Objective:To investigate the effects of cannabidiol(CBD)on the NOD-like receptor protein 3(NLRP3)inflammasome in the brains of rats with multiple cerebral concussions(MCC).Methods:Rats were subjec-ted to the MCC model and divided into Sham,MCC,vehicle(MCC+TW),CBD-L(10 mg/kg),and CBD-H(40 mg/kg)groups.Immunofluorescence double staining was used to observe changes in NLRP3 and microglial cells in the brain,and Western Blot was performed to detect the expression changes of the NLRP3 inflammasome.Results:A sig-nificant increase in lectin-positive microglial cells of the cortex with enlarged cell bodies and elevated immunofluores-cence intensity of NLRP3 in the activated microglial cells was revealed by immunofluorescence double staining following MCC(P＜0.05).The immunofluorescence intensity of NLRP3 in the activated microglial cells was downregulated by the administration of CBD,with a more pronounced effect observed in the CBD-H group compared to the CBD-L group(P＜0.05).The expression of NLRP3,caspase-1,and apoptosis-associated speck-like protein(ASC)in the cortex,hippocampus,and basal ganglia of rats following MCC was significantly increased,as shown by Western Blot analysis(P＜0.05),and cortical areas are more elevated.The expression of these proteins in different brain regions was reduced by CBD-10 and CBD-40 intervention(P＜0.05).Conclusion:Cannabidiol can reduce the inflammatory response of multiple cerebral concussions rats through NLRP3 inflammasome and protect nerve tissue.

Objective:To investigate the association of risky drinking and decision-making ability among off-spring of fathers with alcohol dependence(OFAD).Methods:A case-control study was conducted according to the cutoff of the Alcohol Use Disorder Identification Test(AUDIT)(delimited as 7).OFAD were divided into"risky drinking group"(n=29)and"non-risky drinking group"(n=43).The Iowa Gambling Task(IGT)was used to e-valuate the decision-making ability.Covariance analysis was used to compare differences of IGT between the two groups,and multivariate logistic regression was used to explore the association between risky drinking and decision making ability.Results:There was no significant difference in total scores of IGT between the risky drinking group and the non-risky drinking group(P＞0.05).Risky drinking group had less Selection 2 in block 5 of IGT[(3.8± 2.5)v.s.(5.7±3.1),P＜0.05]than non-risky drinking group.Selection 2 in block 5 was still associated with risky drinking after controlling the covariates(OR=0.72,95％CI:0.57～0.90,P＜0.05).Conclusion:This study indicates that risky drinking group in offspring of parents with alcohol dependence may have better decision-making ability.

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Objective:To explore the robust relationship between insomnia and type 2 diabetes mellitus by two-sample Mendelian randomization analysis to overcome confounding factors and reverse causality in observational studies.Methods:We identified strong,independent single nucleotide polymorphisms(SNPs)of insomnia from the most up to date genome wide association studies(GWAS)within European ancestors and applied them as instrumental variable to GWAS of type 2 diabetes mellitus.After excluding SNPs that were significantly associated with smoking,physical activity,alcohol consumption,educational attainment,obesity,or type 2 diabetes mellitus,we assessed the impact of insomnia on type 2 diabetes mellitus using inverse variance weighting(IVW)method.Weighted median and MR-Egger regression analysis were also conducted to test the robustness of the association.We calculated the F statistic of the selected SNPs to test the applicability of instrumental variable and F statistic over than ten indicated that there was little possibility of bias of weak instrumental variables.We further examined the existence of pleiotropy by testing whether the intercept term in MR-Egger regression was significantly different from ze-ro.In addition,the leave-one-out method was used for sensitivity analysis to verify the stability and relia-bility of the results.Results:We selected 248 SNPs independently associated with insomnia at the genome-wide level(P＜5 ×10-8)as a preliminary candidate set of instrumental variables.After clum-ping based on the reference panel from 1000 Genome Project and removing the potential pleiotropic SNPs,a total of 167 SNPs associated with insomnia were included as final instrumental variables.The F statistic of this study was 39.74,which was in line with the relevance assumption of Mendelian randomi-zation.IVW method showed insomnia was associated with higher risk of type 2 diabetes mellitus that po-pulation with insomnia were 1.14 times more likely to develop type 2 diabetes mellitus than those without insomnia(95％CI:1.09-1.21,P＜0.001).The weighted median estimator(WME)method and MR-Egger regression showed similar causal effect of insomnia on type 2 diabetes mellitus.And MR-Egger re-gression also showed that the effect was less likely to be triggered by pleiotropy.Sensitivity analyses pro-duced directionally similar estimates.Conclusion:Insomnia is a risk factor of type 2 diabetes mellitus,which has positively effects on type 2 diabetes mellitus.Our study provides further rationale for indivi-duals at risk for diabetes to keep healthy lifestyle.

This paper summarized the clinical experience of Professor LIU Shenlin in diagnosing and treating gastric cancer with the thinking of "prescription according to tendency". In this paper， the thinking of diagnosis and treatment for gastric cancer and medication skills were summarized into four dimensions： power， energy， chronology and situation. The diagnosis emphasizes the tendency of qi power， considering that the onset of gastric cancer primarily stems from the disorder of qi movement in zang-fu organs， and emphasizing the importance of regulating the liver and spleen qi to intercept the tendency of disease. It points out that dampness-phlegm-stasis-toxin is a crucial link leading to the metabolic imbalance of body energy， and Professor LIU adepts at using methods such as breaking up blood and expelling stasis， and clearing heat and resolving toxins to block the pathological chain reaction caused by energy imbalance and to restore the homeostasis of the organism. In the treatment process， according to the characteristics of gastric cancer staging and chronological evolution， we will explore the changes of the exuberance and weakness of healthy qi and pathogenic qi in the context of the chronologic tendency， and adjust the dosage of attacking and tonic medicines in different stages of the disease in order to balance and restore the body. The "situation" is in line with the state of consumptive disease in advanced gastric cancer， Professor LIU skillfully uses large doses of Huangqi （Astragalus mongholicus） with flexible combination of medicinals to replenish deficiencies， invigorate qi， and regulate blood vessels.

OBJECTIVE To investigate the effect of Jianpi Yangzheng(JPYZ)formula regulating tumor-associated macrophage(TAM)exosomes on anoikis in gastric cancer and its mechanism.METHODS TAM model was established by inducing human mononuclear THP-1 cells in vitro;M0,TAM and TAM+JPYZ formula exosomes were extracted by ultracentrifugation and co-incuba-ted with gastric cancer cells.Flow cytometry was used to detect the effect of exosomes in each group on anoikis in gastric cancer cells.A BALB/c transplanted tumor mouse model was constructed,and the expression level of apoptotic proteins in transplanted tumors was detected by Western blot.Label-free mass spectrometry proteomics and bioinformatics were used to analyze the differential proteins in gastric cancer cells before and after intervention;Western blot and qPCR experiments were used to detect the expression level of dif-ferential protein isocitrate dehydrogenase 1(IDH1),and ubiquitination experiments were used to detect the ubiquitination level of IDH1;kits were used to detect the levels of α-ketoglutarate(α-KG),NADPH/NADP+,glutathione(GSH/GSSG)and reactive oxy-gen species(ROS)content.RESULTS The anoikis rate of gastric cancer cells was reduced after TAM exosomes intervention(P<0.05,P<0.01),while it was significantly increased after TAM+JPYZ exosomes intervention(P<0.05,P<0.01).In the in vivo mouse experiment,the ratio of Cleaved Caspase-3/Caspase-3 in the tumor of the TAM exosome group was reduced(P<0.05),while the ra-tio was significantly increased after TAM+JPYZ exosome intervention(P<0.05).Proteomic analysis showed that IDH1 was significant-ly different after intervention,and was related to tricarboxylic acid cycle metabolism.Compared with the M0 group,the IDH1 ubiquiti-nation level of gastric cancer cells in the TAM group with exosome intervention was increased,the levels of α-KG,NADPH/NADP+and GSH/GSSG were significantly increased,and the ROS content was reduced(P<0.05),while TAM+JPYZ exosomes could reverse the above phenomenon.CONCLUSION JPYZ Formula can regulate TAM exosomes to cause ubiquitin degradation of IDH1 in gas-tric cancer cells,reduce the level of tricarboxylic acid cycle metabolism in gastric cancer cells,promote ROS accumulation,induce anoikis in gastric cancer,and thus inhibit the development of gastric cancer.

Objective To explore the efficacy and safety of fluoroscopy-guided balloon dilation for esophageal strictures in patients with epidermolysis bullosa(EB).Methods The clinical data and follow-up results of EB patients,who received fluoroscopy-guided balloon dilation due to esophageal stricture at Shanghai Xinhua Hospital from May 2020 to May 2023,were retrospectively collected.The therapeutic efficacy and the prognosis of this treatment method were analyzed.Results A total of 17 EB patients received fluoroscopy-guided balloon dilation treatment due to dysphagia caused by esophageal stricture.Most esophageal strictures were single-site stenosis(13/17,76.5％)and it commonly occurred in the esophageal cervical segment(12/17,70.6％)and the upper thoracic segment(8/17,47.1％)of esophagus.Two patients developed esophageal bleeding after dilatation and no special treatment is required.No other post-treatment complications were observed.In most of the patients(15/17,88.2％)a long-term improvement of the dysphagia symptoms could be obtained after receiving a single balloon dilation treatment.By the last follow-up visit,most of the patients(15/17,88.2％)gained more weight when compared with their pre-treatment body weight,with an average increased weight of 2.97 kg.Conclusion Clinically,EB is a rare etiology that can cause an esophageal stricture.This esophageal stenosis is characterized by a single stenosis mostly located in the upper segment of the esophagus.Fluoroscopy-guided balloon dilation is an effective and safe treatment for this type of esophageal strictures.

Objective:To explore the impact of scutellarin on the levels of phosphatidylinositol 3-kinase(P13K)and phosphorylated P13K(p-PI3K)in activated microglia.Methods:A rat cerebral ischemia model was made by middle cerebral artery occlusion(MCAO)method.SD rats were randomly divided into three groups:sham operation group(Sham),cerebral ischemia group(MCAO),and cerebral ischemia with scutellarin group(MCAO+S).A model of ischemia-hypoxia injury of BV2 microglia was established by glucose-oxygen deprivation(OGD)and randomly assigned as control group(Control),OGD group and OGD+scutellarin group(OGD+S).Changes in PI3K and p-PI3K expres-sion in microglia were assessed using double immunofluorescence staining and Western Blot.Results:Immunofluores-cence staining and Western Blot analyses revealed a significant increase in p-PI3K levels in activated microglia both in vivo and in vitro(P＜0.05).Furthermore,treatment with scutellarin led to a further elevation in p-PI3K(P＜0.05).However,there were no significant alterations observed in PI3 K expression among the groups(P＞0.05).Conclusion:Scutellarin may play a positive role in the treatment of cerebral ischemia by up-regulating the phosphorylation level of P13K in activated microglia.

Objective To standardize nursing management on postoperative patients with a left ventricular assist-ant device(LVAD).Methods The first draft of the Consensus was formed on the basis of literature review.2 rounds of expert consultations and a round of online meeting discussion were held for adjustments and modifications the draft of the Consensus.Results The recovery rate of the inquiry questionnaire was 93.75%.The authority coefficients of the 2 rounds of inquiry experts were 0.927 and 0.920.The concentration degree of expert opinions for each indicator was greater than 3.5 score,and the coefficient of variation was less than 0.25.The Kendall harmony coefficients for 2 rounds of correspondence were 0.402 and 0.407(P<0.01).The final Consensus formed through expert consultations and meetings includes 7 themes:hemodynamic monitoring,LVAD function monitoring,coagulation function monitoring,percutaneous cable and wound care,exercise rehabilitation care,health education and guidance,and pre-discharge assessment.Conclusion The Consensus is scientific,rigorous,and authoritative.The Consensus covers all aspects of postoperative care for patients with LVAD,and it will benefit to clinical practice.

Objective:To determine the safety and efficacy of sandwich surgery in minimally invasive orthopedic surgery.Methods:A retrospective analysis was performed on 79 pectus carinatum patients undergoing minimally invasive orthopedic surgery admitted to the Department of Thoracic Surgery, Beijing Children's Hospital from July 2016 to July 2018, including 53 cases in the Abramson surgery group and 26 cases in the sandwich surgery group.Results:79 cases successfully completed the operation, the difference in complication rate between the two groups was not statistically significant. All cases were followed up to two years after bar removal, and no recurrence during the follow-up period. The excellent rate of orthopedic effect in sandwich surgery group was higher than that in Abramson surgery group.Conclusion:Sandwich surgery is safe, feasible and can achieve satisfactory postoperative results. It can be used as a surgical option for the treatment of pectus carinatum with depression or depression after orthosis.