Nuclear factor-kappa B （NF-κB） is an important intracellular transcription factor widely involved in the processes such as immune response， inflammatory response， cell proliferation， and apoptosis. The abnormal activation of the NF-κB signaling pathway plays a pivotal role in various liver diseases including chronic hepatitis， liver fibrosis， liver cirrhosis， and hepatocellular carcinoma. Extensive studies have shown that inhibiting NF-κB activity may effectively reduce inflammation and fibrosis and improve metabolic disorders. Several natural compounds， such as matrine and salvianolic acid B， have shown the potential in suppressing NF-κB activity， thereby exerting anti-inflammatory， anti-fibrotic， and anti-tumor effects. This article systematically reviews the critical role of the NF-κB signaling pathway in liver diseases and its potential as a therapeutic target， in order to highlight its potential as a therapeutic target for liver diseases and provide new directions for the treatment of liver diseases.

ObjectiveTo investigate the role and possible mechanism of action of rhubarb decoction （RD） retention enema in improving inflammatory damage of brain tissue in a rat model of mild hepatic encephalopathy （MHE）. MethodsA total of 60 male Sprague-Dawley rats were divided into blank group （CON group with 6 rats） and chronic liver cirrhosis modeling group with 54 rats using the complete randomization method. After 12 weeks， 40 rats with successful modeling which were confirmed to meet the requirements for MHE model by the Morris water maze test were randomly divided into model group （MOD group）， lactulose group （LT group）， low-dose RD group （RD1 group）， middle-dose RD group （RD2 group）， and high-dose RD group （RD3 group）， with 8 rats in each group. The rats in the CON group and the MOD group were given retention enema with 2 mL of normal saline once a day； the rats in the LT group were given retention enema with 2 mL of lactulose at a dose of 22.5% once a day； the rats in the RD1， RD2， and RD3 groups were given retention enema with 2 mL RD at a dose of 2.5， 5.0， and 7.5 g/kg， respectively， once a day. After 10 days of treatment， the Morris water maze test was performed to analyze the spatial learning and memory abilities of rats. The rats were analyzed from the following aspects： behavioral status； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） and the level of blood ammonia； pathological changes of liver tissue and brain tissue； the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （AKT）， and mammalian target of rapamycin （mTOR） in brain tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the MOD group， the RD1， RD2， and RD3 groups had a significantly shorter escape latency （all P<0.01）， significant reductions in the levels of ALT， AST， IL-1β， IL-6， TNF-α， and blood ammonia （all P<0.05）， significant alleviation of the degeneration， necrosis， and inflammation of hepatocytes and brain cells， and significant reductions in the mRNA and protein expression levels of PI3K， AKT， and mTOR in brain tissue （all P<0.05）， and the RD3 group had a better treatment outcome than the RD1 and RD2 groups. ConclusionRetention enema with RD can improve cognitive function and inflammatory damage of brain tissue in MHE rats， possibly by regulating the PI3K/AKT/mTOR signaling pathway.

Purpose/Significance To introduce the knowledge graph technology in the field of electronic information into the study of traditional Chinese medicine(TCM)terminology,and to demonstrate the dialectical relationship between the therapeutic effects of TCM and its nature,flavor,meridians and TCM diseases in a vivid way.Method/Process The top-down ontology construction method is adopted to build the top-level structure of TCM ontology on the Protégé platform.Taking the 2020 edition of the Chinese Pharmacopoeia as the data source,the TCM information in the pharmacopoeia is split and extracted,and the information of each axis is sorted,disambiguated and nor-malized.With the help of the Protégé platform,entities and relationships are created,and the TCM triple data is output in RDF data for-mat.Finally,the Neo4j graph database is used to store and display the RDF data to form a systematic TCM knowledge graph.Result/Con-clusion It mainly realizes the construction of the knowledge graph of TCM in the pharmacopoeia,and fully reveals the complex knowledge system structure in the field of TCM through data statistical analysis,knowledge measurement and drawing of visual graphics.

Objective To explore the application effect of upper abdominal moxibustion combined with bedside ultrasound monitoring of gastric residual volume(GRV)in pre-pyloric feeding in stroke patients.Methods Eighty stroke patients admitted to the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital from January 1,to December 31,2023 were selected as the study subjects.They were divided into control group(n=38)and observation group(n=42)using a random number table method.All patients had a nasogastric tube for pre-pyloric feeding.The control group used the traditional syringe aspiration method to monitor GRV,while the observation group used upper abdominal moxibustion combined with bedside ultrasound to monitor GRV.The study compared the differences between two groups in terms of enteral nutrition intolerance,feeding complications,enteral nutrition compliance rate within 7 days of admission,time to achieve enteral nutrition compliance,and changes in hemoglobin(Hb),serum prealbumin,serum albumin(ALB),and serum transferrin before and after 14 days of feeding.Results The incidence rates of vomiting,abdominal distention,intra-abdominal hypertension,reflux,and aspiration pneumonia in observation group were lower than those in control group(P＜0.05).The rate of achieving intestinal nutrition standard within 7 days of hospitalization was significantly higher in observation group compared to the control group.The time to achieve intestinal nutrition standard was shorter in observation group compared to control group.Furthermore,after 14 days of feeding,the levels of Hb and ALB in observation group were higher than those in control group,and the differences were statistically significant(P＜0.05).Conclusion Upper abdominal moxibustion combined with bedside ultrasonic monitoring of GRV can significantly reduce intestinal nutrition intolerance and feeding complications during pre-pyloric feeding in stroke patients,shorten the time to achieve nutritional benchmarks,and improve nutritional status.

Objective:To explore the application of PDCA cycle combined with project management method in the assessment and management of special skills training in clinical skills center.Methods:From January to December in 2018, the PDCA cycle combined with project management method was used to manage the special skills training project team. The utilization rate of special skills simulation equipment before and after management was compared. A questionnaire survey was conducted to investigate the satisfaction with the management model among the students involved in the special skills training in 2018.The data was analyzed by SPSS 13.0.Results:The utilization rate of special skills simulation equipment was significantly improved, and the students were highly satisfied with the management model.Conclusion:Using PDCA cycle combined with project management method, this paper explores a management model of special skills training and assessment in clinical skills center, which improves the quality of special skills training and assessment management in clinical skills center, and is worthy of further exploration and practice.

As an important means of lung protective strategy, prone position ventilation (PPV) which can effectively shorten the time of mechanical ventilation, significantly reduce the mortality of patients with acute respiratory distress syndrome (ARDS), and is suitable for popularization and application in the ICU. However, some studies show that prolonged prone position can significantly increase the incidence of Stress injury, making it difficult to implement PPV in the practical level. In order to achieve the goal of safe and effective prevention of skin Stress injury, and to promote the correct implementation of PPV, this paper review the methods of preventing Stress injury in patients with PPV.

Objective To examine the effect of high intensity interval training(HIIT) and moderate intensity continuous training(MICT) on the body component,serum globular adiponectin and skeletal muscle autophagy in C57BL/6 mice.Methods Thirty-six four-week-old C57BL/6 mice were randomly assigned to the control group,MICT group and HIIT groups.The MICT group underwent 60 minutes' aerobic continuous treadmill training at 12 m/min(75％ VO2max) once a day,5 times/week for 6 weeks,while the HIIT group exercised for 1min at 20 m/min(85％ VO2max) followed by 1 min at 8 m/min (50％ VO2max) for alternating 12 cycles.The body weight,body mass index(BMI),total body water,fat mass and citrate synthase(CS) of the quadriceps femoris were measured using ImpediVET experimental animal body composition analyzer.Mice were sacrificed after the analysis,and the level of serum gAcrp30 was detected using the enzyme linked immunosorbent assay.Western blotting was used to detect the expression of pAMPK-Thr172,LC3II/I,Beclin1 and p62 protein in skeletal muscle tissues.Results After 6-week exercise,the body weight of MICT and HIIT mice decreased significantly compared with the sedentary control group.BMI and fat mass of the HIIT group were significantly lower than the control group,but there were no significant differences between the MICT and control groups in the above two measurements.The activity of CS and serum gAcrp30 in HIIT group was significantly higher than the control group.Moreover,the expression of pAMPK-Thr172,LC3II/I and Beclin1 increased significantly in the skeletal muscle after HIIT intervention while the expression of p62 decreased compared with the control group.Conclusion Compared with the MICT,HIIT has more significant effects to reduce body fat and BMI,and activate the autophagy of skeletal muscles.

Objective To understand the molecular characteristics of human-derived non-O157 Shiga toxin-producing Escherichia coil (STEC) strains circulating in five regions of China.Methods Twenty-seven non-O157 STEC strains isolated in five geographic regions were investigated by serotyping, stx1/stx2 subtyping and PCR screening for adhesion and other virulence genes.A multilocus sequence typing (MLST) scheme provided by E.coil MLST database were performed to amplify and sequence seven housekeeping genes (adk, icd, fumC, rgyrB, purA, mdh and recA) in those strains.Results Twenty-seven non-O157 STEC strains were typed into 16 O∶H serotypes.Among those strains, 11 harbored stx1a, 12 harbored stx1c, two harbored stx2e and the other three strains respectively harbored stx1a+stx2b, stx2d and stx2g.Positive rates of eae, efa1, saa, paa, toxB, astA and ehxA genes were 18.5%, 18.5%, 29.6%, 22.2%, 11.1%, 11.1% and 25.9%, respectively.The 27 strains were typed into 16 different sequence types (STs) based upon MLST.Conclusion Human-derived non-O157 STEC strains circulating in five regions of China are heterogeneous in their serotypes, stx1/stx2 subtypes and virulence gene profiles.

Objective To explore the feasibility and efficiency of metacognitive training (MCT) in inpatients with schizophrenia,as well as the short-term effects of metacognitive training on symptoms,cognitive function,and insight.Methods Sixty inpatients that met the DSM-Ⅳ criteria for schizophrenia were randomly assigned to either MCT (research group,n =30) or an active controlled intervention (control group,n =30).Positive and Negative Syndrome Scale (PANSS),Schizophrenia Cognition Rating Scale (SCoRS),Insight and Treatment Attitude Questionnaire(ITAQ) and beads task are assessed at baseline and after completion of the training.Results After treatment,the scores of the two groups in PANSS,SCoRS,ITAQ and the bead task were significantly improved(P＜0.05).The improvement of positive symptoms,cognitive function and insight in research group (12.8 ± 4.2,31.7 ± 13.9,9.2 ± 6.1 respectively) was significantly better than that in control group (15.6±5.9,38.1± 18.1,5.5±5.8 respectively),and the difference was statistically significant (P＜ 0.05).Conclusion Metacognitive training can effectively improve the clinical symptoms,cognitive function and insight for inpatients with schizophrenia.

Objective To study the effects of 6-week aerobic treadmill exercise on the genes expression in skeletal muscle of C57BL/6 mice.Gene array was performed and the data was analyzed to evaluate the adaptive changes at gene level caused by exercise.Methods Twenty male C57BL/6 mice were randomly divided into two groups:control group(C) and aerobic exercise group (E).The mice from group E were forced to run on treadmill for 6 weeks.After 6 weeks,all mice were fasted for 16 hours,and then sacrificed.Their flexor muscle was removed.4 samples from each group were analyzed with gene chips to dissect the differentially expressed genes between the two groups.Results Our results showed that 723 genes were differentially expressed in E group as compared with C group after the 6 weeks aerobic exercise,among which 510 genes were up-and 213 down-regulated.There were 6 differentially expressed calcium signaling genes and 2 ofwhich(Gnall and Pdgfra) were up-regulated,while the others(Phka1,Picd4,RYR1 and Ppid)were down regulated.