Objective To observe the expression and trends of tight junction proteins Occludin and zonula occlu-den-1(ZO-1)in blood-brain barrier(BBB)of rats with traumatic brain injury(TBI),and to explore the interven-tion effect of cannabidiol(CBD)on the BBB.Methods The TBI model of rat was prepared by modified"Feeney free fall method"and randomly divided into three groups:the sham-operated group(Sham group),the model group(TBI+vehicle group)and the CBD intervention group(TBI+CBD group),with 24 rats in each group.Each group was subdivided into six time points:8 h,1,2,3,5 and 7 d after injury.The expression of Occludin and ZO-1,which are closely related to the permeability of BBB,was detected by immunohistochemistry,immuno-fluorescence staining and Western blot at different points.The permeability of BBB was detected by sodium fluores-cein assay.Results The results of immunohistochemistry showed that compared with Sham group,the positive ex-pression of Occludin and ZO-1 decreased with time after brain trauma(P<0.05),and both reached the lowest level at 2 d.The expression levels of Occludin and ZO-1 were up-regulated after 1 d of CBD intervention(P<0.05).Immunofluorescence staining showed a similar trend to Western blot results,with Occludin and ZO-1 fluo-rescence expression intensity and protein expression reduced after TBI compared with Sham group(P<0.05).And the expression levels of Occludin and ZO-1 were up-regulated after 2 d of CBD intervention(P<0.05).The results of fluorescein sodium experiment showed that the BBB integrity of brain tissue was destroyed after TBI,and the permeability increased after TBI(P<0.01).The permeability of BBB decreased after CBD intervention(P<0.05).Conclusion The expression of tight junction proteins Occludin and ZO-1 decreases after TBI,and the permeability of BBB is disrupted,and CBD intervention reverses the disruption of the BBB by TBI.

Objective To investigate testicular damage in traumatic brain injury(TBI)rats and to analyze the in-terventional effects of cannabidiol(CBD)on TBI-induced testicular damage.Methods 18 Sprague Dawley(SD)rats were randomly divided into three groups:the sham operation group(Sham group),model group(TBI group)and treatment group(TBI+CBD group).HE staining was used to observe the testicular histopathological changes in the rat testis.ELISA was used to detect testosterone level in rat serum.TUNEL staining was utilized to observe apoptosis,while immunofluorescence staining,Western blot and RT-qPCR were employed to evaluate Bax,Bcl-2,Cleaved Caspase-3 and TNF-α protein and mRNA expression.Results HE staining showed pathological changes in the testes of TBI rats compared with those in the Sham group.ELISA assay showed a decrease in testosterone levels in the TBI group compared to the Sham group,but there was no significant difference(P＞0.05).Immunofluores-cence results showed that the intensity of Bax fluorescence expression increased in the TBI group compared with the Sham group(P＜0.01),whereas the intensity of Bax fluorescence decreased and the intensity of Bcl-2 fluorescence increased in the rats after the CBD intervention(P＜0.01).Western Blot results showed that CBD treatment in rats decreased the protein levels of testicular apoptosis-related proteins(Bax and Cleaved Caspase-3,all P＜0.05)and inflammation-related proteins(TNF-α,P＜0.01),and increased the protein level of the anti-apoptotic protein,Bcl-2(P＜0.05).The trend of RT-qPCR results was similar,with mRNA expression of Bax(P＜0.05)and TNF-α(P＜0.01)decreased and mRNA expression of Bcl-2 increased after CBD intervention compared with the TBI group(P＜0.05).Conclusion TBI induces testis injury,and CBD treatment effectively repairs apoptosis and in-flammatory in testicular tissue of TBI rats.

Objective:To explore the clinical characteristics and genetic variant in a child with neurodevelopmental disorders (NDDs).Methods:Clinical data of a child who had presented at Xiaogan Hospital Affiliated to Wuhan University of Science and Technology in December 2020 due to intermittent convulsions for over a year were retrospectively analyzed. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. " HNRNPU gene", "epilepsy", "epileptic encephalopathy", "hereditary epilepsy", "neurodevelopmental disorder", "neurodevelopmental syndrome", " HNRNPU", and "NDDs" were used as the key words to search the CNKI, Wanfang and PubMed databases dated from January 1, 1994 to February 10, 2022. Results:The patient was a 2-year-old boy who had developed seizure at the age of 5 months. His clinical features had included abnormal appearance, recurrent seizures, and low developmental quotients of each functional area as evaluated by the Gesell scale. The child was given sodium valproate for the antiepileptic treatment and rehabilitation training. He had become seizure-free within half a year of follow-up, but his intelligence and motor development did not improve significantly. Genetic testing revealed that he has harbored a heterozygous c. 1720_1722delCTT (p.Lys574del) variant of the HNRNPU gene, which was not found in either of his parents. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was rated as likely pathogenic (PS2+ PM2_Supporting+ PM4). A total of 13 articles were retrieved, and the types of HNRNPU gene mutations have included splice site mutation, nonsense mutation, missense mutation, in-frame deletion, gene duplication, frameshifting mutation, and multiple exon deletion. The main clinical manifestations have included mental retardation, language delay, global developmental delay, epilepsy, craniofacial deformity, mental and behavioral abnormalities. Conclusion:The c. 1720_1722delCTT variant of the HNRNPU gene probably underlay the NDDs in this child. Above finding has enriched the mutational spectrum of the HNRNPU gene.

Objective:To explore the psychological experience and demand of parents of children with delayed recovery after congenital heart disease surgery.Methods:This study adopted phenomenological research methods from qualitative research. Using the purposive sampling method, parents of postoperative delayed recovery children with congenital heart disease who met the inclusion criteria were selected as the research objects from October to November 2019 at Fuwai Hospital, Chinese Academy of Medical Sciences. Semi-structured interviews were conducted with the parents of the children, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 13 parents of children with delayed recovery after congenital heart disease surgery were included. According to the interview results, four themes were extracted, which were negative psychological experience of parents of children with delayed recovery, positive psychological experience and expectation change of parents, heavy economic burden of parents and diversified needs of parents.Conclusions:During the delayed recovery period, psychological experience of parents is complex and their needs are diverse. The nursing staff should identify and pay attention to the causes of the negative psychological experience of the parents of the children, timely channel their negative emotions and strengthen the positive psychological experience in many aspects. They can assist parents to seek social help to reduce physical and mental pressure and meet the diverse needs of parents by providing high-quality nursing services and multi-channel information support.

Objective : To observe the expression of glial fibrillary acidic protein (GFAP) in the brain tissue of rats with traumatic brain injury (TBI) and the differential changes between brain regions. Methods : The TBI model of rats was prepared by the modified Feeney free fall method , and it was randomly divided into the sham⁃operated qPCR were used to observe the morphological changes of activated astrocytes and the expression of GFAP in different brain regions after TBI. Results : Immunohistochemical staining showed that astrocytes were activated in all brain regions on the right side of TBI , and the only brain regions that spilled over to the contralateral side ( left) were cortical region 1 and midbrain regions. RT⁃qPCR results showed that GFAP mRNA was highly expressed in all brain regions on the right side of TBI , affecting the contralateral cortex and midbrain regions. Western blot results showed that GFAP protein was highly expressed in all brain regions on the right side of TBI , and it spread to the contralateral midbrain regions. Conclusion TBI can cause the activation of astrocytes and increase GFAP expression in the right brain regions , while also affecting the contralateral (left) cortex 1 and midbrain regions.

Objective:To compile Chinese version of Compliance with Annual Diabetic Eye Exams Survey (CADEES-C) and to evaluate its reliability and validity.Methods:According to the Brislin translation model, the English version of Annual Diabetic Eye Exams Survey was translated into Chinese and culturally adjusted. Using the convenient sampling method, a total of 287 patients with diabetes from a medical alliance in Guangzhou were selected from June to December 2019. The Chinese version of the questionnaire was tested for content validity, structure validity, internal consistency, criterion validity and test-retest reliability.Results:Five common factors were extracted, containing 25 items in total, and the cumulative variance contribution rate was 62.878%. The questionnaire and its dimensions were positively correlated. The total Cronbach's α coefficient of the questionnaire was 0.902. The total score of the questionnaire, score of each dimension and the criterion r value were from 0.472 to 0.658 ( P<0.01) . The retest reliability coefficients of the questionnaire and its dimensions ranged from 0.813 to 0.917 ( P<0.01) . Conclusions:Chinese version of Compliance with Annual Diabetic Eye Exams Survey has good reliability and validity and its item contents fit well with the theoretical framework, which can be used to measure ophthalmic follow-up compliance of diabetic patients in China.

Objective To establish the quality standard for Bushen-Tongluo granules.Methods Drynariae rhizoma, Paeoniae radix alba, Cyathulae radix, Chuanxiongin rhizome were identified by thin layer chromatography (TLC), and the content of naringin and paeoniflorin was determined by high performance liquid chromatography(HPLC) with chromatographic column Agilent C18 (4.6 mm×250 mm, 5 μm), as the mobile phase was acetonitrile-0.1% phosphoric acid and the scan wave length were 230 and 283 nm. The column temperature was 30 . The flow rate ℃ was 1.0 ml/min. Results TLC could identify Drynariae rhizoma , Paeoniae radix alba, Cyathulae radix, Chuanxiongin rhizome effectively. Under the condition, there was a good linear relationship when the content of naringin was in 6.337 0-50.695 7 μg. There is also a good linear relationship when the content of paeoniflorin was in 26.065 8-130.328 8 μg. The average recovery rate of naringin was 97.13% and RSD was 1.19%.The average recovery rate of paeoniflorin was 96.61% and RSD was 1.51%. Conclusions The established methods are simple, specific, reproducible, and sensitive, and they can be used for the quality control of Bushen-Tongluo granules.

Objective: To understand the infection status, characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli (STEC) in animal feces in Shandong Province. Methods: From 2015 to 2016, convient sampling method was used to collect 1 022 fresh feces of animals in Weishan county and Laizhou city, and 24 non-O157 STEC were isolated. The serotypes of non-O157 STEC strains were confirmed through serum agglutination test. The susceptibility was explored through the antimicrobial sensitivity experiments. ESBLs activity was confirmed by double-disc diffusion. PCR method was used to detect the resistance genes. PFGE typing was operated to assess the relatedness and variability of the strains. The multi-locus sequence typing (MLST) was adopted to get the allelic profile and ST sequence of strains. Analysis was made on the evolutionary relationship between different ST groups was made through CLC Sequence Viewer and Counting Express. Results: A total of 24 non-O157 STEC were isolated from animal feces. 23 strains were from pig feces, and 1 strain was from cow feces, and the serotypes were more dispersed. All of the 24 strains carried stx2 genes. The highest resistance rate was sulfamethoxazole(22 strains), the mount of cotrimoxazole and nalidixic acid was 18 strains, chloramphenicol was 13 strains, tetracycline was 19, and there was a phenomenon of multiple drug resistance. The drug resistance spectrum was sulfamethoxazole tetracycline-compound novammin-naphthidine-chloramphenicol. All strains were sensitive to cefepime and imipenem. The ESBLs confirmatory test showed that 4 strains of non O157 STEC produced beta lactamase. PCR detected 7 resistance genes, and 4 tetracycline resistance genes (Tet A, Tet B, tetC and tetD) were detected. The beta lactamase resistance genes (blaSHV-1, bla CTX-M, bla TEM) were all negative. 24 strains were divided into 15 PFGE types, and their clustering results were more dispersed and no dominant PFGE type. There were 11 kinds of MLST types, most of them are ST540 and ST5133 types, each of which was 4 strains, and clustered into 1 MLST genomes. Conclusion The serotypes of non-O157 STEC in animal feces O157 STEC were dispersed, and the resistant rate to common antibiotic was high. MLST typing results presents obvious polymorphism. Surveillance and manage ment of these strains should be strengthened.

Objective To observe the reintubation rate of acute respiratory failure after thymectomy in patients with myasthenia gravis (MG) by two kinds of oxygen therapy (HFNC) and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC (observation group), and 80 patients were treated with noninvasive mechanical ventilation(control group). The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42%(14/76) , (5.35 ± 1.95) din control group and 7.50%(6/80), (3.42 ± 1.61) d in observation group. The difference was statistically significant (χ2=4.159,P =0.041;t =5.135,P=0.025).The respiratory rate、SpO2, PaO2, PaCO2 was (28.27 ± 4.32)beats/min, 0.9107 ± 0.0130, (86.43 ± 5.66)mmHg, (57.44 ± 5.73) mmHg in observation group and (24.84 ± 2.48) beats/min, 0.8867 ± 0.0309, (81.31 ± 2.85) mmHg, (65.38 ± 10.00) mmHg in control group. The difference was statistically significant (t =5.189-58.502,all P<0.01 or<0.05). Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.

Objective:To study the effect of Qingyi Lidan Granule on the serum levels of high mobility group box 1 (HMGB 1),heat shock protein 70 (HSP70),heat shock protein 27 (HSP27) and interleukin-8 (IL-8) of patients with severe acute pancreatitis.Methods:From August 2015 to July 2016,84 patients with severe acute pancreatitis in our hospital were selected and randomly divided into the observation group and the control group according to random number,42 cases in each group.The control group was given routine treatment,and the observation group was treated by Qingyi Lidan Granule on the basis of control group.The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain,serum levels of HMGB1,HSP70,HSP72 and IL-8 in both groups were observed and compared before and after treatment.Results:After treatment,the total clinical effective rate of observation group was significantly higher than that of the control group[92.86％ (39/42) vs 71.43％ (30/42)] (P＜0.05).The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain in the observation group were significantly shorter than those of the control group (P ＜0.05).Before treatment,no significant difference was found in the serum levels of HMGB 1,HSP70,HSP72,IL-8 between groups (P＞0.05).After treatment,the serum levels ofHMGB1,HSP70,HSP72 and IL-8 in both groups were significantly lower than those before treatment (P＜0.05).The levels ofHMGB1,HSP70,HSP72 and IL-8 in the observation group were lower than those in the control group (P＜0.05).Conclusion:Qingyi Lidan Granule could effectively reduce the levels of serum HMGB 1,H SP70,HSP27 and IL-8 and enhance the clinical curative effect of patients with severe acute pancreatitis.