Objective: To analyze the implementation status and challenges of sex education in special education schools, so as to provide a scientific basis for formulating effective promotion strategies. Methods: From November 2023 to January 2024, a census survey was conducted among 120 in service teachers from 7 special education schools in Luzhou. The questionnaire covered the current status of sex education in schools, teachers attitudes and knowledge toward sex education, and their coping methods for students inappropriate sexual behaviors. Results: About 77.5% of teachers reported having provided sex education to students, but 93.2% indicated a lack of specialized sex education textbooks for special children, 90.4% reported no full time teachers for sex education, and the methods of sex education were relatively limited (50.0% mainly based on lecture method). Nearly 95.8% of teachers held a positive attitude toward sex education, with 98.3% supporting its implementation. Only 26.7% of teachers demonstrated a good grasp of sex education knowledge, with the best understood topic being "recognition and protection of private parts" (21.6%). When dealing with students inappropriate sexual behaviors, the active response rate of teachers was 23.9%, with the highest active response rate observed for "intentionally hugging or kissing the opposite sex" (39.7%). Conclusions The special education schools in Luzhou lack comprehensive sex education curricula, teaching materials and full time teachers, sufficient knowledge among teachers, and adequate proactive responses to students inappropriate sexual behaviors. Greater emphasis should be placed on sex education for special children, including the training of dedicated teachers, to provide comprehensive and high quality sex education services for special children.

Ulcerative colitis （UC）， a chronic， non-specific inflammatory bowel disease with typical symptoms such as abdominal pain， diarrhea， and bloody stools， demonstrates a high relapse rate and difficulty in curing. Sishenwan， first recorded in Internal Medicine Abstract （Nei Ke Zhai Yao）， are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney， and astringing the intestine and stopping diarrhea. In recent years， Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors， including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term， its side effects， high relapse rate， and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan， used alone or in combination with Western medicine or other Chinese medicine compound prescriptions， significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus， pus， and blood in stools， and persistent abdominal pain， reduce Mayo scores and the relapse rate， and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen， isopsoralen， and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level， Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future， a full-chain system covering syndrome differentiation， targeting， and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics， providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.

Ulcerative colitis （UC）， a chronic， non-specific inflammatory bowel disease with typical symptoms such as abdominal pain， diarrhea， and bloody stools， demonstrates a high relapse rate and difficulty in curing. Sishenwan， first recorded in Internal Medicine Abstract （Nei Ke Zhai Yao）， are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney， and astringing the intestine and stopping diarrhea. In recent years， Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors， including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term， its side effects， high relapse rate， and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan， used alone or in combination with Western medicine or other Chinese medicine compound prescriptions， significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus， pus， and blood in stools， and persistent abdominal pain， reduce Mayo scores and the relapse rate， and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen， isopsoralen， and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level， Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future， a full-chain system covering syndrome differentiation， targeting， and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics， providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.

Objective To observe the effects of different virulence types of Helicobacter pylori on pepsin and inflammatory factors.Methods 110 patients admitted from December 2021 to March 2023 were collected and divided into HP positive group(n=79)and HP negative group(n=31)according to 13 carbon breath test results.The HP positive group was divided into type Ⅰ group(n=52),type Ⅱ group(n=11)and undetermined group(n=16)according to the Helicobacter pylori antibody typing.The HP negative group was selected and divided into blank control group(n=12).Gastric juice pH value,sodion(Na+),potassium(K+),chloridion(Cl-),IL-6,IL-8,gastrin 17(G-17),pepsinogen Ⅰ(PG Ⅰ)and pepsinogen Ⅱ(PG Ⅱ)were detected in all patients.Results Th-ere was no difference in pH,Na+,Cl-,K+ between Hp positive group and Hp negative group(P>0.05).The content of Cl-in HP-positive group was lower than that in HP-negative group(P<0.05).The levels of IL-6,IL-8,G-17,PG Ⅰ and PG Ⅱ in HP-positive group were significantly higher than those in HP-negative group(P<0.05).There was no significant difference in pH,Na+ and K+ between type Ⅰ group and type Ⅱ group,undetermined group and blank control group(P>0.05).The content of Cl-in type Ⅰ group and undetermined group was lower than that in blank control group(P<0.05).The levels of IL-6,IL-8 and PG Ⅰ in type I group were higher than those in type Ⅱ group,undetermined group and blank control group(P<0.05).There was a significant difference in PG Ⅱ between the blank control group and the other groups(P<0.05).There was no difference in G-17 content between type Ⅰ group and undetermined group(P>0.05).The level of G-17 in type I group was higher than that in type Ⅱ group and blank control group(P<0.05).Conclusion Type I Hp infection may cause gastric mucosal injury by increasing the expression of IL-6,IL-8 and G-17,and then lead to abnormal digestive function.

BACKGROUND:Periodontitis is an inflammatory and destructive disease with plaque biofilm as the main pathogenic material,which occurs in the gingiva,periodontal ligament,alveolar bone and cementum.The antigen of bacterial complex and its secreted toxin and enzyme directly lead to the destruction of periodontal tissue and trigger the host's immune response,causing indirect damage to the body tissue.Silence information regulatory factors(Sirtuins,SIRTs)play an important role in anti-aging,anti-oxidative stress,regulating inflammation,and mediating autophagy,and are closely related to the occurrence and development of periodontitis. OBJECTIVE:To review the research status of Sirtuins in periodontitis. METHODS:The first author used the computer to search the relevant research regarding the role of Sirtuins in periodontitis in PubMed,Web of Scene,CNKI and WanFang databases.The key words were"Sirtuins,Sirtuin1-7,periodontitis"in English and Chinese.After literature screening,57 articles were included for review and analysis. RESULTS AND CONCLUSION:SIRT1,SIRT2,SIRT3,and SIRT6 participate in regulating the occurrence and development of periodontitis.Inhibition of SIRT1 expression may be the target of periodontitis treatment,while overexpression of SIRT1 can inhibit periodontitis and protect periodontal tissue.The activator of SIRT1 can reduce the inflammation of periodontal tissue and improve the systemic pathological changes caused by periodontitis.SIRT2 is involved in nicotinamide phosphoribosyltransferase-mediated periodontal inflammation and plays a role in the treatment and prognosis of periodontal diseases.SIRT3 can improve age-related periodontal disease.Gastrodin promotes the osteogenic differentiation of periodontal ligament stem cells through the up-regulation of SIRT3.The activator of SIRT3 reduces the damage of periodontitis to periodontal and renal tissues by regulating the level of autophagy in the cells.SIRT6 can inhibit the inflammatory reaction of periodontal tissue and inhibit the differentiation and mineralization of cementoblasts.SIRT6 is beneficial to the prognosis of periapical periodontitis.The relationship between SIRT4,SIRT5,SIRT7 and periodontitis is rarely reported.

Objective:To evaluate the safety and efficacy of tumor-treating fields (TTFields) and chemoradiation in patients with high-grade glioblastoma.Methods:Clinical data of 38 patients admitted to the Jiangsu Cancer Hospital from September 2021 to May 2023 who were diagnosed with high-grade glioblastoma (36 cases of World Health Organization grade Ⅳ and 2 cases of grade Ⅲ) were retrospectively analyzed. All patients received TTFields combined with concurrent chemoradiation after surgery. Response assessment in neuro-oncology (RANO) criteria was used to evaluate the glioma responses as tumor remission, stable or progression. Common terminology criteria for adverse events v5.0 and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Treatment compliance was assessed by data on the NovoTTF-200A therapeutic device, calculated as a percentage of daily TTFields usage time. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test.Results:The median duration of treatment with TTFields in 38 patients was 20 h (rang: 2.4-22.6 h), and the median treatment compliance was 83% (range: 10%-94%). After 42 days of TTFields combined with concurrent chemoradiation, 12 patients who underwent complete tumor resection were assessed as stable according to RANO criteria. Among the 26 patients who underwent partial tumor resection, 23 (88%) were evaluated as disease remission according to RANO criteria. The 7-, 10-, 13-month progression-free survival rate was 81.0%、64.0%、49.5%, repectively. The common adverse events included grade 1 (45%) and grade 2 (8%) dAE, without grade 3-4 dAE. Typical presentations included contact dermatitis, blisters, lesions or ulcers, and abscesses. The median follow-up time was 10.0 months (range: 1.6-21.3 months). At follow-up as of July 2023, 26 of the 38 patients were stable and 12 had disease progression (8 died).Conclusion:The preliminary results show that TTFields combined with chemoradiation is effective, safe and reliable treatment for high-grade glioblastoma.

Over the years of exploration and development, the surgical techniques and prognosis of liver transplantation in China have been significantly improved, resulting in a notable decrease in the prevalence of postoperative complications. However, ischemic-type biliary lesion remain a non-negligible issue. The Third Affiliated Hospital of Sun Yat-sen University formulated and published the "Expert Consensus on the Diagnosis and Treatment of Ischemic-Type Biliary Lesions after Liver Transplantation in Mainland China" in 2015, which has now been updated into a guideline based on current conditions and literature reports. This guideline elaborates in detail on the definition, incidence, pathogenesis, diagnosis, prevention of high-risk factors, and treatment of ischemic-type biliary lesion, aiming to provide standardized and normative guidance for the diagnosis and treatment of ischemic-type biliary lesion after liver transplantation, thereby reducing the rate of re-transplantation and fatality, and to improve the overall quality of life of liver transplant recipients.

Background Cyclic AMP response element binding protein (CREB) and miR-132-3p have been proved to be related to many neurodegenerative diseases. Our research group previously has demostrated that the neurotoxicity of aluminum is relevant to abnormal phosphorylation of tau protein, but whether aluminum affects the abnormal phosphorylation of tau protein through GREB and miR-132-3p has not been reported yet . Objective To investigate the effect of aluminum on CREB and miR-132-3p during abnormal phosphorylation of tau protein in rat hippocampus. Methods Twenty-eight two-month-old SD rats with comparable weigh, were randomly assigned to four groups: control group (saline) and low, middle, and high dose exposure groups [10, 20, and 40 μmol·kg⁻¹ Al(mal)₃] with each group containing 7 rats, and the exposure period was 3 months by intraperitoneal injection every other day. After rats’ exposure to aluminum, Morris water maze was employed to assess their capabilities of learning and memory. The miR-132-3p gene expression level was detected by quantitative real-time PCR (qRT-PCR). The levels of CREB, phosphorylated CREB (p-CREB) (Ser133), RAS p21 protein activator 1 (RASA1) tau, and p-tau (Ser396) proteins were determined by Western blot. Results The results of Morris water maze showed that in the navigation experiment (from first day to the fifth day), the average escape latency of the rats exposed to three doses of aluminum was longer than that of the control rats (P<0.05). The middle dose group and the high dose group demonstrated shorter duration and lower frequency of platform traversal in the designated quadrant when compared to the control group and the low dose group (P<0.05). Moreover, the duration in the target quadrant of the rats exposed to high dose aluminum was shorter than that of the rats exposed to medium dose aluminum (P<0.05). The results of Morris water maze suggested that aluminum could damage the learning and memory ability of rats. The qRT-PCR findings indicated a decline in miR-132-3p gene expression in rat hippocampus correlating with higher Al(mal)₃ dose (P<0.05). The Western blot test showed that the protein expressions of CREB and p-CREB (Ser133) were reduced in both the middle dose group and the high dose group (P<0.05) when compared to the control group and the low dose group, and likewise, compared to the control group, the group receiving low dose exhibited lower level of p-CREB (Ser133) protein expression (P<0.05). It was found that the further increase of aluminum exposure dose would lead to the further decrease of CREB and p-CREB (Ser133) protein expression levels (F=36.429, P<0.001; F=78.672, P<0.001), aluminum exposure dose was negatively correlated with the expression levels of the two proteins (r=−0.848, P<0.001; r=−0.928, P<0.001). The expression levels of RASA1 protein and tau protein in the aluminum exposure groups surpassed those in the control group (P<0.05). The tau protein phosphorylation level was higher in the middle dose group than in the control group (P<0.05), while the high dose group showed elevated phosphorylation level relative to the control group, the low dose group, and the middle dose group (P<0.05). Conclusion Aluminum may promote abnormal phosphorylation of tau protein by affecting CREB and miR-132-3p, which eventually leads to the impairment of learning and memory ability.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

At present, most surgeons use release and subcutaneous transposition of the ulnar nerve to treat cubital tunnel syndrome (CuTS). However, subcutaneous transposition of the ulnar nerve is not effective enough and leads to a high rate of recurrence in clinic when CuTS is complicated with elbow osteoarthritis (EOA). Therefore, an appropriate surgical treatment should be adopted as early as possible if the symptoms are not relieved by a conservative treatment in cases of EOA complicated with CuTS. Different surgical methods lead to different physiological environments of the ulnar nerve, resulting in different outcomes. As a result, the recurrence rate of subcutaneous transposition motion is higher in patients with EOA. Surgical submuscular transposition of the ulnar nerve under the muscle significantly reduces its angular formation during elbow flexion, provides it with a more favorable biological environment and a better anatomical position, benefits the vascular reconstruction and regeneration of the injured nerve, and reduces its chance of secondary entrapment, leading to a better prognosis and a lower recurrence rate. This literature review evaluates the surgical methods for patients with CuTS plus EOA in an attempt to provide helpful references for their treatment.