Objective:To compare the therapeutic efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old.Methods:A retrospective study was conducted to analyze the data of 39 patients aged 65 to 75 years old who had been treated for femoral neck fractures at Department of Trauma Surgery, Hospital Affiliated to Qingdao University from January 2015 to September 2022. The patients were divided into 2 groups according to their internal fixation methods. In the FNS group of 18 cases subjected to FNS fixation, there were 8 male and 10 females with an age of (71.1±2.8) years. In the CCS group of 21 cases subjected to CCS fixation, there were 7 males and 14 females with an age of (70.1±2.9) years. The 2 groups were compared in terms of intraoperative fluoroscopy frequency, surgical time, intraoperative bleeding, hospitalization costs, fracture healing time, internal fixation failure, and Harris hip score, changes in neck shaft angle, and femoral neck shortening at 1 year after surgery.Results:The differences were not statistically significant in the preoperative general data or follow-up time between the 2 groups, indicating comparability ( P>0.05). In the FNS group, the intraoperative fluoroscopy frequency [(15.1±2.3) times] was significantly lower than that in the CCS group [(19.5±3.5) times], the surgical time [(49.2±5.2) minutes] was significantly shorter than that in CCS group [(62.4±11.2) minutes], and the intraoperative bleeding [(74.2±15.6) mL] and hospitalization costs [(39,928.7±1,438.3) yuan] were significantly higher than those in the CCS group [(53.1±17.3) mL and (23,527.9±2,126.3) yuan] (all P<0.05). The difference in fracture healing time was not statistically significant between the 2 groups ( P>0.05). In the FNS group, the decreased neck shaft angle (2.65°±1.66°) and femoral neck shortening (3.9±1.3 mm) were significantly smaller than those in the CCS group [4.18°±2.13° and (6.3±2.5) mm] at 1 year after surgery, and the Harris hip score [(82.2±7.2) points] was significantly higher than that in the CCS group [(76.4±5.9) points] (all P<0.05). Internal fixation failure occurred in 1 case in the FNS group and in 4 cases in the CCS group, respectively, showing no statistically significant difference ( P>0.05). Conclusions:Compared with CCS fixation, FNS fixation may lead to better therapeutic efficacy in patients with femoral neck fracture aged 65 to 75 years old. However, the risk of internal fixation failure should also be taken into consideration.

A novel amide alkaloid,bursatamide A(1),featuring an unprecedented propyl-hexahydronaphthalene carbon frame-work,was isolated from the infrequently studied sea hare Bursatella leachi,alongside a new 3-phenoxypropanenitrile alkaloid,bursatellin B(2),and twelve known compounds.The structures of 1 and 2 were elucidated through comprehensive spectroscopic data analyses,while their relative and absolute configurations(ACs)were established through total synthesis and a series of quantum chem-ical calculations,including calculated electronic circular dichroism(ECD)spectra,optical rotatory dispersion(ORD)methods,and DP4+probability analyses.Bursatamide A(1)demonstrated inhibitory effects against the human pathogenic bacteria Listeria monocyt-ogenes and Vibrio cholerae.Erythro-bursatellin B(21),a diastereoisomer of 2,exhibited notable antibacterial activity against the fish pathogenic bacterium Streptococcus parauberis FP KSP28,with an MIC90 value of 0.0472 μg·mL-1.

Objective To predict the potential mechanism of Punicalagin in the treatment of Inflammatory bowel disease by network pharmacology.Methods The intersection genes of Punicalagin and IBD were obtained from the database,and PPI,GO and KEGG pathways were enriched and analyzed.Punicalagin and the target were verified by molecular docking.C57BL/6J mice were drunk dextran sulfate sodium to establish inflammatory enteritis model,and were given Punicalagin for 7 d of intervention.During the administration,signs of mice in each group were observed,daily disease activity index was calculated;Intestinal permeability test after administration;The colon tissue was stained with hematoxylin eosin to observe the pathological changes and calculate the histological damage score;Detection of tumor necrosis factor(TNF-α),Interleukin-10(IL-10),myeloperoxidase(MPO),chemokine 1(CXCL1)and other cytokines in colon tissue of mice by ELISA.Detection of TNF-α,IL-6,MPO and CXCL1 level in mouse serum by ELISA.CCK8 method was used to determine the effect of Punicalagin on the proliferation activity of caco-2 cells.The levels of cytokines released by caco-2 cells induced by lipopolysaccharide(LPS)were detected by ELISA.Results 14 common targets of Punicalagin and IBD were obtained,including tumor necrosis factor(TNF),arachidonic acid-5-lipoxygenase(ALOX5)and vascular endothelial growth factor A(VEGFA).KEGG enrichment analysis predicted that the treatment of IBD by Punicalagin mainly acted on arachidonic acid signaling pathway,age-rage signaling pathway,VEGR signaling pathway and Ras signaling pathway.Molecular docking showed that Punicalagin had good docking activity with TNF receptor.Compared with the model group,the decreasing range of body mass in Punicalagin group abated(P<0.01);the disease activity index of Punicalagin group decreased significantly(P<0.01);The congestion and edema of colonic mucosa were significantly reduced,and the histological injury score was significantly reduced(P<0.01);The level of TNF-α,IL-1β,MPO,CXCL1,IL-6,IL-18,IFN-γ in colon tissue was significantly decreased(P<0.01);20-300 μmol·L-1 Punicalagin promoted caco-2 cell proliferation and inhibited TNF-α secretion induced by LPS,up-regulation of IL-10 levels.Conclusion Punicalagin inhibits the secretion of TNF-α and other proinflammatory factors,up-regulation of the level of anti-inflammatory factor IL-10,and improvement of colonic inflammatory response in IBD mice.

Background: Long non-coding RNAs (lncRNAs) have been illustrated to contribute to the development of gestational diabetes mellitus (GDM). In the present study, we aimed to elucidate how lncRNA taurine upregulated gene 1 (TUG1) influences insulin resistance (IR) in a high-fat diet (HFD)-induced mouse model of GDM. Methods: We initially developed a mouse model of HFD-induced GDM, from which islet tissues were collected for RNA and protein extraction. Interactions among lncRNA TUG1/microRNA (miR)-328-3p/sterol regulatory element binding protein 2 (SREBP-2) were assessed by dual-luciferase reporter assay. Fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), HOMA pancreatic β-cell function (HOMA-β), insulin sensitivity index for oral glucose tolerance tests (ISOGTT) and insulinogenic index (IGI) levels in mouse serum were measured through conducting gain- and loss-of-function experiments. Results: Abundant expression of miR-328 and deficient expression of lncRNA TUG1 and SREBP-2 were characterized in the islet tissues of mice with HFD-induced GDM. LncRNA TUG1 competitively bound to miR-328-3p, which specifically targeted SREBP-2. Either depletion of miR-328-3p or restoration of lncRNA TUG1 and SREBP-2 reduced the FBG, FINS, HOMA-β, and HOMA-IR levels while increasing ISOGTT and IGI levels, promoting the expression of the extracellular signal-regulated kinase (ERK) signaling pathway-related genes, and inhibiting apoptosis of islet cells in GDM mice. Upregulation miR-328-3p reversed the alleviative effects of SREBP-2 and lncRNA TUG1 on IR. Conclusion Our study provides evidence that the lncRNA TUG1 may prevent IR following GDM through competitively binding to miR-328-3p and promoting the SREBP-2-mediated ERK signaling pathway inactivation.

Objective:To investigate the clinical efficacy of Tofacitinib combined with leflunomide in the treatment of rheumatoid arthritis (RA) and its effects on Janus Kinase (JAK)/signal transduction and activator of transcription (STAT) signaling pathway-related proteins and Matrix metalloproteinase levels in serum of patients with RA.Methods:This was a prospective case-control study. A total of 80 patients with RA in our hospital from March 2020 to September 2021 were included into the study. They were divided into observation group and control group by random number table method, with 40 cases in each group. The patients in observation group were treated with Tofacitinib combined with leflunomide, while the patients in control group were treated with leflunomide alone. After 12 weeks of continuous treatment, the curative effect of the two groups was observed. Typical clinical manifestation [including Visual analogue scale (VAS) score of joint pain, number of tenderness joints, number of swollen joints, time of morning stiffness], disease activity score uses 28 joint counts (DAS28) scores, the MOS item short from health survey (SF-36) total scores and serum JAK3, STAT3, interleukin (IL)-6, IL-17 and matrix metalloproteinase (MMPs) levels were compared between the two groups before and after treatment. The adverse effects of the two groups were also analyzed. Chi-square test, paired sample t test, independent sample t test and Fisher exact probability method were used for statistical analysis. Results:After 4, 8 and 12 weeks of treatment, the american college of rheumatology (ACR)20 compliance rates in the observation group were 37.5%(15/40), 62.5%(25/40) and 80.0%(32/40), respectively, which were significantly higher than those in the control group at the same period [17.5%(7/40), 37.5%(15/40), 57.5%(23/40); χ2=4.01, P=0.045; χ2=5.00, P=0.025; χ2=4.71, P=0.030]. After 8 and 12 weeks of treatment, the ACR50 compliance rates in the observation group were [35.0%(14/40) and 47.5%(19/40), respectively, which were significantly higher than those in the control group at the same period 15.0%(6/40) and 20.0%(8/40), χ2=4.27, P=0.039; χ2=6.76, P=0.009]. After treatment, the joint pain VAS score, number of tenderness joints, number of swollen joints, DAS28 scores and SF-36 total scores in the observation group were lower than those in the control group( t=5.55, P<0.001; t=9.98, P<0.001; t=11.77, P<0.001; t=4.50, P<0.001; t=5.28, P<0.001), and time of morning stiffness was shorter than that in the control group ( t=4.76, P<0.001). After treatment, The serum levels of JAK3, STAT3, IL-6, IL-17, MMP-3, MMP-9 and MMP-13 in the obser vation group were (2 354±476) pg/ml, (1.04±0.17) ng/ml, (12.4±2.8) pg/ml, (30±5) pg/mL, (65±14) μg/L, (76±12) μg/L, (11.5±1.8) μg/L, which were lower than those in control group [(2 715±584) pg/ml (1.22±0.29) ng/mL, (16.8±3.6) pg/ml, (40±7) pg/ml, (98±15) μg/L, (123±20) μg/L, (14.9±2.8) μg/L, t=3.03, P<0.05; t=3.39, P<0.05; t=6.10, P<0.05; t=7.35, P<0.05; t=10.17, P<0.05; t=12.74, P<0.05; t=6.46, P<0.05]. The adverse reaction rate of the observation group [35.0%(14/40)] had no statistically significant difference compared with that in the control group [27.5%(11/40)]( χ2=0.52, P=0.469). Conclusion:The overall effect of Tofacitinib com bined with leflunomide in the treatment of RA is satisfactory and it is a safe and effective way to improve the clinical manifestation, disease activity and quality of life of patients with RA. The effect may be related to the significant down-regulation of the expression levels of Serum JAK/STAT signaling pathway-related Proteins and MMPs.

Teaching practice is an important link in the process of postgraduate training. This paper analyzes the current situation and existing problems of postgraduate teaching practice, and discusses the influence of new teaching practice mode on postgraduate training. Aiming at the problems existing in the teaching practice of postgraduate students, this paper carries out the reform from five aspects: subject course learning, teaching preparation, theoretical teaching, experimental teaching participation and teaching management participation, and evaluates the implementation effect of the reform. Through the reform of postgraduate teaching practice, the teaching ability and social competitiveness of postgraduate students have been effectively improved. The new teaching practice mode provides new ideas and methods for the cultivation of postgraduate students' teaching ability.

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Summary: Structural nasal obstruction（SNO） is a series of diseases caused by congenital or acquired structural anatomical abnormalities of nasal airway and its surrounding tissues, which leads to increased nasal ventilation resistance. The effect of medication drugs for SNO is poor and surgical intervention is often needed. However, the abnormal structure of nasal airway is very complex, including the periphery of nasal airway, internal nasal airway, the front and rear of nasal airway and complex factors. These abnormal structures may interfere with the nasal airflow mechanics by changing the nasal ventilation volume and disrupting the symmetry of the bilateral nasal cavity, and finally lead to subjective feeling of nasal obstruction. In addition, the structure of nasal airway has plasticity. After the abnormal structure appears, the corresponding compensation of nasal airway can occur to ensure normal nasal ventilation and bilateral nasal cavity symmetry. Therefore, the SNO is the result of the failure of nasal airway remodeling after the appearance of abnormal structures. The etiology of SNO is complex, involving original structural abnormalities, nasal symmetry changing and nasal airway structure remodeling. Therefore, accurate identification of the main factors leading to SNO is the vitalpremise of making personalized nasal ventilation surgery.

Objective:To analyze HIV testing behaviors and associated factors in men who have sex with men (MSM) and provide evidence for making intervention on promoting HIV testing.Methods:Our observational study was conducted between April and June, 2018 in Wuxi, Jiangsu province in MSM. A self-completed questionnaire was used to collect the information about their socio-demographic characteristics, sexual behaviors, acceptance of intervention services, psychological status and HIV testing behaviors. Structural equation model (SEM) was chosen to fit data and the model was modified to analyze the relationships between variables.Results:A total of 410 MSM were enrolled in our study, among whom 72.9%(299/410) were aware of the necessity of HIV testing and 69.0%(283/410) reported having HIV tests in the last year. A modified structural equation model presented good fitting results with fitting index of root mean square error of approximation (RMSEA)was 0.065, normed fit index (NFI) was 0.946, relative fit index (RFI) was 0.922, Tucker-Lewis index (TLI) was 0.968 and comparative fit index (CFI) was 0.952. Results of SEM showed that intervention service was the factor with the largest standardized total effect value of 0.57 associated with HIV testing behaviors among MSM. Among intervention services, HIV testing reminding had the biggest factor loading of 0.88. Psychological status scores played a negative role in HIV testing behaviors among MSM with the path coefficient value of -0.33.Conclusions:The awareness and testing rate of HIV among MSM population need to be further improved. While effective measures are implemented to promote HIV testing among MSM, more attention should be paid to the mental health problems of MSM.

OBJECTIVE： To establish a method for simultaneous determination of α-pinene， β-pinene， limonene and α-terpineol in volatile oil of Forsythia suspensa. METHODS： GC method was adopted. The determination was performed on HP-5 capillary column through temperature-programmed route. The inlet temperature was 230 ℃， and detector temperature was 250 ℃； split sampling was applied （split ratio of 8 ∶ 1）； the air flow rate was 300 mL/min， the hydrogen flow rate was 30   mL/min， the tail gas flow rate was 30 mL/min， and the injection volume was 1 μL. Using limonene as internal reference， relative correction factors of α-pinene， β-pinene and α-terpineol were established， and the reproducibility of relative correction factors were investigated by using different chromatographs and columns， and chromatographic peak location of components was measured. The contents of above components were calculated with QAMS， and then compared with the results of external standard method. RESULTS： The linear range of α-pinene， β-pinene， limonene and α-terpineol were 16.5-990.0， 38.1-2 287.5， 8.2-491.2， 2.4-142.5  μg/mL， respectively （r≥0.999 1）. RSDs of precision， reproducibility and stability tests were all lower than 3％ （n＝6）. Average recoveries were 99.7％-105.5％（RSD＜4％，n＝9）. Compared with limonene （1.00），the average relative correction factors of α-pinene， β-pinene and α-terpineol were 0.91，0.86 and 1.11（n＝3）； relative retention time were 0.69-0.74， 0.81-0.86， 1.25-1.35（RSD＜3％，n＝3）. By using different chromatographs and columns， RSDs of relative correction factors were 0.21％-4.65％（n＝6）. Compared with external standard method， determination results of above 4 components were consistent （the absolute value of relative error were all less than 7％）. CONCLUSIONS： QAMS can be used for simultaneous determination of 4 kinds of effective components in volatile oil from F. suspensa.