Objective To screen key genes related to the diagnosis and prognosis of sepsis using bioinformatics methods. Methods A retrospective study was conducted on 90 sepsis patients admitted to the surgical intensive care unit (ICU) of Zhongshan Hospital, Fudan University from August 2022 to January 2023, as well as 30 control patients in ICU during the same period. The sepsis group was divided into a death subgroup (n=36) and a survival subgroup (n=54) based on the outcome, and peripheral blood mononuclear cells were collected for RNA sequencing. Linear models for microarray data (Limma) and weighted gene co-expression network analysis (WGCNA) were used to screen differentially expressed genes and module genes, combined with LASSO regression and random forest model for feature gene screening, candidate genes were determined. Nomogram and ROC curves to evaluate the diagnostic and prognostic value of candidate genes were constructed. The differential expression of candidate genes between the sepsis group and the control group was verified using external datasets and RT-qPCR. Results SEMA4F and PQLC3 were identified as candidate genes, and a nomogram for sepsis diagnosis and prognosis prediction was successfully constructed. The ROC curve showed that the AUC of the predictive efficacy of genes SEMA4F, PQLC3, and their combination for sepsis were 0.830, 0.926, and 0.930, respectively. The AUC of SEMA4F, PQLC3, SOFA score, and their combined predictive power for sepsis prognosis were 0.744, 0.768, 0.759, and 0.832, respectively. The AUC of the two genes in the diagnosis and prognosis prediction of sepsis validated by external datasets was greater than 0.588. The RT-qPCR results showed that there were statistically significant differences in the expression levels of the two genes among the control group, survival subgroup, and death subgroup (P＜0.05). Conclusions The SEMA4F and PQLC3 genes can serve as potential molecular markers for the diagnosis and prognosis of sepsis, and help improve the predictive value of SOFA score.

Objective: To investigate the association between emotional intelligence and sleep problems at the symptom level among junior and senior high school students, so as to provide new insights for interventions targeting junior and senior high school students sleep disorders. Methods: From November 2023 to May 2024, a stratified cluster random sampling method was employed to select 3 531 first year junior high school and first year senior high school students from 6 schools in Guangyuan City and Liangshan Yi Autonomous Prefecture in Sichuan Province, as well as Lhasa City in Tibet Autonomous Region. The Insomnia Severity Index Scale and the Wong and Law Emotional Intelligence Scale(WLEIS) were used to assess sleep problems and emotional intelligence. A network analysis was performed to explore the relationship between emotional intelligence and sleep disorders, and a gender based network comparison analysis was conducted. Results: The reported rate of sleep problems among junior and senior high school students was 47.3%, with severe sleep problems of 2.2%. Difficulty maintaining sleep, worry about sleep, and emotional application were the core symptoms in the network (node strength values: 1.11, 0.98, and 0.82, respectively). Dissatisfaction with sleep and emotional application served as bridge symptoms connecting emotional intelligence and sleep problems (bridge strength values: 1.77 and 1.59, respectively). The edge weights of the emotional intelligence and sleep problems network differed significantly between genders (maximum difference in edge weight values was 0.13， P <0.05). Conclusions Emotional application ability and dissatisfaction with sleep are the key nodes in the network connecting emotional intelligence and sleep problems. Targeted efforts to enhance emotional application ability may effectively reduce the risk of sleep problems among junior and senior high school students.

OBJECTIVE To observe the clinical efficacy of Huatan Tongluo Decoction in the treatment of post-stroke cognitive impairment(PSCI)with phlegm stasis obstructing collaterals syndrome,and its influence on the serum brain-derived neurotrophic fac-tor(BDNF)pathway-related factors.METHODS Sixty patients who met the inclusion criteria were collected and randomly divided into a control group and a treatment group with 30 patients each.The control group was given basic treatment and nimodipine,while the treatment group was given Huatan Tongluo Decoction on the basis of the treatment in the control group.The treatment course for both groups was 4 weeks.Changes in Mini-Mental State Examination(MMSE),TCM syndrome scores and serum levels of BDNF,nuclear transcription factor κB(NF-κB),B lymphocyte tumor-2(Bcl-2)and Bcl-2-associated X protein(Bax)were compared between the two groups before and after treatment.The TCM clinical efficacy in the two groups of patients was evaluated after treatment,and the oc-currence of adverse reactions was observed during treatment.RESULTS After treatment,the MMSE scores of the patients in the two groups increased significantly,the total TCM syndrome scores decreased significantly(P<0.01),and the treatment group was better than the control group(P<0.01);the serum BDNF,NF-κB,and Bcl-2 levels of the two groups of patients were significantly in-creased(P<0.05,P<0.01),and the Bax level was significantly decreased(P<0.01).The treatment group was better than the control group(P<0.01).CONCLUSION Huatan Tongluo Decoction can improve the clinical symptoms of PSCI patients with phlegm stasis obstructing collaterals,and is safe and effective.Its therapeutic mechanism may be related to regulating the BDNF pathway to protect nerve cells and inhibit nerve cell apoptosis.

ObjectiveTo investigate the therapeutic effect of Scutellariae Radix-Coptidis Rhizoma （SRCR） on atherosclerosis （AS） in mice and the effect of SRCR on macrophage pyroptosis in plaques via NOD-like receptor thermal protein domain-associated protein 3 （NLRP3） inflammasomes. MethodApoE^-/- mice were fed with a high-fat diet for the modeling of AS and randomized into model， atorvastatin （5 mg·kg^-1）， and low-， medium-， and high-dose （1.95， 3.9， 7.8 g·kg^-1， respectively） SRCR groups. Normal C57BL/6J mice were selected as the control group. After 8 weeks of administration， hematoxylin-eosin staining was used to observe the pathological status of the aortic plaque. The lipid accumulation in aortic plaque was observed by oil red O staining. The serum levels of total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） in mice were measured. Immunofluorescence double staining was employed to detect the co-localized expression of EGF-like module-containing mucin-like hormone receptor-like 1 （EMR1）/NLRP3 and EMR1/gasdermin D （GSDMD）. The serum levels of interleukin-1β （IL-1β） and interleukin-18 （IL-18） were determined by enzyme-linked immunosorbent assay （ELISA）. The protein levels of NLRP3， apoptosis-associated speck-like protein （ASC）， Caspase-1， cleaved Caspase-1， GSDMD， N-terminus of GSDMD （GSDMD-NT）， pro-IL-1β， IL-1β， and IL-18 were determined by Western blot， and the mRNA levels of NLRP3， ASC， Caspase-1， GSDMD， IL-1β， and IL-18 were determined by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the control group， the model group showed obvious plaques， elevated serum levels of TG， TC， LDL-C， IL-1β， and IL-18 （P<0.01）， lowered serum level of HDL-C （P<0.01）， and up-regulated expression of NLRP3 inflammasomes and molecules related to pyroptosis in the aortic plaques （P<0.01）. Compared with the model group， SRCR， especially at the medium and high doses， alleviated the plaque pathology， reduced the lipid content in plaques （P<0.05， P<0.01）， recovered the serum lipid levels （P<0.05）， reduced the macrophage recruitment （P<0.01）， activation of NLRP3 inflammasomes， and pyroptosis in aortic root plaques （P<0.05）， lowered the serum IL-1β and IL-18 levels （P<0.01）， and down-regulated the protein levels of NLRP3， ASC， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-NT， pro-IL-1β， IL-1β， and IL-18 （P<0.05） and the mRNA levels of NLRP3， ASC， Caspase-1， GSDMD， IL-1β， and IL-18 in the aortic tissue （P<0.05）. ConclusionSRCR exerts a therapeutic effect on high-fat diet-induced AS in mice by inhibiting the activation NLRP3 inflammasomes and reducing the pyroptosis of macrophages in plaques.

ObjectiveTo observe the effect of Scutellariae Radix-Coptidis Rhizoma on plaque stability in atherosclerotic （AS） mice and to explore its possible mechanism of action based on the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa B （NF-κB） signaling pathway. MethodTen normal C57BL/6J mice were used as the normal group， and the same strain of ApoE knockout （ApoE^-/-） mice were fed with a high-fat diet for 12 weeks to construct an atherosclerosis model. Mice were randomly divided into five groups， namely the model group， the atorvastatin group， and the Scutellariae Radix-Coptidis Rhizoma low-， medium-， and high-dose groups， with ten mice in each group. Then normal and model groups were given equal volume of saline gavage， and the low-， medium-， high-dose Scutellariae Radix-Coptidis Rhizoma groups were given 1.95， 3.9， 7.8 g·kg^-1 of the drug by gavage for 8 weeks， respectively. The general state of mice was observed. Hematoxylin-eosin staining was utilized to observe the pathology of aortic root plaques and calculate the percentage of plaque area. Masson staining and oil red O staining combined with immunohistochemistry of F4/80 and α-SMA were used to detect the plaque components of aortic root plaques and calculate the plaque vulnerability index. Enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）. Western blot was applied to detect the protein expression levels of matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase-9 （MMP-9）， TLR4， MyD88， NF-κB p65， and phosphorylation （p） -NF-κB p65 in the aortic tissues of mice in each group. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） assay was employed to detect the expression levels of MMP-2， MMP-9， TLR4， and MyD88， NF-κB p65 mRNA. ResultCompared with the model group， the general state of the mice in each medication group was improved， and no obvious side effects were observed. Compared with the model group， the percentage of plaque area in the aortic root of AS mice was significantly reduced in the medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. The content of collagen fibers and smooth muscle cells in the plaques of the high-dose Scutellariae Radix-Coptidis Rhizoma group was significantly increased （P<0.01）， and the content of lipids and macrophages was significantly reduced （P<0.05）， the plaque vulnerability index of each dose group of Scutellariae Radix-Coptidis Rhizoma was significantly reduced， with significant reduction of the medium- and high-dose groups （P<0.01）. MMP-2 and MMP-9 protein and mRNA expression levels in aortic tissues were significantly reduced in medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. The serum levels of TNF-α and IL-6 were significantly reduced in AS mice in medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. In the medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups， the levels of TLR4， MyD88 protein， and mRNA expression in aortic tissues were significantly reduced （P<0.05）， and the level of NF-κB p65 phosphorylation in aortic tissues was significantly reduced （P<0.05）. ConclusionScutellariae Radix-Coptidis Rhizoma may play an anti-inflammatory and stabilizing role by inhibiting the TLR4/MyD88/NF-κB signaling pathway.

Objective:To explore the effects of etoricoxib combined with sodium hyaluronate on pain and inflammatory factors in patients with knee osteoarthritis (KOA).Methods:A total of 106 KOA patients admitted to Zhujiang Hospital of Southern Medical University were selected as the research objects from March 2018 to October 2020, and they were divided into a control group and a study group using a random number table method, with 53 cases in each group. The control group was treated with sodium hyaluronate, and the study group was treated with etoricoxib on the basis of the control group. The effects of both groups were observed after continuous treatment for 4 weeks. The clinical efficacy and changes of knee joint function, pain and inflammatory factors before and after treatment were compared between the two groups, and the occurrence of adverse reactions during the treatment period was recorded.Results:The total effective rate of the study group was higher than that of the control group: 92.45%(49/53) vs. 77.36%(41/53), the difference was statistically significant ( P<0.05). The American Knee Association score (AKS) and Lysholm score after treatment in the two groups were higher than before treatment ( P<0.05), and the AKS score and Lysholm score in the study group after treatment were higher than control group: (171.84 ± 24.16) scores vs. (159.09 ± 22.21) scores, (81.62 ± 14.76) scores vs. (75.41 ± 13.58) scores, the difference was statistically significant ( P<0.05). The visual analogue score (VAS) of pain after treatment in the two groups was lower than before treatment, and the VAS score of the study group after treatment was lower than the control group: (3.01 ± 0.54) scores vs. (3.45 ± 0.64) scores. the difference was statistically significant ( P<0.05). The levels of interleukin-1β (IL-1β), matrix metalloproteinase-3 (MMP-3) and matrix metalloproteinase-9 (MMP-9) after treatment in the two groups were lower than before treatment, TIL-1β, MMP-3, and MMP-9 of the study group after treatment were lower than the control group: (56.38 ± 9.67) μg/L vs. (62.19 ± 10.73) μg/L, (91.56 ± 15.18) μg/L vs. (98.09 ± 16.74) μg/L, (30.46 ± 5.59) μg/L vs. (35.03 ± 6.27) μg/L, the difference was statistically significant ( P<0.05). There was no statistically significant difference in the incidence of total adverse reactions between the two groups ( P>0.05). Conclusions:Tocoxib combined with sodium hyaluronate in the treatment of KOA can improve the clinical efficacy, improve knee joint function, relieve pain, reduce the level of inflammatory factors, and have good safety.

Objective: To understand the prevalence of school bullying and depressive symptoms among the Han, Yi, and Tibetan adolescents in western China, and to explore the relationships between bullying roles, bullying frequency and depression symptoms. Methods: A combination method of typical sampling and cluster sampling was used to recruit 3 115 participants from six primary and middle schools in Cangxi County and Ganluo County in Sichuan Province, and Lhasa City in Tibet Autonomous Region from April to November 2020. All participants completed self filled questionnaires. Multiple Logistic regression was used to analyze the association between school bullying and depression symptoms. Results: A total of 881 participants (28.3%) had experienced school bullying in the past 6 months, and 892 participants(28.6%) were detected with depressive symptoms. The rates of school bullying in the Han, Yi, and Tibetan adolescents were 20.5%, 46.4% and 23.8%, respectively. Among them, the rates of victims were 15.3%, 25.0% and 11.8%, respectively; the rates of bully were 2.3%, 5.7% and 6.7%, respectively; the rates of bully victims were 2.9%, 5.7% and 5.4%, respectively. The prevalence of depressive symptoms in the Han, Yi, and Tibetan adolescents were 20.4%, 37.9% and 36.5%, respectively. After adjusting for age, grade, ethnicity, smoking, and drinking, the odds for depressive symptoms among victims ( AOR=1.98, 95%CI =1.61- 2.45 ), bully ( AOR=2.63, 95%CI =1.81-3.82), and bully victims ( AOR=3.33, 95%CI =2.44-4.54) were significantly higher than those without school bullying experience( P <0.01). And the risks increased with the increasing bullying frequency. Conclusion School bullying and depressive symptoms of the Yi and the Tibetan adolescents in western China were higher than those of the Han adolescents. Meanwhile, participation in school bullying and the high frequency of bullying were closely related to depressive symptoms. Future interventions should pay attention to various bullying roles and minority adolescents.

Objective To investigate the effect of narrative medicine mode in perioperative medical and nursing care for patients underwent radical nephrectomy. Methods A total of 124 patients received radical nephrectomy from February 2014 to October 2016 were selected and divided into experimental group and control group by block randomization grouping method with 62 cases each. Narrative medical treatment and care was applied in experimental group while control group received conventional treatment and care. The psychological status and social support of the patients were evaluated by Zung Self-rating Anxiety Scale(SAS), Self-rating Depression Scale (SDS) and social support rating scale(SSRS), as well as rehabilitation indexes including complications, first feeding time, hospitalization time, costs, etc. Results Anxiety and depression status were existed in both experimental and control groups before operations, and there were no significant difference in all pre-operative scales between two groups (P>0.05). The score of SAS, SDS, SSRS was (44.71 ± 4.67), (40.84 ± 4.05), (43.21 ± 3.60) points after operation and (54.98 ± 5.93), (46.52 ± 5.07), (31.87 ± 3.22) points before operation in experimental group. The score of SAS, SDS, SSRS was (53.24±5.97), (44.63±4.37), (32.61± 2.72) points after operation and (54.92 ± 5.83), (46.53 ± 4.89), (32.16 ± 2.48) points before operation in control group. Significant differences were found between before and after operation in experimental group (t=18.73, 8.85, 18.18, all P<0.01). However, no significant difference could be found between before and after operation in control group (t=1.590, 1.400, 1.910, P>0.05). After operation, the complications, first feeding time, hospitalization time and costs was 22.58%(14/62), (2.50±0.92) d, (11.16±3.72) d, (24.6±4.0) thousand yuan in experimental group, which was 48.39%(30/62), (3.98 ± 1.44) d, (15.48 ± 5.44) d, (40.2 ± 3.1) thousand yuan in control group. Significant differences were found between experimental group and control group (χ2=9.02, t=2.07, 8.06, 3.93, P<0.05 or 0.01). Conclusions Narrative medicine mode can provide medical care filled with respect, empathy, and humanistic concern, andimprove patients′psychological status, thus promoting rehabilitation.

Robotic assisted laparoscopic radical prostatectomy (RALP) is a perfect combination of modern remote information technology, intelligent engineering technology and minimally invasive surgical technique, with less hemorrhage and damage as patients getting good prognosis. In the past 10 years, the development of RALP has improved in our country rapidly. In this review, the progress of nursing researches of RALP were discussed, including preoperative therapeutic communication and comprehensive geriatric assessment, intraoperative anesthesia and heat preservation, and postoperative observation and fast recovery.

OBJECTIVETo analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province.

METHODSIn 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze.

RESULTSIn the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001).

CONCLUSIONThere were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.

Child ; China ; Ethnic Groups ; Family ; Female ; Health Behavior ; ethnology ; Humans ; Infant ; Maternal Health ; ethnology ; Maternal Health Services ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Rural Population