Acute Gelsemium poisoning is a systemic disease primarily affecting the central nervous system and respiratory symptoms caused by the ingestion of a substantial amount of Gelsemium within a short period. It manifests as sudden onset and rapid progression, primarily caused by accidental ingestion due to misidentification, and posing significant health risks. The compilation of the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning describes in detail the specialized practice and technical requirements in the process of handling acute Gelsemium poisoning, including accident investigation and management, laboratory testing and identification, in-hospital treatment, and health monitoring. The guidelines clarify key procedures and requirements such as personal protection, investigation elements, etiology determination, medical rescue, and health education. The key to acute Gelsemium poisoning investigation lies in promptly identifying the toxin through exposure history, clinical manifestations, and sample testing. Because there is no specific antidote for Gelsemium poisoning, immediate removal from exposure, rapid elimination of the toxin, and respiratory monitoring are critical on-site rescue measures. Visual identification of food or herbal materials, followed by laboratory testing to determine Gelsemium alkaloids in samples is a rapid effective screening method. These guidelines offer a scientific, objective, and practical framework to support effective emergency responses to acute Gelsemium poisoning incidences.

BACKGROUND:Previous studies have successfully constructed erythropoietin-overexpressed umbilical cord mesenchymal stem cells.It was found that the apoptosis of ischemic and hypoxic human neuroblastoma cell line(SH-SY5Y)was significantly reduced by erythropoietin-overexpressed umbilical cord mesenchymal stem cells. OBJECTIVE:To explore the possible neuroprotective mechanisms of erythropoietin-overexpressed umbilical cord mesenchymal stem cells against ischemic-hypoxic SH-SY5Y and their associated epigenetic mechanisms. METHODS:Oxygen-glucose deprivation was applied to ischemia-hypoxia-induced SH-SY5Y cell injury,and multifactorial assays were applied to detect the expression levels of inflammatory factors in the cells before and after hypoxia and co-culture,respectively,with mesenchymal stem cells,as well as lentiviral-transfected null-loaded plasmids of the negative control mesenchymal stem cells and erythropoietin-overexpressed umbilical cord mesenchymal stem cells.The expression levels of supernatant inflammatory factors were detected by multifactor assay after co-culture.Proteomics was used to detect the differentially expressed proteins of negative control mesenchymal stem cells and erythropoietin-overexpressed umbilical cord mesenchymal stem cells.Cleavage under targets and tagmentation sequencing was applied to detect genomic H3K4me2 modification,and joint analysis was conducted with RNA-sequencing.Lentiviral vector infection was applied to construct the stable knockdown of REST in SH-SY5Y cells.qRT-PCR and western blot assay were performed to detect the expression level of REST.The apoptosis was detected by flow cytometry after co-culture of oxygen-glucose deprivation treatment with erythropoietin-overexpressed umbilical cord mesenchymal stem cells.The expression difference of H3K36me3 group proteins was detected by western blot assay,and transcriptome sequencing was performed to analyze the differentially expressed genes. RESULTS AND CONCLUSION:(1)Compared with the control group,monocyte chemotactic protein 1,interleukin-6,interleukin-18,and interleukin-1 beta,interferon α2,and interleukin-23 levels significantly increased in the cerebrospinal fluid supernatant of patients with ischemic-hypoxic encephalopathy(P<0.01).(2)After co-culturing SH-SY5Y cells with erythropoietin-overexpressed umbilical cord mesenchymal stem cells under ischemia and hypoxia,the expression levels of monocyte chemotactic protein 1 and interleukin-6 were significantly reduced.(3)Analysis of protein network interactions revealed significant downregulation of monocyte chemotactic protein 1,interleukin-6 related regulatory proteins CXCL1 and BGN.(4)Transcriptome sequencing analysis found that pro-inflammatory genes were down-regulated,and functional enrichment of histone modifications,and the expression of transcription factors REST and TET3 significantly up-regulated in the erythropoietin-overexpressed umbilical cord mesenchymal stem cell group compared with the negative control mesenchymal stem cell group.(5)Combined analysis of transcriptome sequencing and cleavage under targets and tagmentation revealed changes in epigenetic levels as well as significant activation of the promoter regions of transcription factors REST and TET3.(6)Stable knockdown REST in SH-SY5Y cells was successfully constructed;the transcript levels of REST mRNA and protein expression were both decreased.(7)After the REST knockdown SH-SY5Y cells were co-cultured with erythropoietin-overexpressed umbilical cord mesenchymal stem cells,apoptosis was significantly increased and H3K36me3 expression was significantly decreased.Transcriptome sequencing results showed that the expression of inflammation-related genes Aldh1l2 and Cth,as well as apoptosis-suppressor genes Mapk8ip1 and Sod2 was reduced at mRNA transcription level(P<0.01).(8)It is concluded that erythropoietin-overexpressed umbilical cord mesenchymal stem cells activated the expression of REST and TET3 by altering the kurtosis of H3K4me2 and upregulated the modification level of H3K36me3,which in turn regulated the expression of inflammation-related genes Aldh1l2 and Cth,as well as apoptosis-suppressor genes Mapk8ip1 and Sod2,and facilitated neuronal survival.

Objective To explore the pharmacologically active components in areca nut that induce oral submucosal fibrosis(OSF)and the possible mechanism.Methods The chemical components in areca nut were analyzed using Thermo QE plus liquid chromatography tandem high-resolution mass spectrometer and Compound discover 3.2 data processing software.The chemical activity of the top 20 compounds was analyzed based on Chinese Pharmacopoeia(2015),PubChem,Chemical book,and SciFinder databases.The potential active components,core targets,biological functions and signaling pathways affecting OSF were analyzed by network pharmacology.The targets of OSF were obtained by integrating Genecards and KEGG databases.The compounds acting on the targets were selected from the Systematic Pharmacology Technology Platform of Traditional Chinese Medicine(TCMSP),and the target-compound,compound-TCM,target-compound-TCM network was constructed.Molecular docking was used to analyze the component-target binding.Immunohistochemistry was used to examine the expressions of key proteins in the PI3K-Akt and MAPK pathways in clinical samples of OSF.Results The core intersection target genes between the top 10 active ingredients in areca nut extract and OSF involved mainly the PI3K-Akt and MAPK pathways.In the clinical samples,the expressions of PI3K protein decreased and the expressions p-PI3K,AKT1 and P-Akt all increased significantly in OSF tissue,where increased JNK protein expression and enhanced activity of c-Jun and c-Fos transcriptional factors were also detected.The OSF patients had significantly elevated plasma levels of IL-6 and IL-8 compared with healthy individuals.Conclusion The main active ingredients including arecoline,arecaine,and guvacine are capable of activating the PI3K-Akt and MAPK pathways to promote the expressions of inflammatory mediators IL-6 and IL-8 and induce collagen hyperplasia,thus leading to the occurrence of oral submucosal fibrosis.

Objective:To explore the evaluation and influence factors of computed tomography(CT)and magnetic resonance imaging(MRI)on thoracolumbar burst fracture combined with injury of posterior ligament complex(PLC).Methods:A total of 68 patients with thoracolumbar burst fractures who were diagnosed and treated in Handan First Hospital from January 2020 to June 2023 were selected as the research object,and the surgical result was used as gold standard.The 32 cases,who were diagnosed as thoracolumbar burst fractures combined with PLC injury according to the gold standard,were divided into PLC group.The 32 cases without PLC injury were divided into non-PLC group.Before operation,all patients underwent CT and MRI examinations,and the positively and negatively predictive values of CT and MRI in diagnosing thoracolumbar burst fracture combined with PLC injury were calculated by four-grid method.The area under curve(AUC)value,sensitivity and specificity of CT and MRI in diagnosing thoracolumbar burst fracture combined with PLC injury were analyzed by receiver operating characteristic(ROC)curve.Logistic regression model was used to analyze the risk factors of patients with thoracolumbar burst fracture who occurred PLC injury.The differences of the scores of ligamentous complex stability(LCS)score,intraspinal space occupancy rate and thoracolumbar injury classification and severity(TLICS)score,and the scoliosis angle(Cobb),superior iliac crest angle(SIEA),local kyphosis(LK)angle and intervertebral disc space depth(IISD)between two groups were compared.Results:For 68 with thoracolumbar burst fractures,the 34 cases were confirmed as PLC injury and 34 cases were confirmed as non-PLC injury by using CT examination.The positively and negatively predictive values of CT examination were respectively 70.59%(24/34)and 76.47%(26/34)for PLC injury,and the consistency between CT and gold standard was general(Kappa=0.471,P<0.001).The 33 cases were confirmed as PLC injury and 35 cases were confirmed as non-PLC injury by using MRI examination.The positively and negatively predictive values of MRI examination were respectively 90.91%(30/33)and 94.29%(33/35)for PLC injury,and the consistency between MRI examination and gold standard was general(Kappa=0.853,P<0.001).The diagnostic accuracy of MRI was 92.65%(63/68),which was significantly higher than that(73.53%,50/68)of CT(x2=8.843,P<0.05).ROC curve analysis showed that the AUC values of CT and MRI were respectively 0.730 and 0.919 in diagnosing thoracolumbar burst fracture combined with PLC injury.The sensitivities of them were respectively 70.60%and 75.40,and the specificities of them were respectively 88.20%and 95.70%.There were no significant differences between PLC group and non-PLC group in gender,age,body mass index(BMI),cause of injury,LCS score and intraspinal space occupancy rate(P>0.05).There were significant differences in TLICS score,Cobb angle,SIEA,LK and IISD between the two groups(x2=19.443,4.181,4.973,5.198,5.056,P<0.05),respectively.Logistic regression analysis showed that TLICS score>5 points,Cobb angle,SIEA,LK and IISD were risk factors that affected the occurrence of PLC injury in patients with thoracolumbar burst fracture(OR=13.973,1.155,1.365,1.385,5.262,P<0.001),respectively.Conclusion:The efficiency of MRI is higher than that of CT in diagnosing PLC injury in patients with thoracolumbar burst fracture,and TLICS score,Cobb angle,SIEA,LK and IISD have influences on the occurrence of PLC injury in patients with thoracolumbar burst fracture.

Objective To explore the pharmacologically active components in areca nut that induce oral submucosal fibrosis(OSF)and the possible mechanism.Methods The chemical components in areca nut were analyzed using Thermo QE plus liquid chromatography tandem high-resolution mass spectrometer and Compound discover 3.2 data processing software.The chemical activity of the top 20 compounds was analyzed based on Chinese Pharmacopoeia(2015),PubChem,Chemical book,and SciFinder databases.The potential active components,core targets,biological functions and signaling pathways affecting OSF were analyzed by network pharmacology.The targets of OSF were obtained by integrating Genecards and KEGG databases.The compounds acting on the targets were selected from the Systematic Pharmacology Technology Platform of Traditional Chinese Medicine(TCMSP),and the target-compound,compound-TCM,target-compound-TCM network was constructed.Molecular docking was used to analyze the component-target binding.Immunohistochemistry was used to examine the expressions of key proteins in the PI3K-Akt and MAPK pathways in clinical samples of OSF.Results The core intersection target genes between the top 10 active ingredients in areca nut extract and OSF involved mainly the PI3K-Akt and MAPK pathways.In the clinical samples,the expressions of PI3K protein decreased and the expressions p-PI3K,AKT1 and P-Akt all increased significantly in OSF tissue,where increased JNK protein expression and enhanced activity of c-Jun and c-Fos transcriptional factors were also detected.The OSF patients had significantly elevated plasma levels of IL-6 and IL-8 compared with healthy individuals.Conclusion The main active ingredients including arecoline,arecaine,and guvacine are capable of activating the PI3K-Akt and MAPK pathways to promote the expressions of inflammatory mediators IL-6 and IL-8 and induce collagen hyperplasia,thus leading to the occurrence of oral submucosal fibrosis.

Objective The nursing treatment ability scale of patients with nuclear radiation damagein the hospital was developed to provide an evaluation basis for improving the nursing ability of nurses with nuclear radiation damage. Methods The scale was prepared by literature review, expert interview and expert consultation, and a total of 330 clinical nurses from a third-class hospital was randomly selected as the research objects. The scales were issued for item analysis and reliability and validity test. Results The scales were divided into 6 dimensions, including basic knowledge of nuclear radiation damage, specialized equipment use ability, specialized ward management ability, basic nursing ability, specialized nursing ability and self-ability recognition, with 51 items. After exploratory factor analysis, there were 6 principal components, and the cumulative interpreted variance was 70.757%. The χ², df, χ²/df, CFI, IFI, TLI, NFI, PNFI, PCFI, RMSEA fitting indexes of confirmatory factor analysis were all acceptable. Cronbach's α coefficient was 0.976, the retest reliability was 0.823, and the S-CVI (S-CVI/UA) was 0.84. The evaluation content validityS-CVI (S-CVI/AVE) was 0.98, and the content validity I-CVI of the item level was 0.78～1.00. Conclusion The items and dimension Settings of this scale have been tested, and all indicators met the requirements. The reliability and validity test results were good. It can be used as a scale for preliminary evaluation of hospital nursing ability of patients with nuclear radiation damage.

Objective:To explore the correlation between serum C1q, thyroid hormone (serum FT 3, FT 4, TSH) and depression by detecting the difference of serum C1q, thyroid hormone (serum FT 3, FT 4, TSH) between depression patients and normal people. Methods:A total of 275 depressive patients(depression group) and 275 healthy controls(healthy group) were recruited.The serum levels of C1q, FT 3, FT 4 and TSH were compared between the two groups.The serum levels of C1q, FT 3, FT 4 and TSH in depression patients with different age, gender, course of disease and HAMD were compared.Further regression analysis was used to evaluate the effects of serum C1q, FT 3, FT 4 and TSH levels on the incidence and severity of depression in patients with depression. Results:Serum C1q, FT 3, TSH of depression group(C1q: 203(165, 239)mg/L, FT 3: (4.39±0.70)pmol/L, TSH: 1.69(1.17, 2.46)mIU/L) were significantly lower than those of healthy group(C1q: (236.25±27.06)mg/L, FT 3: 4.61(4.29, 4.95)pmol/L, TSH: 2.04(1.42, 3.01)mIU/L)(all P<0.01). Compared with the serum indexes in depression group, the level of C1q and TSH in men(C1q : 188.00 (164.00, 221.00) mg/L, TSH: 1.52(1.13, 2.16)mIU/L) were significantly lower than those in women(C1q : 213.00 (168.25, 247.75) mg/L, TSH: 1.85(1.28, 2.57)mIU/L)( P<0.05), and the level of FT 3 and FT 4 in men(FT 3: 4.64 (4.23, 5.06) pmol/ L, FT 4: 16.76(15.05, 18.20)pmol/L) were significantly higher than those in women (FT 3: 4.34 (3.82, 4.72) pmol/L, FT 4: 15.92(14.35, 17.40)pmol/L). Serum C1q ( B=-0.020, P<0.01, OR95% CI: 0.980 (0.975, 0.985)), FT 3 ( B=-0.576, P<0.01, OR95% CI: 0.562 (0.408, 0.775)), TSH ( B=-0.274, P<0.01, OR95% CI: 0.761 (0.648, 0.893)) level were the influencing factors of depression. Conclusion:Serum C1q and thyroid hormone may be involved in the pathogenesis of depression, and may be affected by gender factors.

Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.

OBJECTIVE:To observe therapeutic efficacy and safety of Shensong yangxin capsules combined with edaravone in the treatment of cerebrovascular disease complicated with cerebrocardiac syndrome(CCS). METHODS:A total of 128 cerebrovas-cular disease patients with CCS were randomly divided into control group (64 cases) and observation group (64 cases). Control group received routine treatment,observation group was additionally given Shensong yangxin capsule 1.6 g orally,3 times a day+Edaravone injection 30 mg added into 0.9% Sodium chloride solution 250 mL intravenously,2 times a day. Treatment courses of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were observed,and MDA,SOD,catecholamine(NE,E,DA)levels,cT-nI,NIHSS scores,correlation of cTnI level with NIHSS score were also observed before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of nervous system and electrocardio gram in observation group were significant-ly higher than control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in MDA,SOD,NE,E,DA,cTnI levels or NIHSS scores between 2 groups(P>0.05). After treatment,MDA,NE,E,DA,cTnI levels and NIHSS scores of 2 groups were significantly lower than before,and the observation group was significantly lower than the control group;SOD of 2 groups were significantly higher than before,and the observation group was significantly higher than the antrol group,with statistical significance (P<0.05). cTnI level was positively correlated with NIHSS score (r=0.956,P=0.001). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on rou-tine treatment,Shensong yangxin capsules combined with edaravone can significantly improve therapeutic efficacy of cerebrovascu-lar disease patients with CCS,and improve the levels of catecholamine,MDA and SOD without increasing the occurrence of ADR.

Objective:To evaluate the effect of fluoride on the viability of rat ameloblast HAT-7 cells and calcium concentration in the cells.Methods:HAT-7 cells were exposed to NaF at 0,0.4,0.8,1.6,3.2 and 6.4 mmol/L for 24,48 and 72 h respectively. CCK-8 assay was performed to examine the cells proliferation;the apoptosis rate was determined by flow cytometry;Ca2 +concentration in the cells was detected by laser scanning confocal microscopy.Results:The cell proliferation was increased by NaF at 0.4 mmol/L and 0.8 mmol/L,whereas inhibited at 1.6 mmol/L and above.The effects were in a time-dependent manner.NaF increased apoptosis of the cells and increased Ca2 + concentration in the cells in a concentration-dependent manner.Conclusion:Fluoride at low doses promotes proliferation,at high doses inhibits proliferation of HAT-7 cells.NaF of 1.6 mmol/L or more induces apoptosis of HAT-7 cells and in-duce Ca2 + overloading in the cells.