Objective: To determine the active components of Eupolyphaga sinensis Walker (Tu Bie Chong) and explore the mechanisms underlying its fracture-healing ability. Methods: A modified Einhorn method was used to develop a rat tibial fracture model. Progression of bone healing was assessed using radiological methods. Safranin O/fast green and CD31 immunohistochemical staining were performed to evaluate the growth of bone cells and angiogenesis at the fracture site. Methylthiazoletetrazolium blue and wound healing assays were used to analyze cell viability and migration. The Transwell assay was used to explore the invasion capacity of the cells. Tubule formation assays were used to assess the angiogenesis capacity of human vascular endothelial cells (HUVECs). qRT-PCR was used to evaluate the changes in gene transcription levels. Results: Tu Bie Chong fraction 3 (TF3) significantly shortened the fracture healing time in model rats. X-ray results showed that on day 14, fracture healing in the TF3 treatment group was significantly better than that in the control group (P = .0086). Tissue staining showed that cartilage growth and the number of H-shaped blood vessels at the fracture site of the TF3 treatment group were better than those of the control group. In vitro, TF3 significantly promoted the proliferation and wound healing of MC3T3-E1s and HUVECs (all P < .01). Transwell assays showed that TF3 promoted the migration of HUVECs, but inhibited the migration of MC3T3-E1 cells. Tubule formation experiments confirmed that TF3 markedly promoted the ability of vascular endothelial cells to form microtubules. Gene expression analysis revealed that TF3 significantly promoted the expression of VEGFA, SPOCD1, NGF, and NGFR in HUVECs. In MC3T3-E1 cells, the transcript levels of RUNX2 and COL2A1 were significantly elevated following TF3 treatment. Conclusion TF3 promotes fracture healing by promoting bone regeneration associated with the RUNX2 pathway and angiogenesis associated with the VEGFA pathway.

Background Exposures to environmental pollution and specific occupational hazards exacerbate pulmonary fibrosis which has a complex pathogenesis and lacks effective therapeutic drugs. The extract from Dracocephalum moldavica L. can alleviate pulmonary fibrosis through anti-inflammatory and anti-pyroptosis pathways, but its mechanism of prevention and treatment for pulmonary fibrosis remains unclear. Objective To elucidate the targets and potential mechanism underlying the anti-pulmonary fibrosis efficacy of Dracocephalum moldavica L. extract by employing an amalgamation of network pharmacology and empirical verification. Methods The chemical composition of the extract of Dracocephalum moldavica L. was retrieved with the help of China National Knowledge Infrastructure (CNKI) and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The disease targets related to pulmonary fibrosis were inquired using Gene Cards and DisGeNET. A protein-protein interaction (PPI) was constructed using the Search Tool for the Retrieval of Interacting Genes (STRING) database and Cytoscape software. The predicted potential targets were analyzed by the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses through the Database for Annotation, Visualization and Integrated Discovery (DAVID) and validated by molecular docking. Thirty-two rats were randomly divided into a control group, a model group, a low-dose group of Dracocephalum moldavica L. extract (100 mg·kg⁻¹), and a high-dose group of Dracocephalum moldavica L. extract (400 mg·kg⁻¹), with eight rats in each group. A rat model of pulmonary fibrosis was constructed using bleomycin (5 mg·kg⁻¹) intratracheal instillation, and an equal volume of saline was instilled into the control group. After modelling, 400 and 100 mg·kg⁻¹ of Dracocephalum moldavica L. extract were given the high-dose and low-dose groups by gavage, and an equal volume of saline was given by gavage to the control group and the model group, once per day, for consecutive 28 d. The animals were then neutralized, and lung tissues were collected. Structural changes in rat lung tissue were evaluated by observing stained pathological sections. Western blot (WB) was used to detect fibrosis-related proteins type I collagen (Col-I), α-smooth muscle actin (α-SMA), phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT) in lung tissues. Real-time fluorescence quantitative PCR (RT-qPCR) was used to detect α-SMA and Col-I mRNA levels in lung tissue. Enzyme-linked immunosorbent assay (ELISA) was used to detect tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) in rats. Results A total of 378 key chemical components of the Dracocephalum moldavica L. extract and 1611 lung fibrosis-related targets were identified. Among them, 574 potential targets of Dracocephalum moldavica L. extract acting on lung fibrosis were obtained. The key targets determined by Degree value were albumin (ALB), tumour necrosis factor (TNF), AKT1, etc. The results of KEGG analysis suggested that the potential targets of Dracocephalum moldavica L. extract against pulmonary fibrosis mainly involved the PI3K-AKT, HIF-1 signaling pathway, TNF signaling pathway, and MAPK signaling pathway. The molecular docking results showed that the binding energy between the active components (quercetin, apigenin, aesculetin, quercitrin) of Dracocephalum moldavica L. extract and the core targets of pulmonary fibrosis (TNF, IL-6, ALB, AKT1) were all <-29.288 kJ·mol⁻¹, indicating good binding ability. The animal validation results showed that compared with the control group, the rats in the model group had disrupted alveolar structure, obvious inflammatory cell infiltration, positive blue-striped collagen fibre deposition, and increased Col-I and α-SMA protein expression and transcription levels (P<0.001), p-PI3K and p-AKT expression levels (P<0.001), and levels of inflammatory factors TNF-α, IL-6, and IL-1β (P<0.001). Compared with the model group, the high- and low-dose groups of Dracocephalum moldavica L. extract alleviated the progression of pulmonary fibrosis, reduced inflammatory cell infiltration, and attenuated collagen fibre deposition in rats, with a decrease in the protein expression and transcription levels of Col-I and α-SMA (P<0.01), the expression levels of p-PI3K and p-AKT (P<0.001), and the levels of inflammatory factors IL-6 and TNF-α (P<0.05, P<0.001). Conclusion Dracocephalum moldavica L. extract manifests anti-pulmonary fibrotic properties through the modulation of the PI3K-AKT signaling cascade and the suppression of inflammatory reactions.

Objective:To construct a competency evaluation indicator system for infection prevention and control nurses in Operating Rooms (hereinafter referred to as "IPC") and provide an objective basis for the management of IPC nurses.Methods:From June to November 2022, an initial competency evaluation indicator system for IPC nurses was developed through literature review and semi-structured interviews. The Delphi method was employed to consult 20 experts from 11 provinces and municipalities across the country. Analytical Hierarchy Process (AHP) and mean distribution method were applied to quantify and determine the weight of each level of indicators within the system.Results:Nineteen experts were finally included, with two rounds of questionnaire recovery rates of 95.00% (19/20) and 100.00% (19/19), respectively. The authority coefficients of the experts were 0.858 and 0.861, familiarity coefficients were 0.850 and 0.853, and coefficients of judgment basis were 0.865 and 0.868, respectively. The Kendall's W coefficient of concordance for the two rounds of inquiries were 0.139 and 0.202 ( P<0.05), respectively. The final IPC nurse competency evaluation indicator system included six primary indicators, 22 secondary indicators, and 66 tertiary indicators. Conclusions:The constructed IPC nurse competency evaluation indicator system is scientific, reasonable, objective, and comprehensive, providing a valuable reference for the capability training, assessment, entry standards, and qualification certification of IPC nurses.

Objective To evaluate the clinical efficacy of transjugular intrahepatic portosystem shunt (TIPS) and gastric coronary vein embolization (GCVE) in the treatment of patients with cirrhosis,portal hypertension and upper gastrointestinal bleeding.Methods From Jan 2014 to May 2017 72 patients were enrolled and divided into the TIPS group (36 cases,receiving TIPS) and TIPS + E group (36 cases,byTIPS+GCVE).Results Portal vein diameter (1.21 ±0.08)cm vs.(1.26 ±0.09)cm,portal pressure (23.9 ± 2.1) cmH2O vs.(25.1 ± 2.2) cmH2O and congestion index (0.06 ± 0.03) cm/s vs.(0.08 ±0.03) after 1 month of treatment in TIPS + E group was significantly lower than the TIPS group,and the portal vein velocity was significantly higher than that of the TIPS group (42 ± 6) cm/s vs.(38 ± 7) cm/s,t =2.491,2.367,2.828,t =2.343,all P ＜ 0.05.The Child-Pugh score in the TIPS + E group was significantly lower than that in the TIPS group (7.9 ± 1.4) vs.8.6 ± 1.6,t =2.074,P =0.042).There was no statisticall different difference in postoperative hepatic encephalopathy in the two groups (17％ vs.11％,x2 =0.465,P =0.496).The one-year rebleeding rates in the TIPS group and the TIPS + E group were 14％ and 3％,respectively.The risk of rebleeding in the TIPS + E group was significantly lower than that in the TIPS group (HR =0.218,P =0.041).The one-year access obstruction rates in the TIPS group and the TIPS + E group were 17％ and 14％,respectively.(P =0.679).The all-cause mortality rates of the TIPS group and the TIPS + E group were 8％ and 3％,respectively,showing no statistically (P =0.299).Conclusions TIPS + GCVE therapy in the treatment of portal hypertensive upper gastrointestinal bleeding effectively reduces the risk of rebleeding.

Objective: To explore the diagnosis and treatment of head and neck Castleman′s disease (CD), and to improve the understanding of the disease. Methods: The clinical data of 41 patients with head and neck CD treated from January 2007 to July 2017 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. The patients were divided into two groups: localized CD (LCD, n=27) and multicentric CD (MCD, n=14). The clinical manifestations, laboratory examinations, operations, pathological findings and follow-up data were analyzed. Results: LCD was characterized by asymptomatic enlargement of the single lymph node with mild clinical symptoms. The main pathological type was hyaline vascular type, which can be cured by surgical treatment. MCD accompanied by fever 9 cases(64.3%), anemia 8 cases (57.1%), splenomegaly 7 cases (50.0%), respiratory symptoms 6 cases (42.9%), with multiple enlarged superficial and deep lymph nodes with pain, pleural effusion, and edema of lower extremity, C-reaction protein increased in 8 cases (57.1%), hypoproteinemia 8 cases(57.1%), globulin increased 7 cases (50.0%) and neutropenia 6 cases(42.9%). The main pathological type was plasma cell type in 7 cases (50.0%), and also there were 4 cases of hyaline vascular type and 2 cases of mixed type. Chemotherapy with or without rituximab was the main treatment. Most patients received complete or partial remission except for 2 patients who died of lung infection due to chemotherapy. Conclusions The diagnosis of head and neck CD depends on pathological examination. LCD shows mild symptoms and good prognosis after surgery. However, clinical manifestations of MCD are complex, with relatively poor prognosis after comprehensive treatment.

This study aimed at analyzing the medication regularity based on differentiation in traditional Chinese medicine (TCM) for losing weight using text mining technique.All the references over losing weight were retrieved in CNKI,Wangfang Database,VIP Database and Pubmed.The drugs from the references were classified in accordance with drug property,drug flavor,channel tropism and drug efficacy.Frequency and constituent ratio of a single drug in TCM prescriptions for losing weight were put into analysis using chi square test and factor analysis to find out the medication regularity.It was found that the properties of TCM drugs in the prescriptions contained both cold and warm,while the flavors of the drugs involved pungent,sweet and light.The channel tropism of the drugs mainly belonged to spleen meridian,liver meridian,stomach meridian and lung meridian.They were mostly tonic,relieving,blood-activating,qi regulating,inhibiting-damp and antipyretic drugs.Through factor analysis we found that the common formula compatibilities were concluded as:cassia seed,lotus leaf,hawthorn,salvia miltiorrhiza,polygonum cuspidatum and radix polygonum multiflorum;capillary artemisia,epimedium herb,stephania tetrandra and ligusticum wallichii;dried tangerine peel,pinellia ternata and poria cocos;plantain seed,pericarpium arecae and selfheal;paeonia lactiflora,angelica sinensis,scutellaria baicalensis and ligusticum wallichii;poria cocos,cassia twig,atractylodes and glycyrrhiza;immature bitter orange and bark of magnolia;radix bupleuri,lycium chinensis and jujube;Chinese yam and coix seed;and astragalus,pueraria lobata and polygonatum.In conclusion,formula compatibility mainly combined syndrome differentiation with disease differentiation for the treatment of obesity in clinic,using the drugs belonging to liver meridian,spleen meridian,stomach meridian and lung meridian with the flavors of sweet,bitterness or pungent and the nature of both warm and cold.

Purpose To explore the application of single index,double exponential and tensile density index model diffusion weighted imaging and other parameters on endometrial carcinoma diagnosis to offer new ideas for it.Materials and Methods Intravoxel incoherent motion imaging data of 28 endometrial carcinoma patients and 24 patients of normal endometrium were analyzed retrospectively.Single index,double exponential and DWI parameter of endometrial carcinoma tissue and normal endometrial tissue were measured respectively,including standard apparent diffusion coefficient (ADC-stand),slow apparent diffusion coefficient (ADC-slow),fast apparent diffusion coefficient (ADC-fast,perfusion fraction (f),distributed diffusion coefficient (DDC) and a.Receiver operator characteristic (ROC) curve was adopted to assess threshold value and diagnostic efficiency of each parameter,and analyzed difference among each parameter in two groups and relativity of each parameter in the same group.Results ADC-stand,ADC-slow,f,DDC and a in endometrial carcinoma group were all lower than those in normal endometrium group.The difference was statistically significant (P＜0.05).The difference of ADC-fast was not statistically significant (P＞0.05).Areas of ADC-stand and ADC-slow on ROC curve were 0.949 and 0.911 respectively,and threshold values were 1.245×10-3 mm2/s and 0.998× 10-3 mm2/s.ADC-stand in endometrial carcinoma group was positive correlated with ADC-slow and DDC value (r=0.787 and 0.880,P＜0.05).ADC-slow was significantly lower than ADC-stand (P＜0.05).Conclusion The differences in single index,double exponential and DWI can provide new ideas for endometrial carcinoma diagnosis.

Objective To investigate the expression level of fatty acid synthase (FASN) in different grades ofgliomas and its relationship with glioma malignancy.Methods Glioma U87 and U373 cell lines were routinely cultured in vitro;immunofluorescence assay was performed to detect the cellular localization of FASN in glioma U87 and U373 cell lines.Sixty-seven human glioma samples,collected in our hospital from March 2012 to March 2013,were used in our study;grade Ⅰ was noted in three samples by WHO grading,grade Ⅱ in 29,graded Ⅲ in 22,and grade Ⅳ in 13;immunohistochemistry was performed to detect the expression levels of FASN,CD34 and Ki-67 and microvascular density (MVD) in these human glioma samples.Spearman's correlation was used to analyze the relationship between FASN expression and both Ki-67 expression and MVD in human gliomas.Results (1) FASN could express in the cytoplasm of glioma U87 and U373 cell lines.(2) immumohistochemical staining indicated that FASN mainly located in the cytoplasm,Ki-67 in the cell nucleus,and CD34 in the cytomembrane.FASN expression in samples of grade Ⅰ (3.3683±0.6549) was significantly lower than that in samples of grade Ⅱ (4.0512±0.4859,P＜0.05),and FASN expression in samples of grade Ⅲ (4.1881±0.5755) was significantly lower than that in samples of grade Ⅳ (4.6996±0.5164,P＜0.05);MVD in samples of grade Ⅱ was significantly smaller than that in samples of grade Ⅲ(P＜0.05),and MVD in samples of grade Ⅲ was significantly lower than that in samples of grade Ⅳ(P＜0.05);Ki-67 expression in samples of grade Ⅱ was significantly lower than that in samples of grade Ⅲ (P＜0.05).(3) There was a positive and significant correlation between FASN expression and MVD (r=0.606,P=0.030);a positive and significant correlation between FASN expression and Ki-67 was also noted (r=0.636,P=0.014).Conclusion High expression level of FASN indicates high proliferation capability and high blood supply in haman gliomas.

Objective To establish the baseline data of body weight, main organ weights, hematological and biochemical indexes in SPF congenital cataract mice. Methods Body weight, main organs weights, hematological and biochemical indexes of the congenital cataract mice were determined at 28 days and 56 days of age, respectively. Normal KM mice in the same age were taken as control. Results There were no statistically significant differences in all indexes of the mice at 28 days of age. Compared with the 56?day old normal KM mice: (1) Statistically significant differences were found in the body weight, and weights of the heart, liver, spleen, lung, kidney and testis ( P<0?05 or P<0?01; ( 2 ) Statistically significant differences were found in hematological indexes WBC, PLT, MPV, LYMP, PDW for female mice and MPV, PDW for male mice (P<0?01);(3) Among the biochemical indexes, there were also statistically significant differences in UREA, ALP, TP, UA, TG, GLU for female and ALT, ALP, TP, ALB, UA, GLU for male mice. Conclusions There are statistical differences in the body weight, main organ weights, hematological indexes and biochemical indexes between the congenital cataract mice and normal KM mice at 56 days of age. These results may provide a useful reference for future research.

Objective To understand the status of service contract signing conducted by primary medical and health institutions.Methods A questionnaire survey and in-depth interview methods were used to study the service contract signing at primary health care institutions.Results The contract signing rate of the institutions surveyed was 1 9.1%,and valid contract signing rate was 76%.Senior people above 65 years old accounted for 33.5% of those signers,while hypertension patients accounted for 1 9.5% and diabetes patients for 10.6%.Interviews to the general practitioners team at the primary health institutions found that main factors affecting residents′ intention to sign were drug availability, attraction for signing the services,treatment habits among others.Interviews to the staff the primary health institutions found that contracted services are facing such difficulties as medical staff shortage,lack of motivation,lack of competence among others.Interviews to leaders of the primary health institutions found that the lack of publicity and support of medical insurance also has great influence to service contract signing.Conclusions The enthusiasm of general practitioners and residents to sign up for the service remains to be improved.