Objective To investigate the effect of tritiated water on the immune system of zebrafish and its potential molecular mechanism. Methods Zebrafish embryos (2.5 to 3 hours post-fertilization [hpf]) were exposed to 3.7 × 10⁴ Bq/mL tritiated water (tritiated water group), and those exposed to E3 culture medium were used as the control group. The mortality rate, hatching rate, deformity rate, heart rate, body length, yolk sac area, neutrophil count in the tail, immune-related gene expression, and immune-related protein expression of zebrafish in the two groups were determined. Then transcriptome technology was used to further analyze the possible mechanism of tritiated water affecting the immune system of zebrafish. Results Compared with the control group, zebrafish at 72 hpf in the tritiated water group had no significant changes in the mortality rate, hatching rate, deformity rate, body length, and yolk sac area((t = 0.9045, 0.5000, 1.0000, 0.7238, 0.0337, P = 0.4169, 0.6433, 0.3739, 0.4785, 0.9735), but had significantly increased heart rate(t = 4.575，P = 0.002). At 4 days post-fertilization (dpf), the neutrophil count in the tail of zebrafish in the tritiated water group was significantly increased(t = 2.563，P = 0.0196), the mRNA expression of TNF-α was significantly decreased(t = 2.891, P = 0.045), the protein expression of nuclear factor-kappa B (NF-κB) was significantly increased(t = 3.848, P = 0.018), and the protein expression of NLRP3 was significantly decreased(t = 14.98, P = 0.001). At 7 dpf, the neutrophil count in the tail and the protein expression levels of NF-κB, NLRP3, and interleukin-1β were significantly decreased(t = 3.772, 7.048, 15.620, 4.423, P = 0.014, 0.002, 0.0001, 0.012). Transcriptome sequencing revealed that differentially expressed genes were mainly enriched in the “neutrophil activation” and “platelet activation pathways” at 4 dpf and in the “neutrophil apoptosis”, “ferroptosis”, and “necroptosis” pathways at 7 dpf. Conclusion Tritiated water exposure induces a temporally dynamic immune response in zebrafish, potentially affecting immune homeostasis by regulating neutrophil activation and apoptosis, as well as the expression of NF-κB and NLRP3.

Objective To analyzes the current status and hot spots of nursing of adverse drug reactions in chemotherapy for cancer patients,and provides reference for future research.Methods Literature related to the nursing of chemotherapy adverse drug reactions in cancer patients from 2018 to 2022 was retrieved from CNKI,Wanfang and VIP databases,and statistical analysis was conducted using bibliometrics.CiteSpace information visualization software was used to describe and analyze high-frequency keywords and to describe their graphs.Results A total of 1112 literatures were included,distributed in 256 domestic journals,and 537 literatures were co-authored,with a co-authored rate of 48.29％.Gastrointestinal reaction,cancer-induced fatigue,traditional Chinese medicine nursing,evidence-based nursing,negative emotion are the hot issues in this field.Conclusion The future nursing intervention for adverse reactions of cancer patients should adopt evidence-based nursing method to develop intervention programs.The research in this field has the problems of small sample size and single institution.It is suggested that the cooperation between authors and institutions should be strengthened in the future research,so as to build a closer cooperation network and a stable cooperation group.To construct nursing intervention plan and effect evaluation criteria suitable for nursing of adverse reactions of chemotherapy drugs in cancer patients.To ensure the safety of the intervention process,we should actively carry out multidisciplinary collaboration.

Objective:To analyze the distribution of clopidogrel metabolism-related gene variability in Kawasaki disease (KD) children with coronary artery lesions (CAL) across different age groups and the impact of genetic variability on the efficacy of clopidogrel antiplatelet therapy.Methods:A retrospective cohort study was conducted. Clinical data were collected from 46 KD children with CAL who were hospitalized in the Cardiovascular Center of Children′s Hospital of Fudan University between January 2021 and August 2022 and were treated with clopidogrel, including gender, age, body mass index, course of KD, CAL severity grade, and baseline platelet count. According to their age, the children were divided into ≥2-year-old group and <2-year-old group. Their platelet responsiveness was assessed by adenosine diphosphate-induced platelet inhibition rate (ADPi) calculated via thromboelastography, and children were categorized into high on-treatment platelet reactivity (HTPR) and normal on-treatment platelet reactivity (NTPR) groups. Genotypes of CYP2C19, PON1 and ABCB1 were detected. The t test, one-way analysis of variance and Chi-square test were used for intergroup comparison. Results:Among the 46 KD children with CAL, 34 were male and 12 were female; 37 were ≥2-year-old and 9 were <2-year-old; 25 cases were in the HTPR group and 21 cases were in the NTPR group, with 19 HTPR and 18 NTPR in the ≥2-year-old group, and 6 HTPR and 3 NTPR in the <2-year-old group. Genetic analysis showed that 92 alleles among the 46 children, with frequencies of CYP2C19*1, CYP2C19*2, CYP2C19*3, CYP2C19*17, PON1 192Q, PON1 192R, ABCB1 3435C, ABCB1 3435T at 59% (54/92), 32% (29/92), 9% (8/92), 1% (1/92), 36% (36/92), 64% (59/92), 63% (58/92) and 37% (34/92), respectively. Analysis of the impact of genotype on ADPi revealed that in children aged ≥2 years, those with CYP2C19*1/*3 genotype had significantly lower ADPi than those with CYP2C19*1/*1 genotype ((34±15)% vs. (61±29)%, t=2.18, P=0.036). There were also no significant difference in ADPi among children with PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes ((40±22)% vs. (52±33)% vs. (65±27)%, F=2.17, P=0.130), or among those with ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((55±34)% vs. (60±27)% vs. (49±24)%, F=0.33, P=0.719). In <2-year-old group, there were no significant differences in ADPi across CYP2C19*1/*1, CYP2C19*1/*2 and CYP2C19*2*2 genotypes ((40±20)% vs. (53±37)% vs. (34±16)%, F=0.37, P>0.05). There were no significant differences in ADPi across CYP2C19*1/*1 and CYP2C19*1/*3 genotypes ((44±27)% vs. (42±20)%, t=0.08, P>0.05). There were no significant differences in ADPi across PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes (45% vs. (55±27)% vs. (24±5)%, F=1.83, P>0.05). There were no significant differences in ADPi across ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((36±16)% vs. (50±35)% vs. 45%, F=0.29, P>0.05). The risk analysis of HTPR in different genotypes revealed that in children aged ≥2 years, carrying at least 1 or 2 loss-of-function alleles of CYP2C19 was a risk factor for HTPR ( OR=4.69, 10.00, 95% CI 1.11-19.83, 0.84-119.32, P=0.033, 0.046, respectively), and PON1 192R homozygosity and carrying at least one PON1 192R allele were protective factors against HTPR ( OR=0.08, 0.13, 95% CI 0.01-0.86, 0.01-1.19, P=0.019, 0.043, respectively). Conclusion:KD children aged ≥2 years carrying CYP2C19 loss-of-function alleles and PON1 192Q are more likely to develop HTPR.

To explore the biological characteristics related to the pathogenesis and severity of respiratory syncytial virus (RSV) bronchiolitis by RNA sequencing of white blood cells in children with RSV bronchiolitis. This study is a case-control study. A total of 87 children diagnosed with bronchiolitis and RSV antigen positive and/or RSV nucleic acid positive in the pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to April 2022 were selected as the case group. The case group was divided into three groups based on the condition: mild, moderate, and severe, and there were two groups according to the presence or absence of atopic symptoms: the atopic group and the non -atopic group, forty healthy children in the same period were selected as the control group. The whole blood leukocyte RNA of the children in the case group and the control group was extracted for RNA sequencing, and the data were analyzed to obtain differentially expressed genes (DEGs). Then, the immunobiological pathways and genes related to the pathogenesis, disease condition, and atopy were screened through Gene Ontology (GO) annotation, Kyoto Gene and Genome Encyclopedia (KEGG) annotation, and protein interaction network (PPI) construction methods. Construct the weighted gene co-expression network analysis (WGCNA) module to identify potential biological indicators related to disease severity.Compared with the control group, the case group had a total of 1 782 DEGs, including 1 586 upregulated genes and 196 downregulated genes. The GO pathway enrichment of DEGs is mainly enriched in molecular functions such as peroxidase activity and oxidoreductase activity. In the cytological components, it is mainly enriched in cytoplasmic vesicle lumen and secretory granule lumen. In biological processes, it is mainly enriched in processes such as neutrophil activation involved in immune responses, neutrophil degranulation, and neutrophil activation. KEGG analysis is mainly concentrated in the signal pathway of the viral protein interaction with cytokine and cytokine receptor. A PPI network was constructed to screen four genes at the core position, including CCL2, IL-10, MMP9 and JUN. The DEGs obtained by comparing different disease groups with the control group are mainly enriched in retrograde endocannabinoid signaling and cell apoptosis pathways. WGCNA analysis showed that the brown module related to oxygen saturation was most closely related to the disease, and its gene was mainly enriched in the RNA helicase retinoic acid inducible gene-I (RIG-I) like receptor signal pathway. There are 230 specific DEGs in the atopic group and 444 in the non -atopic group. KEGG enrichment analysis results show that both groups are enriched to NF-κB signaling pathway, the characteristic does not cause significant changes in immune response and transcriptome characteristics in children with RSV bronchiolitis. In conclusion, neutrophil activation, degranulation pathway and signal pathway of interaction between viral protein and cytokine and cytokine receptor are involved in the immune response of RSV bronchiolitis host. CCL2, IL-10, MMP9 and JUN genes may be associated with the pathogenesis. They might be potential biomarkers related to disease severity in RIG-I like receptors, cell apoptosis, and endogenous cannabinoid related signaling pathways.

Objective To retrieve evidences on the assessment and management of post-stroke fatigue and summarise the best evidences.Method Evidence-based nursing was employed to systematically retrieve the literatures on assessment and management of post-stroke fatigue from both foreign and domestic databases,including BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence-Based Health Care Centre Database,American Guide Network,Scottish Intercollegiate Guide Network,Medlive,Cochrane Library,PubMed,CNKI and Wanfang Data.Joanna Briggs Institute(JBI)critical appraisal tool was used to assess the evidences retrieved from the databases.Results A total of two evidence-related summaries,five clinical practice guidelines and twenty systematic reviews were included.After evidence extraction and aggregation,three evidence-related themes were identified:assessment,behavioral intervention and health education and they comprised 18 pieces of best evidence on post-stroke fatigue.Conclusion This study summarised the best evidences for the assessment and management of post-stroke fatigue in patients.The best evidences provide nursing managers with valuable references in conducting evidence-based post-stroke nursing hence to prevent post-stroke fatigue and improve the quality of nursing care.

Purpose Focusing on the characteristics of for-malin fixed paraffin embedded(FFPE)samples,explored nano-magnetic bead nucleic acid extraction solutions with higher qual-ity/yield and continued to improve molecular pathology technolo-gy.Methods Alternative magnetic beads were synthesised in four major categories and 15 sub-categories and we screened to obtain high-quality/yield magnetic beads centred on FFPE samples.Simulated conventional tissues,simulated coarse needle punctures(liver),and simulated fiberoptic bronchoscopy sam-ples(lungs)were sectioned with the same number of serial slices in tubes.The nucleic acids of slices were extracted using the best magnetic beads screened in this study and common com-mercially available kits,and then perform comparison and purifi-cation quality parameters such as total amount and fragment size.The downstream applications of nucleic acids were validated by PCR and Sanger sequencing.Results Screening all homemade nanomagnetic beads centered on the DNA of FFPE samples,the total recoveries of the best performance nanomagnetic beads were obtained to be 58.5％±1.58％,and the total recoveries of five commercially available commercial magnetic beads and three do-mestic kit magnetic beads ranged from 18.68％to 40.71％.The total amount of DNA(ng)extracted from the same amount of tis-sue(serial slices),the nucleic acid yield of this study in simu-lated conventional tissues,simulated coarse needle punctures,and simulated fiberoptic bronchoscopy samples were increased by 39.49％-181.72％compared with those of the commercially a-vailable kits(P＜0.05).The total amount of extracted nucleic acid from simulated fiberoptic bronchoscopy tissue sections can be more than 100 ng for 1 slice(4 μm)and more than 400 ng for 5 slices.Conclusion The DNA purification nanomagnetic beads screened with DNA from FFPE samples have a significant enhancement comparing to the existing commercial bead proto-cols,and provide space for quality assurance,automated testing,and program expansion for clinical molecular pathology testing.

Objective:To explore the effect of Jian-Pi-Zhi-Dong decoction on autonomous activity and dopamine (dopamine, DA) synaptic vesicle protein expression in the striatum of Tourette syndrome (TS) model rats.Methods:The 4-week-old male SD rats were used to establish the TS model by intraperitoneal injection of N-aminodipropionate. Thirty successfully modeled rats were randomly divided into model group, Chinese medicine group, and tiberide group according to random number table method, with 10 rats in each group. And another 10 rats with matched body mass were selected as the control group. Rats in Chinese medicine group were given Jian-Pi-Zhi-Dong decoction solution (1.6 g/100 g) and the rats in tiapride group were given sulfate tiapride suspension (2.1 mg/100 g), while rats in control group and model group were given an equal volume of 0.9% sodium chloride solution, once a day for 4 weeks.The number of autonomous activities in rats was determined by autonomous activity programmer. ELISA was used to detect the level of DA in the striatum of rats and the expression of dopamine transporter (DAT).Vesicular monoamine transporter-2 (VMAT2) and α-synuclein (α-syn) were measured by Western blot.SPSS 25.0 software was used for data analysis. Multiple group comparisons were performed using one-way ANOVA, non-parametric test and repeated measures ANOVA.Results:Comparing the number of autonomous activities among the 4 groups, the interaction effect between time and group was significant ( F=184.354, P<0.001). At the 1-4 weeks of gavaging, the numbers of autonomic activities in the model group were more than those in the control group (all P<0.05).While the numbers of autonomic activities in Chinese medicine group and tiapride group were less than those in the model group (all P<0.05). Moreover, the numbers of autonomic activities in Chinese medicine group and tiapride group from 1 to 4 weeks were less than those after model making (all P<0.05). The Western blot results showed significant differences in the relative expression of α-syn ( H=29.098), DAT ( F=54.632) and VMAT2 ( H=18.982) among the 4 groups (all P<0.001). The expression levels of α-syn protein in Chinese medicine group and tiapride group were both lower than that in the model group (0.39(0.36, 0.51), 0.39(0.36, 0.50), 0.62(0.50, 0.70)) (both P<0.05). The expression level of DAT protein in Chinese medicine group was higher than that in the model group and lower than that in tiapride group ((0.37±0.06), (0.26±0.07), (0.49±0.09)) (both P<0.05). And the expression level of VMAT2 protein in Chinese medicine group had no significant difference compared with that in the model group ( P>0.05).The ELISA results showed significant differences in DA content of striatum among the 4 groups ( F=75.370, P<0.001). The level of DA in the model group was higher than that in the control group ((7.65±0.72) ng/L, (3.71±0.59) ng/L, P<0.05). The levels of DA in Chinese medicine group ((3.92±0.81) ng/L) and tiapride group ((4.40±0.53) ng/L) were lower than that in the model group (both P<0.05), and the difference between Chinese medicine group and tiapride group was not significant ( P>0.05). Conclusion:Jian-Pi-Zhi-Dong decoction can relieve the tic symptoms of the model rats with TS, and its mechanism may be related to inhibiting the excessive release of α-syn, improving the expression of DAT and VMAT2, improving the DA synaptic vesicle circulation, and reducing the DA content in the synaptic space of the brain.

Objective:To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics.Methods:A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline.Results:(1) CO ( r=0.155, P<0.001), TFC ( r=0.338, P<0.001), MAP ( r=0.204, P<0.001), and HR ( r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation ( r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age ( r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR ( P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy ( P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions:The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.

Objective To analyze the hot spots and trends of digital intelligence technology research in intensive care unit(ICU).Methods ICU digital intelligence technology related literature collected in Web of Science core database,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform were searched,and the retrieval period is from the establishment of the database to December 12,2023,and visualized analysis was performed by CiteSpace software.Results 700 Chinese literatures and 1705 English literatures were included.Conclusion A total of 18 clusters were formed in Chinese literature,including smart phones,data mining,ventricular premature beats,sepsis,etc.A total of 17 clusters were formed in English literature,including deep learning,expert systems,natural language processing,physiological characteristics,etc.Among them,risk prediction model and clinical decision support are the trends of future research.Conclusion By broadening the scope of diseases and populations,joint artificial intelligence research and development of wearable devices and intelligent detection cloud systems,robots,etc.,is the development trend of the future application field of ICU digital intelligence technology.

Objective:To explore the relationship among ruminating,affiliate stigma and post-traumatic growth in parents of autistic children.Methods:Totally 339 parents of autistic children were selected.The Affiliate Stigma Scale(ASS),Post-traumatic Growth Inventory(PTGI),ERRI Intrusive Subscale(ERRI-I)and ERRI De-liberate Subscale(ERRI-D)of Event Related Rumination Inventory(ERRI)were used to measure affiliate stigma,post-traumatic growth,intrusive ruminating and deliberate ruminating.SPSS macro program PROCESS was used to test the mediating role.Results:There were positive correlations among the scores of ASS,ERRI-I and ERRI-D(r=0.39-0.72,Ps＜0.01).The PTGl scores were negatively correlated with ASS scores(r=0.26,Ps＜0.01)and positively correlated with ERRI-D scores(r=0.10,Ps＜0.05).The ERRI-D scores played a partial mediating role in the relationship between ASS and PTGl scores(95％CI:0.01-0.07).The ERRI-I scores and ERRI-D scores played a serial mediating role in the relationship between ASS and PTGI scores(95％CI:0.03-0.14).Both me-diation paths had suppression effect.Conclusion:In the negative correlation between affiliate stigma and post-trau-matic growth in parents of autistic children,the deliberate ruminating plays a partial mediating role,while intrusive ruminating and deliberate ruminating play a serial mediating role.