinety rats were randomly divided into five groups： sham operation group， model group， low-dose Buyang Huanwutang group （12.5 g·kg^-1）， high-dose Buyang Huanwutang group （25 g·kg^-1）， and Buyang Huanwutang + inhibitor group （25 g·kg^-1 + 5 g·kg^-1 RSL3）. The SCI model was established by using the allen method. Tissue was collected on the 7th and 28th days after operation. Motor function was assessed by using the Basso-Beattie-Bresnahan （BBB） scale. Hematoxylin-eosin （HE）， Nissl， and Luxol fast blue （LFB） staining were performed to observe spinal cord histopathology. Transmission electron microscopy was used to examine mitochondrial ultrastructure. Immunofluorescence staining was used to detect the number of NeuN-positive cells and the fluorescence intensity of myelin basic protein （MBP）， GPX4， and ACSL4. Real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） was used to analyze the mRNA expression of GPX4 and ACSL4. Enzyme linked immunosorbent assay （ELISA） was performed to measure the levels of reactive oxygen species （ROS）， malondialdehyde （MDA）， glutathione （GSH）， and superoxide dismutase （SOD）. Colorimetric assays were used to determine the iron content in spinal cord tissue. ResultsCompared to the sham operation group， the model group exhibited significantly reduced BBB scores （P<0.01）， severe pathological damage in spinal cord tissue， and marked mitochondrial ultrastructural disruption. In addition， the model group showed a decrease in the number of NeuN-positive cells （P<0.01）， reduced fluorescence intensity of MBP and GPX4 （P<0.01）， lower levels of GSH and SOD （P<0.01）， and downregulated mRNA expression of GPX4 （P<0.01）. Moreover， compared to the sham operation group， the model group had elevated levels of ROS， MDA， and tissue iron content （P<0.01）， along with increased fluorescence intensity and mRNA expression of ACSL4 （P<0.01）. Compared with the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group showed significantly improved BBB scores （P<0.05， P<0.01） and exhibited less severe spinal cord tissue damage， reduced edema and inflammatory cell infiltration， increased neuronal survival， and more intact myelin structures. Additionally， mitochondrial ultrastructure was significantly improved in the Buyang Huanwutang group. Compared to the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group significantly increased the number of NeuN-positive cells and the fluorescence intensity of MBP （P<0.05， P<0.01）. Furthermore， Buyang Huanwutang significantly increased the fluorescence intensity and mRNA expression of GPX4 （P<0.01） and decreased the fluorescence intensity and mRNA expression of ACSL4 （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. Finally， the Buyang Huanwutang group significantly decreased ROS， MDA， and tissue iron content （P<0.01） and significantly increased GSH and SOD levels （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. ConclusionBuyang Huanwutang inhibits ferroptosis through the GPX4/ACSL4 axis， reduces secondary neuronal and myelin injury and oxidative stress， and ultimately promotes the recovery of neurological function.

Objective To explore the role of TMAO from gut microbiota in non-alcoholic fatty liver disease(NAFLD),we detected the serum level of TMAO and its precursor metabolites in NAFLD,as well as the expression level of Eubacterium rectum,Bacteroidetes multiforme,Lactobacillus and bifidobacterium in the intestinal flora.Methods We collected 118 subjects and divided into NAFLD group(86 cases)and healthy control group(32 cases)randomly.We also detected the serum level of TMAO and its precursor metabolites in subjects by high performance liquid chromatography tandem mass spectrometry detection(LC-MS),and the expression of target bacterial DNA was detected by qRT-PCR.Results Serum TMAO,TMA and choline levels were significantly increased in NAFLD(P<0.05),and liver fat content was positively correlated with TMAO(P<0.05).The expression level of Lactobacillus and Eubacterium rectum in NAFLD group were increased(P<0.05);the expression level of Bifidobacterium and Bacteroides multiform were decreased(P<0.05).The serum TMAO level was positively correlated with Eubacterium rectum(r=0.280,P<0.05),and negatively correlated with Bifidobacterium(r=-0.332,P<0.05).Conclusion The level of TMAO in serum shows a positive correlation with NAFLD.The structure of intestinal flora in individuals with NAFLD is altered and linked to TMAO.This suggests that the intestinal flora may have a significant impact on the development of NAFLD through TMAO.

Objective:To evluate the vascular impedance of the pulmonary arteries in fetuses with tetralogy of Fallot (TOF) by Doppler echocardiography.Methods:A total of 42 fetuses with TOF (TOF group) and 84 gestational age-matched normal fetuses(control group)were prospectively collected from August 2022 to January 2023 in the Second Xiangya Hospital of Central South University. The severity of TOF was classified into mild TOF (Z score≥-2), moderate TOF (-40.05). However, DLPA-PI decreased significantly in severe TOF compared with mild TOF ( P<0.05). Conclusions:Fetuses with TOF present increas vascular impedance in pulmonary trunk and decreased impedance in distal pulmonary artery branches. Further large and follow-up studies are needed to demonstrate the associations between the changes in vascular impedance and the development of pulmonary artery in patients with TOF.

Objective: To explore the effects of Buyang Huanwu decoction (BYHWD) on vascular neogenesis and hemorheological parameters following cervical spinal cord injury (SCI). Methods: An acute cervical SCI model was established using 84 female Sprague–Dawley rats. Functional recovery of the rats was evaluated using the forelimb locomotor scale score, forelimb grip strength test, and Basso-Beattie-Bresnahan score. The animals were subsequently euthanized at days 7 and 28 postoperatively. The gross morphology, neuronal survival, and myelin sheath in the injured area were evaluated using hematoxylin and eosin (HE), Nissl, and luxol fast blue (LFB) staining, respectively. Immunofluorescence staining was used to observe CD31 expression 7 days post-injury. Furthermore, the expression of CD31, neuronal nuclear protein (NeuN), and myelin basic protein (MBP) were evaluated 28 days post-injury. Additionally, vascular endothelial growth factor A (VEGFA) and VEGF receptor-2 (VEGFR-2) expression was evaluated using western blotting. Whole-blood viscosity, plasma viscosity, and red blood cell aggregation were measured using a hemorheometer. Results: From postoperative days 3–28, motor function in the BYHWD group began to recover considerably compared to the SCI group. BYHWD effectively restored spinal cord histopathology. In addition, the number of NeuN-positive cells, and fluorescence intensity of CD31at 7 and 28 days and MBP significantly increased in the BYHWD group compared with the SCI group (all P < .05). Moreover, this decoction significantly upregulated the expression of VEGFA and VEGFR-2 (all P < .05). BYHWD improved the hemorheology results (i.e., except erythrocyte aggregation index in the low-dose group), revealing statistically significant differences compared with the SCI group (all P < .05). Conclusion BYHWD effectively promoted angiogenesis, improved hemorheological parameters, and protected neurons and myelin sheaths, ultimately promoting the recovery of neurological function after cervical SCI in rats. These findings suggest that BYHWD promotes vascular neogenesis through the VEGFA/VEGFR-2 pathway.

Objective To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI T1 mapping,R2*quantitative parameters,and their combined indicators in assessing liver function in patients with hepatitis B cirrhosis.Methods The data from 52 patients with hepatitis B cirrhosis who underwent Gd-EOB-DTPA enhanced MRI and modified Dixon quantification(mDixon-Quant)scans were analyzed retrospectively.Patients were divided into three groups based on Child-Pugh scores:Child-Pugh A,B,and C.T1 mapping images were obtained pre,mid,and HBP.Quantitative values of T1 relaxation time reduction rates(△T1 mid and △T1 HBP),liver-related T1 relaxation times(T1 pre,T1 mid,and T1 HBP),fat fraction(FF),and R2* were measured and calculated.One-way ANOVA was used to compare the differences in MRI quantitative parameters between different Child-Pugh grading groups.Spearman's rank correlation analysis was performed to assess the correlation between MRI quantitative parameters and Child-Pugh grading.The receiver operating characteristic(ROC)curve was used to evaluate the performance of distinguishing liver function classification by statistically significant MRI parameters.Results Between different Child-Pugh grading groups,the differences in T1 mid,T1 HBP,△T1 mid,△T1 HBP,and R2*were statistically significant(P＜0.05),however T1 pre and FF were not statistically significant(P＞0.05).T1 mid,T1 HBP and R2*were positively correlated with Child-Pugh grading(rs=0.365,0.566,0.597,respectively;P＜0.05),meanwhile △T1 mid and△T1 HBP were negatively correlated with Child-Pugh grading(rs=-0.680,-0.771,respectively;P＜0.05).There were no significant correlations between T1 pre,FF and Child-Pugh grading(P＞0.05).The area under the curve(AUC)of T1 HBP,△T1 mid,△T1 HBP,R2*and their combined indicators for distinguishing Child-Pugh A grade from Child-Pugh B grade were about 0.888,0.784,0.955,0.764,and 0.961,respectively(P＜0.05).The AUC of △T1 mid,△T1 HBP,R2* and their combined indicators for distinguishing Child-Pugh B grade from Child-Pugh C grade were about 0.853,0.860,0.797,and 0.941,respectively(P＜0.05).Conclusion Gd-EOB-DTPA enhanced MRI T1 mapping and R2*quantitative parameters can be used to independently evaluate the status of liver function in hepatitis B cirrhosis,and the combined evaluation of the two kinds of parameters has a higher diagnostic efficiency.

Objective:To strengthen the understanding of clinical features, chest imaging changes and myositis markers of interstitial lung disease associated with anti-synthase syndrome, and to broaden clinical thinking for the diagnosis and treatment of lung disease.Methods:Analyze the clinical diagnosis and treatment process of a patient with anti synthetase antibody syndrome who was admitted to Weifang People's Hospital on March 12, 2023, and summarize the literature.Results:The patient complained of coughing, chest tightness, and shortness of breath for more than 2 months. The initial diagnosis upon admission is community-acquired pneumonia and interstitial pneumonia. After admission, complete relevant auxiliary examinations, supplement the diagnosis of anti synthetase antibody syndrome, and provide standardized treatment Afterwards, the patient's clinical symptoms such as chest tightness and cough were completely relieved, and a follow-up chest CT scan showed a significant reduction in the size of the lesion.Conclusion:For patients with unexplained interstitial pneumonia, it is necessary to actively broaden the diagnosis and treatment thinking, especially considering the possibility of some rheumatic and immune diseases complicated with interstitial lung disease.

The principles for surgical treatment of femoral neck fracture are anatomical reduction, rigid fixation and reduction of iatrogenic tissue damage to maintain sufficient blood supply and reduce the risk of complications such as avascular necrosis of the femoral head. In the evolution of internal fixation structures for femoral neck fracture, a variety of new products have been developed, such as the neck-shaft angle stabilization structure represented by dynamic hip screw, the multi-screw structure represented by three cannulated screws, and the plate-screw structure represented by multi-screw structure combined with a locked plate. These internal fixation structures have their own advantages and disadvantages in terms of stability and reduced risk of complications. However, none of them can perfectly meet the requirements of all the surgical principles. Femoral neck system (FNS) was firstly applied in clinic practice in 2017 to further improve the internal fixation of femoral neck fracture. In recent years, its mechanical properties and clinical effects have been widely reported in an attempt to further improve the implantation of this internal fixation device. This article reviews the researches on the mechanical properties and clinical efficacy of FNS and the suggestions put forward by orthopedic surgeons to improve the implantation methods of FNS.

Objective:To establish the reference value of the angle between the left ventricular inflow and outflow tract (LIOA) in normal fetuses in the second and third trimesters, and observe the correlation between fetal LIOA and gestational age, cardiac axis, cardiac size, and estimated fetal weigh (EFW).Methods:Fetal LIOA in normal fetuses with gestational age from 16 weeks to 39 + 6 weeks were obtained prospectively by two-dimensional ultrasound in the Second Xiangya Hospital from November 2022 to April 2023. Pearson′s correlation coefficient was used to analyze the correlation between fetal LIOA and gestational age, cardiac axis, cardiovascural size and EFW. Results:The LIOA range of 651 normal fetuses was (44.39±7.67)°, and it was found that LIOA was not related to gestational age. LIOA mildly positively correlated with the cardiac axis ( r=0.22, P<0.05) while not correlated with gestational age, cardiovascural size or EFW (all P>0.05). Conclusions:The range of LIOA in normal fetuses were established. Fetal LIOA is constant in the second and third trimesters and it is mildly positively correlated with the cardiac axis. Evaluating fetal LIOA may also provide information for future research on the fetal aortic hemodynamic development.

To summarize the nursing experience of hematopoietic stem cell transplantation for a child with monocytopenia and mycobacterium infection syndrome complicated with pulmonary alveolar proteinosis.The key aspects of nursing encompass the establishment of a multidisciplinary diagnostic and treatment team,as well as the enhancement of warehousing preparation.Fine nursing plays a pivotal role in infection prevention and control,while also promoting hematopoietic reconstruction.Vigilant monitoring of condition changes is crucial to proactively prevent cardiopulmonary failure.Moreover,an intensified management approach towards underlying diseases should be implemented alongside predictive nursing interventions.The utilization of precision medication plans allows for the observation of drug efficacy and adverse reactions.Narrative nursing serves as a foundation to alleviate the child's inner concems,while personalized follow-up plans ensure the continuity of high-quality care.With careful treatment and care,the child successfully underwent hematopoietic stem cell transplantation.After 41 days post-transplantation,the child was discharged from the hospital after a successful recovery.The follow-up after a month showed good progress.

To investigate the prevalence and epidemiological characteristics of diabetic retinopathy (DR) in Yunnan Province, explore its risk factors, and provide a basis for the prevention and treatment of chronic complications of diabetes mellitus (DM). This is a large cross-sectional study, in all, 1 524 DM patients in 16 communities and villages of Yunnan Province who were registered in health service centers were included in this study from August to November 2019. All patients completed a uniform questionnaire, anthropometric measurements, biochemical measurements, and auxiliary examinations. Logistic regression analysis was used to screen the risk factors of DR. The prevalence rates of DR, mild non-proliferative DR (mild-NPDR), and referable DR (RDR) were 16.0% (244/1 524), 4.5% (69/1 524), and 11.5% (175/1 524), respectively. Glycated hemoglobin A 1c (HbA 1c)≥7.0% was the risk factor of mild-NPDR ( OR=1.872, 95% CI 1.055-3.323) and RDR ( OR=4.821, 95% CI 2.917-7.969). Blood pressure≥130/80 mmHg (1 mmHg=0.133 kPa) was the risk factor of mild-NPDR ( OR=1.933, 95% CI 1.112-3.358) and RDR ( OR=1.505, 95% CI 1.063-2.130). In Yunnan Province, 16.0% DM patients had accompanying DR, wherein about 71.7% of them required an ophthalmology referral, and the high incidence of RDR in DM patients was associated with poor control of blood glucose and blood pressure.