ObjectiveTo explore the regulation of hypothalamic-pituitary-gonadal （HPG） axis by modified Erxian decoction in rats with perimenopausal syndrome （PMS） and to further analyze the expression of proteins related to the silent information regulator 1 （SIRT1）/hypothalamic kisspeptin （Kisspeptin）/gonadotropin-releasing hormone （GnRH） signaling pathway in the arcuate nucleus region （ARC） of the hypothalamus， so as to reveal the potential target of action and molecular biological mechanism of modified Erxian decoction for the treatment of perimenopausal syndrome. MethodsAn animal model was established via the incomplete castration method， with successful modeling confirmed by the exfoliated cervical cell smear method. The 48 rats were divided into six groups based on the randomization principle after successful modeling， including a sham operation group， a model group， an estradiol valerate group （0.09 mg∙kg^-1∙d^-1）， high-， medium-， and low-dose modified Erxian decoction groups （7.614， 3.807，1.903 5 g∙kg^-1∙d^-1）， with 8 rats in each group. The estradiol valerate group and the high-， medium- and low-dose modified Erxian decoction groups were continuously administered by gavage for 28 days， and the indicators were detected 24 hours after the last administration. Body weights and uterine indices were measured. The pathological changes of the uterus were observed by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of estradiol （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and gonadotropin-releasing hormone （GnRH）. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to determine the expression levels of SIRT1， Kisspeptin， kisspeptin receptor （GPR54）， and GnRH in the ARC region of the hypothalamus and gonadotropin-releasing hormone receptor （GnRH-R） in pituitary. ResultsCompared with the sham operation group， rats in the model group had a significantly increased body weight （P0.01）， reduced wet weight and index of uterus （P0.01）， endometrial thinning or atrophy， glandular atrophy， and a decreasing number of glands. Additionally， serum levels of E₂ and the expression of SIRT1 in the ARC region of the hypothalamus significantly decreased （P0.01）. Serum levels of FSH， LH， and GnRH， the expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus， and GnRH-R in pituitary significantly increased （P0.01）. Compared with the model group， the estradiol valerate group and the high-， medium-dose modified Erxian decoction groups had significantly reduced body weight， serum levels of FSH， LH， and GnRH， and expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus and GnRH-R in pituitary （P0.05， P0.01） and significantly increased wet weight and index of uterus， serum level of E₂， and expression of SIRT1 in the ARC region of the hypothalamus （P0.05， P0.01）. In addition， they showed thickened endometrium， increased number of endometrial glands， and improved glandular atrophy. ConclusionModified Erxian decoction regulates the function of the HPG axis through multi-targets， and its mechanism of action may be related to the up-regulation of the expression of SIRT1 in the ARC region of the hypothalamus， the inhibition of the over-activation of the Kisspeptin/GnRH signaling pathway， the regulation of the expression of GnRH-R in the pituitary， the restoration of secretion balance of gonadotropins， and the elevation of the estrogen level. This study provides an experimental basis for the interpretation of the scientific connotation of modified Erxian decoction in the treatment of perimenopausal syndrome and a theoretical reference for the development of a novel therapeutic strategy based on the SIRT1/Kisspeptin/GnRH pathway.

The seat of human intelligence is the human cerebral cortex, which is responsible for our exceptional cognitive abilities. Identifying principles that lead to the development of the large-sized human cerebral cortex will shed light on what makes the human brain and species so special. The remarkable increase in the number of human cortical pyramidal neurons and the size of the human cerebral cortex is mainly because human cortical radial glial cells, primary neural stem cells in the cortex, generate cortical pyramidal neurons for more than 130 days, whereas the same process takes only about 7 days in mice. The molecular mechanisms underlying this difference are largely unknown. Here, we found that bone morphogenic protein 7 (BMP7) is expressed by increasing the number of cortical radial glial cells during mammalian evolution (mouse, ferret, monkey, and human). BMP7 expression in cortical radial glial cells promotes neurogenesis, inhibits gliogenesis, and thereby increases the length of the neurogenic period, whereas Sonic Hedgehog (SHH) signaling promotes cortical gliogenesis. We demonstrate that BMP7 signaling and SHH signaling mutually inhibit each other through regulation of GLI3 repressor formation. We propose that BMP7 drives the evolutionary expansion of the mammalian cortex by increasing the length of the neurogenic period.
Animals ; Mice ; Humans ; Ependymoglial Cells/metabolism* ; Hedgehog Proteins/metabolism* ; Ferrets/metabolism* ; Cerebral Cortex ; Neurogenesis ; Mammals/metabolism* ; Neuroglia/metabolism* ; Bone Morphogenetic Protein 7/metabolism*

Background Type 2 diabetes mellitus is one of the most prevalent diseases,which imposes a heavy burden on patients' families and the society.Sleep disorders are recognized as risk factors for the development of diabetes,which may affect the onset and development of diabetes through neuro-endocrino-metabolic pathways,so identifying the factors responsible for the sleep quality of diabetic patients is of great importance in improving their sleep quality.Objective To investigate the relationship among fear of disease progression,executive function and sleep quality in patients with type 2 diabetes mellitus,so as to provide references for improvement of sleep quality in patients with type 2 diabetes mellitus.Methods A sample of 197 patients with type 2 diabetes mellitus who were admitted to the Endocrinology Department of the Second Affiliated Hospital of the Air Force Military Medical University from January to May 2023 and met the criteria defined in the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China(2020 edition)were consecutively selected.All subjects were assessed using Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Behavior Rating Inventory of Executive Function-Adult version(BRIEF-A)and Pittsburgh Sleep Quality Index(PSQI).Then the Process macro for SPSS(Model 4)and Bootstrap technique were applied to examine the mediating effect of executive function on the relationship between fear of disease progression and sleep quality in patients with type 2 diabetes mellitus.Results ①75 patients(38.07%)with type 2 diabetes mellitus were found to have sleep problems.②PSQI score in patients with type 2 diabetes mellitus was positively correlated with FoP-Q-SF score and BRIEF-A score(r=0.159,0.287,P<0.01).③Executive function mediated the relationship between fear of disease progression and sleep quality,the indirect value was 0.076(95%CI:0.022～0.146),accounting for 39.58%of the total effect.Conclusion Sleep disorders are common in patients with type 2 diabetes mellitus,and executive function may play a medicating role in the relationship between fear of disease progression and sleep quality.

In the study of cardiovascular diseases,Peroxiredoxin 6(PRDX6)is the only mammalian 1-Cys member of the Peroxiredoxin(PRDX)family and has attracted much attention.PRDX6 plays a unique role in oxidative stress due to its peroxidase activity and phospholipase A2 activity,and has been shown to participate in redox homeostasis and phos-pholipid metabolism.In recent years,the role of PRDX6 in the occurrence and development of cardiovascular diseases has received great attention.However,there is no unified understanding of the function of PRDX6 in the cardiovascular system at present.This article aims to briefly summarize the research progress of PRDX6 in cardiovascular diseases such as atherosclerosis,pulmonary hypertension,myocardial infarction,heart failure,abdominal aortic aneurysm,and systemat-ically review the expression changes,mechanism of action,and possible therapeutic potential of PRDX6 in these cardiovas-cular diseases,hoping to provide new ideas and strategies for cardiovascular diseases intervention.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective:To investigate the safety and feasibility of endoscopic thyroidectomy by gasless trans subclavian approach (ETGTA) in treatment of papillary thyroid carcinoma (PTC) .Methods:The clinical data of 148 patients with PTC radical operation admitted to the Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from Jul. 2020 to May. 2022 were retrospectively analyzed. They were divided into subclavian approach group (53 cases) and modified miccoli group (95 cases) according to different surgical approaches. The operation time, intraoperative bleeding volume, postoperative drainage flow, postoperative drainage days, postoperative hospital stay, postoperative complications and cosmetic satisfaction were recorded in the 2 groups. Statistical software was used to analyze the results, including t test, Mann-Whitney U test, χ2 test, etc. P<0.05 was considered statistically significant. Results:There were no significant differences in age, sex ratio, maximum diameter, stage, tumor lesion or surgical method between the 2 groups ( P>0.05). The postoperative drainage days increased in the subclavian group than in the modified miccoli group (4.57±2.45 vs. 2.98±1.07) ( P<0.01), but there was no statistical difference in operation time, intraoperative blood loss, postoperative drainage, or postoperative hospital stay between the two groups ( P>0.05). The incidence of swallowing discomfort at 1 month [5.6% (3/53) vs. 18.9% (18/95), P=0.04] and 3 months [0% (0/53) vs. 7.4% (7/95) , P=0.04], anterior cervical area tightness or stiffness at 1 month [0% (0/53) vs. 11.6% (11/95), P=0.01] and 3 months [0% (0/53) vs. 8.4% (8/95), P=0.03] were less than that of the modified miccoli group, and the difference was statistically significant (4.1±0.7 vs. 2.4±0.8) ( P<0.01), and the cosmetic satisfaction of the subclavian approach was higher than that of the modified miccoli group ( P<0.01). There was no significant difference in postoperative temporary recurrent laryngeal nerve injury, postoperative 3d neck pain, postoperative hand-foot numbness or postoperative hematoma between the two groups (all P>0.05) . Conclusion:The radical resection of papillary thyroid carcinoma without inflatable subclavicular approach is safe and feasible, with few postoperative complications and better cosmetic effect, which is worth popularizing.

Objective To explore the current situation and influencing factors that affect stroke specialist nurses in Henan Province and provide a reference for targeted interventions.Methods A total of 140 stroke specialist nurses from over 103 general hospitals in Henan Province were selected to participate the study with the convenience sampling method,between March and November 2022.General data questionnaire and the core competence evaluation questionnaire of stroke specialist nurses in Henan Province were employed for the investigation.Influencing factors were analysed by binary Logistic regression.Results A total of 134 specialist nurses responded to the survey.The findings revealed that the total score of core competence in the stroke specialist nurses was 279.5(257.0,306.0).Among the dimensions of core competence,the clinical thinking ability scored the highest at 4.4(4.0,4.9),while professional development ability scored the lowest at 3.7(3.4,4.0).Cluster analysis categorised that the scores＜250 were of a low score group(n=26)and those≥250 were of a high score group(n=108).Binary Logistic regression analysis indicated that education level,years working as a stroke specialist nurse,and the working experience in the stoke fast track team of A&E were the factors that influenced the core competence of the stroke specialist nurses in Henan Province(all P＜0.05).Conclusions This study has found that the core competence of stroke specialist nurses in Henan Province is at an acceptable level.Education,years working as a stroke specialist nurse and the working experience in the fast track team of A&E are the primary factors which influence core competence.Nursing managers should devise supportive programs to target the influencing factors and to improve the core competence of the stroke specialist nurses.

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).

Objective:To explore the application effect of time-sensitive incentive nursing in patients with multiple myeloma (MM) .Methods:From January 2019 to May 2021, the convenient sampling method was used to select 86 MM patients admitted to Henan Provincial People's Hospital as the research objects. According to the time of admission, 43 patients admitted from January 2019 to January 2020 were divided into the control group and 43 patients admitted from February 2020 to May 2021 were divided into the study group. The control group was given routine nursing, while the study group was given time-sensitive incentive nursing based on the control group. The psychological resilience and quality of life of the two groups before and after intervention were compared, and the occurrence of adverse reactions between the two groups during intervention was statistically analyzed.Results:After the intervention, the dimension scores of psychological resilience scale and the dimension scores of quality of life scale in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The incidence of gastrointestinal reactions in the study group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Time-sensitive incentive nursing can improve the psychological resilience of MM patients, reduce the occurrence of gastrointestinal reactions caused by chemotherapy and improve the quality of life.