Objective:To investigate alterations in functional connectivity network and brain function activity in childhood absence epilepsy (CAE) based on neuromagnetic signals by using multi-frequency magnetoencephalography.Methods:Twenty-five drug-naive children diagnosed with CAE from the Affiliated Brain Hospital of Nanjing Medical University and the Affiliated Children′s Hospital of Nanjing Medical University during October 2022 and March 2024 and 25 healthy controls matched for age and sex from community were recruited in this cross-sectional study. The interictal data, ictal data of CAE and healthy control children were collected using a CTF-275 channel magnetoencephalography system. Corrected amplitude envelope correlation was used to construct functional connectivity network, and network-based statistics were used to compare network differences between groups. Relative power spectral density was used to describe the distribution characteristics of whole-brain spectral power. Nonparametric permutation tests were conducted 1 000 times to compare spectral power differences between groups.Results:In terms of functional connectivity, significant increases in network activity were observed in the low-frequency bands (δ, θ) during interictal periods in children with CAE. A sub-network with significantly increased functional connectivity, including key nodes of the default mode network, was observed in the δ band. Compared with interictal periods, functional connectivity in the δ band decreased during absence seizures in children with CAE, while connectivity in the mid-to-high-frequency bands (α-γ2) increased. In terms of spectral power, children with CAE during interictal periods exhibited widespread magnetic source activation in the δ band, activation in parts of the parietal and occipital lobes in the θ band, and significantly decreased magnetic source intensity in most areas of the parietal, occipital, and temporal lobes in the α-γ2 band. Compared with interictal periods, children with CAE during absence seizures exhibited widespread magnetic source activation in the δ band, and significantly decreased activation in the θ-γ2 band. According to the magnetic source distribution map, during absence seizures, the frontal lobe replaced the parieto-occipital region in cortical activation in the α band.Conclusion:In the analysis of functional network and spectral power based on multi-frequency neuromagnetic signals, the network pattern and magnetic source activation of children with CAE during interictal periods were significantly different from those of healthy children, and there were characteristic changes in neuromagnetic signals during consciousness impairment caused by absence seizures in children with CAE.

ObjectiveTo study the intervention effect of Bixie Fenqingwan on hyperuricemia （HUA） rats by regulating urate transporters. MethodSixty healthy rats were randomly divided into normal， model， allopurinol （0.03 g·kg^-1）， and Bixie Fenqingwan low-， medium- and high-dose （0.8， 1.6， 3.2 g·kg^-1） groups， 10 in each group. Except the normal group， the other rats were given potassium oxonate 1.5 g·kg^-1 and adenine 0.1 g·kg^-1 for 28 consecutive days to establish the HUA rat model， and rats with increased serum uric acid （SUA） were considered successfully modeled. After modeling， corresponding drugs were given to the groups， once per day. Urine and blood was collected after 24 h of the final administration. The levels of urine uric acid （UUA）， SUA， blood urea nitrogen （BUN） and serum creatinine （SCr） were measured by enzymatic colorimetry. The rat kidneys were taken and weighed to calculate the kidney index. The pathological changes of kidney tissue were observed by haematoxylin-eosin （HE） staining. The protein and mRNA expressions of urate transporter 1 （URAT1）， glucose transporter 9 （GLUT9）， adenosine triphosphate-binding cassette transporter protein G2 （ABCG2）， organic anion transporter 1 （OAT1） and organic anion 3 transporter （OAT3） in kidney tissue were detected by immunohistochemistry and real-time quantitative polymerase chain reaction （Real-time PCR）， respectively. ResultCompared with the conditions in the normal group， the kidney index， levels of SUA， BUN and SCr， and protein and mRNA expressions of URAT1 and GLUT9 in kidney tissue were increased （P<0.05）， while the UUA level and protein and mRNA expressions of OAT1， OAT3 and ABCG2 were decreased in the model group （P<0.05）. In addition， there was compensatory dilatation with urate crystals and protein casts in renal tubules in the model group. Compared with the model group， the intervention groups had lowered kidney index （P<0.05）， reduced levels of SUA， BUN and SCr （P<0.05）， down-regulated protein and mRNA expressions of URAT1 and GLUT9 （P<0.05）， elevated UUA level （P<0.05） and up-regulated protein and mRNA expressions of OAT1， OAT3 and ABCG2 （P<0.05）， and the kidney tissue lesions were alleviated （P<0.05）. ConclusionBixie Fenqingwan has intervention effect on HUA， and its mechanism may be related to regulating urate transporters.

Objective:To explore the clinical efficacy and safety of single-layer with full thickness of duct-to-mucosa pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.Methods:The clinical data of 45 patients who underwent laparoscopic pancreaticoduodenectomy with the procedures of single-layer with full thickness in Second Hospital of Hebei Medical University from Jan 2020 to Jan 2022 were retrospectively collected and compared with 45 matched patients with traditional two-layer pancreaticojejunostomy.Results:The laparoscopic pancreaticoduodenectomy procedures were successfully performed in all the 90 cases. The mean operation time (285.6±92.4 minutes) and the media pancreaticojejunostomy time 20(15, 35) minutes) of the single-layer with full thickness pancreaticojejunostomy group were shorter than those of the two-layer pancreaticojejunostomy group [the mean operation time: 317.0±85.5 minutes, the media pancreaticojejunostomy time: 46(30, 58) minutes] with significantly statistical differences (all P value<0.05). There were no significantly statistical differences on intraoperative blood loss, the postoperative complications or hospital stay between the two groups. Conclusions:Compared with traditional pancreaticojejunostomy, the single-layer with full thickness of duct-to-mucosa pancreaticojejunostomy is simple and safe, which has the advantage of easy manipulation and less time-consuming and can be recommended for laparoscopic procedures.

【Objective】 To observe the reactive change of cortical perivascular cells after craniocerebral injury and explore its mechanism. 【Methods】 The controllable cortical impact animal model was used to simulate craniocerebral injury, the expressions of cortical pericyte markers at different time points after trauma were studied by Western blotting, and the biological behavior of vascular pericytes after craniocerebral injury was determined by transmission electron microscopy. Post-traumatic high mobility group box 1 (HMGB1), receptor for advanced glycation end product (RAGE), and nuclear factor κB (NF-κB) were detected by Western blotting. The experimental animals were divided into FPS-ZM1 (a specific RAGE receptor blocker) injection group and wild-type group. Wet and dry brain weight and transmission electron microscopy were used to study the post-traumatic effects of HMGB1-RAGE on pericytes. The primary mouse brain microvascular pericytes were cultured and supplemented with HMGB1 recombinant protein; the cultured pericytes supplemented with FPS-ZM1 were used as the control to explore the effect of HMGB1-RAGE pathway on vascular pericytes in vitro. 【Results】 The expression levels of early post-traumatic cortical pericyte markers platelet-derived growth factor receptor beta (PDGFR-β) and NG2 proteoglycan (NG2) decreased (PDGFR-β, Control vs. CCI 3D P<0.05; NG2, Control vs. CCI 6H P<0.05; Control vs. CCI 1D P<0.05). We found that pericytes were detached from blood vessels, accompanied by local blood-brain barrier opening. The expression of HMGB1-RAGE-NF-κB signaling pathway was increased in the early cortex after trauma (HMGB1, Control vs. CCI 6H P<0.05, Control vs. CCI 1D P<0.05; RAGE, Control vs. CCI 6H P<0.05, Control vs. CCI 1D P<0.05, Control vs. CCI 3D P<0.05, Control vs. CCI 5D P<0.05, Control vs. CCI 7D P<0.05; NF-κB, Control vs. CCI 6H P<0.05, Control vs. CCI 1D P<0.05). After blocking the binding of RAGE with the ligand, cortical edema was reduced (CCI 6H P<0.05, CCI 1D P<0.05), and neurovascular unit damage was reduced. HMGB1 recombinant protein could increase the migration ability of cultured pericytes (Control vs. HMGB1 P<0.05, Control vs. HMGB1+FPS-ZM1 P<0.05), and could be reversed by FPS-ZM1 (HMGB1 vs. HMGB1+FPS-ZM1 P<0.05). 【Conclusion】 High-level HMGB1 after traumatic brain injury mediates pericytes’ detachment from blood vessels through RAGE on pericytes and leads to the occurrence of local cerebral edema.

Objective:To compare and analyze the perioperative outcomes of jaundiced patients undergoing laparoscopic pancreaticoduodenectomy (LPD) using preoperative percutaneous transhepatic cholangial drainage (PTCD) versus endoscopic nasobiliary drainage (ENBD).Methods:The perioperative data of 173 patients who underwent LPD at the Second Hospital of Hebei Medical University from January 2016 to December 2020 and were treated preoperatively with either PTCD versus ENBD to alleviate jaundiced were retrospectively analyzed. There were 100 males and 73 females, with age of (60.4±10.8) years old. These patients were divided into the PTCD group ( n=126) and the ENBD group ( n=47). Clinical data including operation time, blood loss, transfusion volume, R 0 resection, and postoperative complications were compared. Results:There was no convension to open surgery. There were no significant differences in operation time, blood loss, transfusion volume, R 0 resection rate, pathological results and hospital stay between the two groups ( P>0.05). For the PTCD group, the pancreatic fistula rate was 10.3% (13/126) and the post-operative hemorrhage rate was 8.7% (11/126). They were both significantly lower than those of the ENBD group [25.5% (12/47) and 25.5% (12/47) respectively, P<0.05]. There were also significant differences in the postoperative complications according to the Clavien-Dindo classification system between the two groups ( P=0.008). Conclusion:Compared with ENBD, PTCD had the advantages of lower post-operative pancreatic fistula and post-operative hemorrhage rates, resulting in a better postoperative recovery.

OBJECTIVE To investigate the improvement effects of Jinkui shenqi pills on polycystic ovary syndrome （PCOS） model rats and the mechanism. METHODS Totally 40 rats were given letrozole suspension instragastrically （1 mg/kg， once a day， for consecutive 21 d） to induce PCOS model. Model rats were divided into model group， ethinylestradiol and cyproterone acetate tablets （short for diane-35）+metformin group （diane-35 0.2 mg/kg + metformin 230 mg/kg， as positive control）， Jinkui shenqi pills low-dose， medium-dose and high-dose groups （0.5， 1.0， 2.0 g/kg）， with 10 rats in each group. Other 10 healthy rats were included in normal group. Each group was given the corresponding drugs， once a day， for consecutive 30 d. Twelve hours after the last administration， serum levels of blood glucose， insulin， estrogen （E2）， testosterone （T）， gonadotropin-releasing hormone （GnRH）， follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were measured. The insulin resistance indexes were calculated， and the ovary coefficients of rats were calculated. The pathological changes of ovary were observed. The protein and mRNA expressions of liver kinase B1 （LKB1） and AMP-activated protein kinase （AMPK） in ovary tissue were detected. RESULTS Compared with normal group， the levels of blood glucose， insulin， insulin resistance index， serum levels of T， GnRH and LH and ovarian indexes were significantly increased （P＜0.05）， while serum levels of E2 and FSH as well as protein and mRNA expressions of LKB1 and AMPK in ovary tissue were decreased significantly （P＜0.05）； collagenization of ovarian cortex， increased number of atresia follicles and cystic follicles without cumulus， and follicular cystic lesions could be seen. Compared with model group， most of above indexes of Jinkui shenqi pills groups were reversed significantly （P＜0.05）； the number of follicle at each level was increased and no follicular cystic lesion was found in Jinkui shenqi pills medium-dose and high-dose groups. CONCLUSIONS Jinkui shenqi pills can significantly improve the abnormal level of sex hormones， insulin resistance and 222102310139） ovarian cystic changes， the mechanism of which may be related to up-regulating the activation of LKB1/AMPK signaling pathway.

OBJECTIVE To investigate th e intervention effect of Jinkui shenqi pills on renal fibrosis （RF）model rats and its mechanism based on transforming growth factor β1/Smads（TGF-β1/Smads）and TGF-β1/extracellular signal regulated kinase （ERK） signaling pathway. METHODS Male SD rats were given adenine suspension （250 mg/kg）to induce RF model. After modeling ， they were randomly divided into model group ，Colchicine tablet group （positive control ，0.45 mg/kg）and Jinkui shenqi pills low-dose，medium-dose and high-dose groups （0.5，1，2 g/kg），with 10 rats in each group. Other 10 healthy rats were selected as normal group. The rats in administration groups were given the corresponding drugs intragastrically ；normal group and model group were given 0.1％ sodium carboxymethyl cellulose solution ，once a day ，for consecutive 30 d. After last medication ，the serum levels of creatinine （Cr）and blood urea nitrogen （BUN），renal weight and body weight were detected. The ratio of BUN/Cr and renal coefficient were calculated. The pathological morphology of renal tissue in rats were observed. The protein and mRNA expressions of TGF-β1，Smad2，Smad3，ERK1 and ERK 2 were detected. RESULTS Compared with normal group ，serum levels of Cr and BUN and renal coefficient were all increased significantly in model group （P＜0.05），while the ratio of BUN/Cr was decreased significantly （P＜0.05）. The volume of the kidney was significantly increased ，and the surface was seriously granulated. Mesangial hyperplasia ，dilation or atrophy of renal tubules ，accompanied by large-area collagen deposition，could be found. Protein and mRNA expressions of TGF-β 1，Smad2，Smad3，ERK1 and ERK 2 were increased significantly in renal tissue （P＜0.05）. Compared with model group ，above indexes of Jinkui shenqi pills groups were all reversed significantly （P＜0.05）；dilation or atrophy of renal tubules was relieved ，and collagen deposition was reduced to different extents. CONCLUSIONS Jinkui shenqi pills can improve renal function of RF model rats ，the mechanism of which may be associated with inhibiting TGF-β1/Smads and TGF-β1/ERK signaling pathway.

Objective:To study the factors related to development of pancreatic fistula after laparoscopic distal pancreatectomy.Methods:The clinical data of all patients who underwent laparoscopic distal pancreatectomy at the Second Hospital of Hebei Medical University from January 2019 to December 2020 were retrospectively analyzed. Gender, age, intraoperative blood loss, treatment of pancreatic stump, body mass index (BMI), pancreatic texture, albumin and other indicators were analyzed between patients with and without pancreatic fistula. Logistic regression analysis was used to determine independent risk factors for pancreatic fistula.Results:Of 93 patients in this study, there were 33 males and 60 females, mean age (49.23±15.62), range 16 to 76 years. The incidence of postoperative pancreatic fistula was 34.4% (32/93). On univariate analysis, BMI (χ 2=4.515, P=0.034), pancreatic texture (χ 2=3.891, P=0.049), preoperative serum albumin ( t=2.644, P=0.010) and albumin difference ( t=-2.293, P=0.024) were significantly associated with postoperative pancreatic fistula. Multivariate logistic regression analysis showed that low preoperative albumin ( OR=0.551, P<0.001), large difference in albumin ( OR=1.542, P<0.001), BMI≥25 kg/m 2 ( OR=3.303, P=0.035) and soft pancreatic texture ( OR=3.065, P=0.049) were independent risk factors for pancreatic fistula. Conclusion:For patients with BMI≥25 kg/m 2 and patients with a soft pancreas, there was a higher chance to develop pancreatic fistula after operation.

Objective: To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China. Methods: The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety. Results: A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5% were defined with anxiety, and 18.7% reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the OR (95%CI) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the OR (95%CI) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the ORs (95%CI) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years. Conclusion Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.

Objective To study the relationship between psychological resilience and occupational stress of nurses in disinfec-tion supply center. Method A cluster sampling method was used to investigate 387 nurses in the supply and demand center by using the Chinese version of the Connor-Davidson scale (Connor-Davidson resilience, CD-RISC) and the nurse job stressors scale. Results In the disinfection supply center, the nurses' mental resilience score was (76.72±13.67), at the middle level. The total score on occupa-tion pressure was (72.84±12.19), at the moderate stress level. Pearson correlation analysis showed that the sterilization and supply cen-ter nurses' mental resilience score, together with the dimensions were positively correlated with occupation pressure. The mental re-silience and occupation pressure were positively correlated (P<0.05). Conclusions The psychological toughness and occupational stress of nurses in the sterilization and supply center are in the middle level. The nursing managers can promote the sustainable develop-ment of the nurses' psychological toughness through the stress management training and the nursing profession quality improvement.