To study the prevalence of depression, anxiety, and insomnia among social workers during the prolonged battle against the COVID-19 pandemic and explore the associated risk factors.

OBJECTIVE To explore mecha-nisms of imperatorin on regulating P-glycoprotein(P-gp)in blood-brain barrier(BBB)based on net-work pharmacology combined with in vitro experi-ment.METHODS Drug targets were predicted using the Pharmapper and Swiss targets data-bases;disease targets were obtained through the Genecards database;intersections between drugs and disease targets were screened by Cytoscape software;the obtained core targets were used to construct protein-protein interaction(PPI)network,gene ontology(GO)functions,and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.The effects of imperatorin(20,50,100 μ mol·L-1)on P-gp activity were monitored in hCMEC/D3in vitro BBB model,and the effects of imperatorin on the expression of target proteins were verified using Western blot method.RESULTS 55 drug targets and 3102 disease targets were obtained from the network pharmacology screening,and 37 core targets were obtained after the combination.Enrichment analysis showed that core targets were closely related to chemical synaptic trans-mission regulation,neurotransmitter receptor activity,proteinkinaseregulationactivity,G protein-coupled receptor signaling pathway,neural active ligand receptor interaction pathway,PI3K-Akt sig-naling pathway,VEGF signaling pathway,etc..In vitro experimental validation suggested that all tested concentration groups of imperatorin signifi-cantly reduced the activity and expression of P-gp,which were achieved by significantly downregu-lating the phosphorylation levels of PI3K and Akt,and repressing the expression of VEGFR2 pro-tein.CONCLUSION Network pharmacology was used to predict the core targets and signaling pathways of imperatorin on regulating P-gp in BBB and relevant validation was conducted through in vitro experiments,providing a refer-ence basis for further exploration of the mecha-nisms of imperatorin on regulating P-gp in BBB.

Objective:To explore the curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds.Methods:A retrospective observational study was conducted. From October 2016 to June 2018, 20 patients with wounds on palms and multiple fingers who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 15 males and 5 females, aged 18 to 77 years. After debridement, the wound area was 8 cm×4 cm-17 cm×12 cm. The wound was repaired by ultrathin anterolateral femoral flap with area of 9 cm×5 cm to 19 cm×13 cm. According to the wound condition of finger, the finger division was performed in one stage, and the length-to-width ratio of the split-finger flap was 2.0:1.0-2.5:1.0. During the surgery, the descending branches of lateral circumflex femoral artery and accompanying vein of flap were anastomosed end-to-end to the radial artery and vein in the recipient area, respectively, and the anterolateral femoral cutaneous nerve of flap was bridged with the superficial branch of radial nerve in the recipient area. The wounds in the donor area of flap in 14 patients were sutured directly, the wounds in the donor area of flap in 3 patients were repaired by relay superficial iliac circumflex artery perforator flap, and the wounds in the donor area of flap in 3 patients were covered by free trunk medium-thick skin graft. The survival of flap, occurrence of vascular crisis and other complications, and healing of wounds in the donor area of flap were recorded. The appearance of flap, scar hyperplasia in the donor and recipient areas and the patients' satisfaction with the shape and function of the donor and recipient areas were followed up. In 1 year after surgery, the two-point discrimination distance of the flap was measured, and the recovery of hand function was evaluated by the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association.Results:The flaps of 17 patients survived without vascular crisis or other complications after surgery. The flap of 1 patient had poor blood circulation and partial necrosis, and the wound was healed 14 days after dressing change and grafting of split-thickness skin graft from head. Two patients had mild cyanosis at the margin of flap after surgery, which disappeared spontaneously 5 days later. Incisions at donor site, relay flaps, and skin grafts of all patients survived well. After surgery, the color and texture of flap were basically the same as that of the normal skin of hand, and linear scars were observed in the donor and recipient areas. The patients were satisfied with the recovery of appearance and function of donor and recipient areas. After 1 year of follow-up, the patients' hand sensory function recovered well, the two-point discrimination distance of flap was 4-6 mm, and the recovery of hand function was evaluated as excellent in 18 cases and good in 2 cases.Conclusions:The ultrathin anterolateral femoral flap in repairing the palmar combined with multiple finger wounds in one-stage split-finger can significantly reduce the number of surgeries and improve the function and beauty of the hand, so it is worthy of clinical promotion.

Objective: To explore the clinical application of individualized design of facial artery perforator flap for the repair of midfacial defect caused by tumor resection. Methods: From January 2015 to January 2018, a total of 36 cases of midfacial defect were repaired by individualized designed facial artery. Flaps were designed and harvested according to the location and size of the midfacial defect resulted from tumor resection, including propeller flaps, droplet flaps and swallowtail-shape flaps. Flap size was between 1.3 cm × 1.6 cm and 2.0 cm × 4.2 cm with the donor site being sutured in the first stage. Results: During the 6 months to 3 years of postoperative follow-up, no tumor recurred. All the 36 cases of individualized designed facial artery perforator flaps survived well. Furthermore, flaps being designed according to the wound defect had a good appearance, the flaps matched the color and texture of the surrounding skin and had a favorable appearance. Besides, flaps had a certain degree of sensory recovery while there was no obvious scarring presented in the donor area. Conclusions Individualized design of facial artery perforator flap has great advantages of simple and flexible, easy manipulation, reliable flap blood flow and minimal donor injury, which render it valuable for clinical application.

Aim To investigate the influence of echi-nacoside ( ECH ) on monoaminergic neurotransmitter extracellular of the hippocampus and cerebral cortex in rat model of Alzheimer′s disease ( AD) , and ultimately to provide a theoretical basis for ECH′s improving the ability of learning and memory. Methods 60 male SD rats were randomly divided into 6 groups with 10 rats in each group : sham operation group, model, ECH groups of low, medium and high doses (10, 20, 40μg ·g-1 ·d-1 ) , and Hup A ( Huperzine A, 0. 02 μg· g-1·d-1) group. The AD rat model was established by abdominal cavity injection with D-galactose and uni-laterally injected with amyloid beta-protein fragment 25-35 ( Aβ25-35 ) into the right hippocampus. Morris wa-ter maze test was used to study the animals′ ability of spatial learning and memory. The synchronous dual-probe dual-channel brain microdialysis sampling tech-nology was applied to collect dialysates from different encephalic areas continuously, and combined with HPLC electrochemical detection were used to measure the extracellular levels of norepinephrine ( NE) , dopa-mine (DA), 5-serotonin (5-HT). Results 1. Com-pared with the sham operation group, the mean escape latency of the model group was significantly prolonged ( P<0. 05 ) , and the time that rats were in the plat-form quadrant was significantly shortened ( P<0. 05 );on the contrary, compared with the model group, the mean escape latency of ECH groups were significantly shortened ( P<0. 05 ) , and the time that rats were in the platform quadrant was significantly extended ( P<0. 05). 2. Compared with the sham operation group, the contents of NE,DA and 5-HT were significantly de-creased in the model group ( P <0. 05 ) . However, compared with the model group , ECH could improve the concentrations of NE, DA, 5-HT in the hippocam-pus and cerebral cortex, and these monoamine levels of the brain regions were restored to near control. Con-clusion ECH can effectively improve the ability of learning and memory of rats with AD, giving a rise to the monoamine neurotransmitter both in hippocampus and cortex, exerting a positive effect on treatment of cognitive dysfunction . The ECH low dose group is sig-nificantly lower than the ECH groups of medium and high doses and Hup A group in improving the ability of learning and memory.

OBJECTIVE Toexplorethecredibityoftwoimprovedmodelsofsyntheticvascular dementia(VD)rats.METHODS OneimprovedmodelofVDratswasestablishedbyligatuingthebilat-eral common carotid artery twice at 3 d (improved 2-VO),while the other was established by blocking the middle cerebral artery on the left side by separating pterygopalatine arteria (i mproved MCAO/R). The learning and me mory ability was determined by escape latency in Morris water maze directional navi-gation test and cross-over ti mes in target areas in spatial probe test and the search strategy.The organi-zational structure in CA1 area of the hippocampus was observed and analyzed under a microscope after HEstaining.RESULTS Thelearningandmemoryabilitydecreasedsignificantlyin2modelgroupsat 20 d after the operation.The escape latency was much longer in improved 2-VO group and improved MCAO/R group than that in sham group(P<0.05)especially in improved 2-VO group.41 d after the operation,no difference between MCAO/R and sham group (P <0.05 ).The differences between improved 2-VO group and sham group remained significant(P<0.01 ),and difference between improved 2-VO group and improved MCAO/R group was significant(P<0.01 )at 41 d.The cross-over times in the target area in spatial probe test decreased more significantly in 2 model groups than in sham group. 41 d after the operation,improved MCAO/R group was not different from sham group(P<0.05). Search strategy results showed that swimming trajectory in the improved 2-VO groupwas mostly edge and random type,but was of tendency type and straight type in the improved MCAO/R group.In the organization structure of hippopal CA1 area of rats,the nu mber of cells was reduced,their arrange ment was sparse and chaotic,the morphology of cells was inco mplete,the structure of cells was abnormal, cytoplasmwasscarce,andnucleoliwereinconspicuous.CONCLUSION TwoimprovedVDmodelscan lead to behavior and pathological changes in rats.The i mproved 2-VO model,si mple and stable,is suitable for drug efficacy research.The improved MCAO/R model is the ideal short-term efficacy study.

Aim Tostudytheeffectsofechinacoside on striatal and hippocampus extracellular fluid of mono-amine neurotransmitter in Parkinsonˊs disease rat, and discuss the possible mechanism of the ECH effect on brainprotection.Methods Doublepointinjectionof 6-hydroxy dopamine damaged was adopted to make PD model, the corresponding drugs or normal saline were intraperitoneally injected for 4 consecutive weeks, mi-cro-dialysis program in double targets was taken after treatment, the dialysate was injected into HPLC-EDC, and striatal and hippocampus extracellular fluid of DA, DOPAC, HVA, NA, 5-HT levels of each group were measured. Results Compared with control group, striatal and hippocampus extracellular fluid of DA, DOPAC, HVA, NE, 5-HT levels were significantly re-duced in model group ( P <0. 01 ); compared with model group, striatal and hippocampus extracellular fluid of DA, DOPAC, HVA, NE, 5-HT levels were significantly increased in treatment group ( P <0 . 05 , P<0. 01 ) , and the content of five kinds of substances in ECH high dose group was similar to that in MD group.Conclusion ECHcouldincreaseextracellular monoamine neurotransmitters in striatum and hippo-campus, ECH has a therapeutic effect on PD, and echinacoside is possible mechanisms of the brain pro-tective effect of PD rats.

Aim To investigate the effects of echina-coside ( ECH ) on the learning and memory capacities and brain level of oxygen free radicals of rats with de-mentia induced by amyloid β-peptide. Methods Six-ty Sprague Dawley rats, weighing (300±10) g, were randomly divided with 10 rats pergroup into 6 groups:sham operated group, model, ECH high dose (40 mg ·kg-1·d-1), ECH middle dose (20 mg· kg-1· d-1), ECH low dose (10 mg·kg-1·d-1) and Hup A (Huperzine A, 0. 02 mg·kg-1·d-1) group. Mor-ris maze tests were conducted for evaluating the learn-ing and memory ability. Content of malondialdehyde (MDA), nitric oxide (NO) and activities of superox-ide dismutase ( SOD) and NO synthase ( NOS) in the hippocampus and cortex were detected. ResultsAβ25-35 induced significant learning and memory im-pairment in the rats. Compared with the rats in model group, those treated with ECH at different doses all manifested alleviation of learning and memory impair-ment ( P<0 . 01 , P<0 . 05 ) . Cotents of MDA of ECH treatment group were obviously decreased, while SOD activities were obviously increased, and significantly reduced the release of NO and NOS in the hippocam-pus and cortex brain tissue ( P <0 . 01 , P <0.05 ) . Conclusion ECH can enhance the learning and mem-ory ability in rats with AD, which is presumably relat-ed to accelerating the cleaning of oxygen free radicals and reducing oxidative stress in brain of AD rats.

Aim To investigate the protective effects of echinacoside ( ECH ) on oxidative stress injury in vascular dementia rats. Methods Vascular dementia model was duplicated by means of permanent ligation of bilateral common carotid artery at two times intervals for three days. Biochemical methods was used to detect the GSH, NO, GSH-Px, NOS in each group rat’ s cor-tex and hippocampus. The change of the tissue struc-ture in CA1 area of hippocampus in each group was ob-served and analyzed by microscope after HE staining. Results Compared with sham group, the content of GSH and activity of GSH-Px in the rats of the model group were decreased significantly ( P<0. 01 ) , while the content of NO and activity of NOS were increased obviously (P<0. 05, P <0. 01). Meanwhile, in tis-sue structure of rat’ s hippocampal CA1 area, the num-bers of cells were reduced, cell arrangement was sparse and in disorder, cell form was not intact and cell struc-ture was not normal, cytoplasm, nucleus and cyto-plasm were blurry, nuclei were hyperchromatic and in contraction, and were changed to triangular or irregular shape, lacking nucleoli, and proliferation of glial cells appeared. Compared with the model group, the content of GSH and activity of GSH-Px in the rats of the treat-ment groups were increased significantly ( P<0. 05 , P<0 . 01 ) , while the activity of NOS was decreased ob-viously (P<0. 05, P<0. 01). Meanwhile, in rat tis-sue structure of hippocampal CA1 area, the rat cells in each treatment group were arranged in order, the form of structure was normal, the nuclei were less hyper-chromatic and contracted. Compared with Gal group and sham group, the rats of ECH high dosage group were not different in every part of experiment ( P >0. 05 ) . Conclusion ECH exerts protection on oxida-tive stress injury in vascular dementia rats.

Objective To compare the clinical value of three visual rating scales (VRS) for white matter lesions (WML) in Alzheimer's disease (AD) and mild cognitive impairment (MCI).Methods Totally 184 subjects (including 107 AD patients,47 MCI patients and 30 normal controls)were recruited.All subjects underwent comprehensive neuropsychological tests and were examined with a standard protocol of MR imaging.WML burden was rated with the Age-Related White Matter Changes (ARWMC) rating scale,Cholinergic Pathways Hyperintensities Scale (CHIPS) and Fazekas scale.Consistence of the three rating scales were analyzed,and detection results of WML in AD/ MCI/NC group with the three rating scales were compared.The relationship between WML and cognitive function in AD and MCI groups were explored.Results ARWMC rating scale,CHIPS and Fazekas scales were moderately to highly correlated with WML (r=0.61-0.78,all P＜0.01).ARWMC showed that WML were in the left and right frontal lobes in AD and MCI groups and in the right frontal lobe and left temporal lobe in NC group,which had significant differences (F=4.20,4.69,4.69,3.36,respectively,all P＜0.05).WML in the left temporal lobe had a significant difference between MCI group and NC group (F=3.36,P＜0.05).CHIPS showed that WML in the front left side of centrum semiovale in AD and MCI groups had significant difference as compared with that in NC group (F=4.88,P＜0.05),and WML in the rear right side of low external capsule had a significant difference between AD and NC groups (F=3.04,P＜0.05).Fazekas scale showed that there was no difference in WML among AD,MCI and NC groups.ARWMC showed that scores of WML in right temporal lobe were positively correlated with concentration and visual construction,and bilateral basal ganglia were negatively correlated with the concentration.Fazekas scale showed that scores of WML in periventricular were negatively correlated with concentration,MMSE and orientation,scores of WML in deep white matter were negatively correlated with concentration,abstraction and judgment,and the whole scores were negatively correlated with concentration.CHIPS showed that the scores of WML in the rear left side of low external capsule were negatively correlated with short-term memory in MCI group.Conclusions The three rating scales well consistent with each other.ARWMC rating scale and CHIPS can detect the differences in WML between AD,MCI and NC groups.The scores of CHIPS in WML are related with cognition in MCI group,while scores of ARWMC and Fazekas scale in WML are correlated with many aspects in cognitive function in AD group.In general speaking,CHIPS in MCI patients and ARWMC rating scale in AD patients show more advantages in the detection of WML and have better correlation with cognitive function.