Present Situation of Enhanced Recovery after Surgery in Shiyan Taihe Hospital and Plan of Establishing Strategic Alliance with General Surgery Department

The accelerated rehabilitation specialist surgery and general established strategic alliance plan of Taihe hospital is introduced in the paper.The background of strategic alliances established,and the political,environmental and technological factors are introduced,and stakeholder analysis and management plan,risk analysis and management plan are made.Furthermore,a junior coalition problem that may occur in the process and the resulting deep thinking is analyzed,to provide the reference and enlightenment for the management of hospital and establishment of strategic alliance.

Observation of Suicide Prevention in Hospitalized Patients with Depression Based on Taihe Emotion-distress Index

[Objectives]To reduce suicidal ideation and suicidal behavior through initial screening of patients with suicidal tendencies and implementing suicide prevention interventions during their hospitalization.[Methods]The Taihe Emotion-distress Index(THEI)was used to conduct pre-admission and post-discharge tests to explore the effects of suicide prevention measures during hospitalization on the alleviation of the disease and the reduction of suicidal behaviors.The study selected patients who were diagnosed with depression in the psychological outpatient department of Taihe Hospital from April 2019 to September 2019 and had to be hospitalized,including patients with moderate depressive episodes,severe depressive episodes with or without psychotic symptoms,and patients with suicidal thoughts and self-harming behaviors.[Results]The pre-admission and post-discharge test data of hospitalized patients were analyzed,and the non-parametric paired sample T test was carried out,and the result was P<0.05,showing that there are significant differences between the pre-admission and post-discharge test data.[Conclusions]The measures of suicide prevention intervention are effective to a certain extent.

GPCR-Gs mediates the protective effects of ginsenoside Rb1 against oxygen-glucose deprivation/re-oxygenation-induced astrocyte injury

Objectives:To investigate whether the protective actions of ginsenoside Rb1(Rb1)on astrocytes are mediated through the G_(s)-type G-protein-coupled receptor(GPCR-G_(s)).Methods:Primary astrocyte cultures derived from neonatal mouse brain were used.Astrocyte injury was induced via oxygen-glucose deprivation/re-oxygenation(OGD/R).Cell morphology,viability,lactate dehydrogenase(LDH)leakage,apoptosis,glutamate uptake,and brain-derived neurotrophic factor(BDNF)secretion were assessed to gauge cell survival and functionality.Western blot was used to investigate the cyclic adenosine monophosphate(cAMP)and protein kinase B(Akt)signaling pathways.GPCR-G_(s)-specific inhibitors and molecular docking were used to identify target receptors.Results:Rb1 at concentrations ranging from 0.8 to 5μM did not significantly affect the viability,glutamate uptake,or BDNF secretion in normal astrocytes.OGD/R reduced astrocyte viability,increasing their LDH leakage and apoptosis rate.It also decreased glutamate uptake and BDNF secretion by these cells.Rb1 had protective effects of astrocytes challenged by OGD/R,by improving viability,reducing apoptosis,and enhancing glutamate uptake and BDNF secretion.Additionally,Rb1 activated the cAMP and Akt pathways in these cells.When the GPCR-G_(s) inhibitor NF449 was introduced,the protective effects of Rb1 completely disappeared,and its activation of cAMP and Akt signaling pathways was significantly inhibited.Conclusion:Rb1 protects against astrocytes from OGD/R-induced injury through GPCR-G_(s) mediation.

Incidence and Risk Factors of Sub-syndromal Delirium in Patients after Cardiac Surgery

[Objectives]This study aimed to investigate the incidence and risk factors associated with SSD in patients following cardiac surgery.[Methods]A total of 378 patients who underwent cardiac surgery in Taihe Hospital were recruited and screened.Diagnosis of delirium was made using evaluation methods and DSM-5 criteria.SSD was defined as the presence of one or more core features of delirium without meeting the full diagnostic criteria.Statistical analysis included independent samples t-test for group comparisons and binary logistic regression analysis to identify independent risk factors for SSD after cardiac surgery.[Results]Among the 378 subjects,112(29.63%)had SSD,28(7.41%)had delirium,and the remaining 238 patients(62.96%)did not present with delirium.Univariate analysis revealed that age,APACHE II score,duration of aortic clamping,length of ICU stay,duration of sedation use,and daily sleep time were significant risk factors for the occurrence of SSD(P<0.05).Logistic regression analysis identified age>70 years old,APACHE II score>20 points,length of ICU stay>5 d,and duration of sedation use>24 h as independent risk factors for SSD after cardiac surgery(P<0.05).A functional model was fitted based on the analysis results of the binary logistic regression model,yielding the equation logit P=1.472X_(1)+2.213X_(2)+3.028X_(3)+1.306X_(4).[Conclusions]Comprehensive clinical assessment is crucial for patients undergoing cardiac surgery,and appropriate preventive measures should be taken for patients with identified risk factors.Close monitoring of the patient s consciousness should be implemented postoperatively,and timely interventions should be conducted.Further research should focus on model validation and optimization.

sTREM-1 as promising prognostic biomarker for acute-on-chronic liver failure and mortality in patients with acute decompensation of cirrhosis

BACKGROUND Acute decompensation(AD)of cirrhosis is associated with high short-term mortality,mainly due to the development of acute-on-chronic liver failure(ACLF).Thus,there is a need for biomarkers for early and accurate identification of AD patients with high risk of development of ACLF and mortality.Soluble triggering receptor expressed on myeloid cells-1(sTREM-1)is released from activated innate immune cells and correlated with various inflammatory processes.AIM To explore the prognostic value of sTREM-1 in patients with AD of cirrhosis.METHODS A multicenter prospective cohort of 442 patients with cirrhosis hospitalized for AD was divided into a study cohort(n=309)and validation cohort(n=133).Demographic and clinical data were collected,and serum sTREM-1 was measured at admission.All enrolled patients were followed-up for at least 1 year.RESULTS In patients with AD and cirrhosis,serum sTREM-1 was an independent prognosis predictor for 1-year survival and correlated with liver,coagulation,cerebral and kidney failure.A new prognostic model of AD(P-AD)incorporating sTREM-1,blood urea nitrogen(BUN),total bilirubin(TBil),international normalized ratio(INR)and hepatic encephalopathy grades was established and performed better than the model for end-stage liver disease(MELD),MELD-sodium(MELD-Na),chronic liver failure-consortium(CLIF-C)ACLF and CLIF-C AD scores.Additionally,sTREM-1 was increased in ACLF and predicted the development of ACLF during first 28-d follow-up.The ACLF risk score incorporating serum sTREM-1,BUN,INR,TBil and aspartate aminotransferase levels was established and significantly superior to MELD,MELD-Na,CLIF-C ACLF,CLIF-C AD and P-AD in predicting risk of ACLF development.CONCLUSION Serum sTREM-1 is a promising prognostic biomarker for ACLF development and mortality in patients with AD of cirrhosis.

Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study

BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.AIM To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.METHODS Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure(ACLF)study cohort were included in this study.The clinical characteristics and outcomes,and the 90-d survival rate associated with each clinical type of AoCLD were analyzed,using the Kaplan-Meier method and the log-rank test.RESULTS A total of 3375 patients with AoCLD were enrolled,including 1679(49.7%)patients with liver cirrhosis acute decompensation(LC-AD),850(25.2%)patients with ACLF,577(17.1%)patients with chronic hepatitis acute exacer-bation(CHAE),and 269(8.0%)patients with liver cirrhosis active phase(LC-A).The most common cause of chronic liver disease(CLD)was HBV infection(71.4%).The most common precipitants of AoCLD was bacterial infection(22.8%).The 90-d mortality rates of each clinical subtype of AoCLD were 43.4%(232/535)for type-C ACLF,36.0%(36/100)for type-B ACLF,27.0%(58/215)for type-A ACLF,9.0%(151/1679)for LC-AD,3.0%(8/269)for LC-A,and 1.2%(7/577)for CHAE.CONCLUSION HBV infection is the main cause of CLD,and bacterial infection is the main precipitant of AoCLD.The most common clinical type of AoCLD is LC-AD.Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.

Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae （CRKP） and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China

我们的学习的目的是调查 Carbapenem 抵抗的 Klebsiella pneumoniae (CRKP ) 和班的基因特征的流行的目的在临床的 Klebsiella pneumoniae 拉紧的多药 resistance.Methods 上的 CRKP 的 1 integron 在华中从一所医院的多重部门被收集。CRKP 紧张在 isolates 之中被识别，并且 CRKP 紧张的抗菌素危险性被分析。聚合酶链反应(PCR ) 被采用放大类 1 个 integron 变量区域。integron 基因结构与酶消化和 DNA 定序技术被分析。在班 1 integron 和药抵抗之间的关系被分析完全， 955 Klebsiella pneumoniae 拉紧的 statistically.Results 从医院的改变的地点被孤立，并且(12.3%) 117 作为 CRKP 他们被识别，与在 2013 的8.9%的分离率( 26/292 )，11.3%( 38/336 )在 2014 和16.2%( 53/327 )在 2015 ，哪个表演到年的一个增加的趋势。(52/117 )44.4% 与 ICU 的标本 CRKP 紧张被分开，并且(72/117 )61.5% 从唾沫。超过 95% CRKP 紧张对 ampicillin/sulbactam， aztreonam， imipenem， meropenem， ceftazidme， cefotaxime， cefepime，和 piperacillin 抵抗，当相对低的抵抗的率在 tigecycline (12.8%) 和 colistin (35.9%) 被发现时。班 1 integron 在 77.8% 被检测(91/117 ) CRKP 紧张。CRKP 的班 1 integron 显著地与抗菌素抵抗被相关到 tobramycin， gentamicin 和 amikacin (所有 P < 0.01 ) 。班 1 integron 的可变区域的基因盒子分析证明 aadA2 占 64.8%(59/91 ) ， aacA4-catB8-aadA1 23.1%(21/91 ) ，并且 aadA2-dfrA25 12.1%(11/91 ).Conclusions CRKP 在他们的中国，和大多数在临床的设置有一个增加的趋势对多重抗菌素抵抗。在 CRKP 的班 1 integron 有强壮的能力从环境捕获对 aminoglycosides 抗菌素抵抗的基因，与象最流行的 aadA2 基因。

Prevalence and clinical characteristics of autoimmune liver disease in hospitalized patients with cirrhosis and acute decompensation in China

BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in China.METHODS We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic areas.Patients were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree mortality.Acute-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the Liver(EASL).Risk factors for death were analyzed with logistic regression model.RESULTS In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,respectively.In ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related ACLF.The etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate analysis.Total bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate analysis.The development of ACLF during hospitalization only independently correlated to TB and international normalized ratio.CONCLUSION AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the most common etiology.90-d LT-free mortality were independently associated with TB,HE and BUN.

Rapamycin reverses ferroptosis by increasing autophagy in MPTP/MPP+-induced models of Parkinson's disease

Parkinson’s disease is a neurodegenerative disorder,and fe rroptosis plays a significant role in the pathological mechanism underlying Parkinson’s disease.Rapamycin,an autophagy inducer,has been shown to have neuroprotective effects in Parkinson’s disease.However,the link between rapamycin and ferroptosis in Parkinson’s disease is not entirely clear.In this study,rapamycin was administe red to a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinson’s disease mouse model and a 1-methyl-4-phenylpyridinium-induced Parkinson’s disease PC12 cell model.The results showed that rapamycin improved the behavioral symptoms of Parkinson’s disease model mice,reduced the loss of dopamine neurons in the substantia nigra pars compacta,and reduced the expression of ferroptosis-related indicators(glutathione peroxidase 4,recombinant solute carrier family 7,member 11,glutathione,malondialdehyde,and reactive oxygen species).In the Parkinson’s disease cell model,rapamycin improved cell viability and reduced ferro ptosis.The neuroprotective effect of rapamycin was attenuated by a ferroptosis inducer(methyl(1S,3R)-2-(2-chloroacetyl)-1-(4-methoxycarbonylphenyl)-1,3,4,9-tetrahyyridoindole-3-carboxylate)and an autophagy inhibitor(3-methyladenine).Inhibiting ferro ptosis by activating autophagy may be an important mechanism by which rapamycin exerts its neuroprotective effects.Therefo re,the regulation of ferroptosis and autophagy may provide a therapeutic target for drug treatments in Parkinson’s disease.

Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage

BACKGROUND Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men.AIM To investigate the correlation between vascular endothelial growth factor(VEGF)and cortisol(Cor)and the prognosis of patients with hypertensive cerebral hemorrhage.METHODS A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group.Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group.Peripheral venous blood was collected,and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay.RESULTS A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment(P<0.05).Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group.Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses.Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage(P<0.05).CONCLUSION Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.

Inhibition of Eukaryotic Initiating Factor eIF4E Overcomes Abemaciclib Resistance in Gastric Cancer

Objective Aberrant activating mutations in cyclin-dependent kinases 4 and 6(CDK4/6)are common in various cancers,including gastroesophageal malignancies.Although CDK4/6 inhibitors,such as abemaciclib and palbociclib,have been approved for breast cancer treatment,their effectiveness as a monotherapy remains limited for gastroesophageal tumors.The present study explored the underlying mechanism of abemaciclib resistance.Methods Abemaciclib-resistant gastric cancer cell lines were generated,and the phospho-eukaryotic translation initiation factor 4E(p-eIF4E)and eIF4E expression was compared between resistant and parental cell lines.In order to analyze the role of eIF4E in cell resistance,siRNA knockdown was employed.The effectiveness of ribavirin alone and its combination with abemaciclib was evaluated in the gastric cancer xenograft mouse model.Results The upregulation of eIF4E was a common feature in gastric cancer cells exposed to prolonged abemaciclib treatment.Gastric cancer cells with increased eIF4E levels exhibited a better response to eIF4E inhibition,especially those that were resistant to abemaciclib.Ribavirin,which is an approved anti-viral drug,significantly improved the efficacy of abemaciclib,both in vitro and in vivo,by inhibiting eIF4E.Importantly,ribavirin effectively suppressed the abemaciclib-resistant gastric cancer growth in mice without causing toxicity.Conclusion These findings suggest that targeting eIF4E can enhance the abemaciclib treatment for gastric cancer,proposing the potential combination therapy of CDK4/6 inhibitors with ribavirin for advanced gastric cancer.

Neonatal methicillin-resistant Staphylococcus aureus pneumonia-related recurrent fatal pyopneumothorax: A case report and review of literature

BACKGROUND Although neonatal Staphylococcus aureus pneumonia is common and usually curable,it can also be refractory and life-threatening.Herein,we report a case of severe neonatal community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA)necrotizing pneumonia with bilateral recurrent pyopneumothorax,respiratory failure,heart failure,and cardiac arrest.We hope our report will add to the understanding of this disease.CASE SUMMARY An 18-d-old boy presented with cough for five days,fever for three days,and dyspnea for two days.Preadmission chest radiograph revealed high-density shadows in both lungs.On admission,his oxygen saturation fluctuated around 90%under synchronized intermittent mandatory ventilation.He was unconscious,with dyspnea,weak heart sounds and hepatomegaly.Moist crackles were present throughout his left lung,while the breath sounds in the right lung were decreased.After high-frequency oscillatory ventilation,empiric antimicrobials(meropenem and vancomycin),improved circulation,and right pleural cavity drainage for right pneumothorax(approximately 90%compression),his oxygen saturation level stayed above 95%,and recruitment of the right lung was observed.His condition did not deteriorate until the 5th day of hospitalization(DOH 5).On the morning of DOH 5,his oxygen saturation decreased.Subsequent chest radiograph showed bilateral pneumothorax with nearly 100%compression of the left lung.Desaturation was not relieved after urgent left pleural cavity drainage,and cardiac arrest occurred soon thereafter.Although his spontaneous heartbeat returned through emergency resuscitation and salvage antibacterial therapy(linezolid and levofloxacin)was administered given the detection and antimicrobial susceptibility of MRSA,he showed no improvement,with recurrent pyopneumothorax and continued drainage of purulent fluid and necrotic lung tissue fragments from the pleural cavity.Eventually,his parents refused extracorporeal membrane oxygenation(ECMO)and gave up all the treatments,and the newborn passed away soon after withdrawal on DOH 13.CONCLUSION Neonatal MRSA pneumonia can be refractory and lethal,especially in cases where necrotizing pneumonia leads to extensive lung necrosis and recurrent pneumothorax.Despite treatment with linezolid and other medical measures,it may still be ineffective.Currently,ECMO has been a remedial therapy,but if the lung tissue is too severely eroded to be repaired,it may be useless unless the infection can be controlled and lung transplantation can be performed.Regardless of whether ECMO is initiated,the key to successful treatment is to achieve control over the pneumonia caused by MRSA as soon as possible and to reverse lung injury as much as possible.

Research Progress of Swallowing Therapy in Relieving Dysphagia after Stroke

This article summarizes the current rehabilitation treatment methods for dysphagia after stroke,including feeding-swallowing function treatment,acupuncture treatment,neuromuscular electrical stimulation,balloon catheter dilatation,etc.,all of which have many clinical applications,hoping to play a guiding role in future research.

Application of Medical Failure Mode and Effect Analysis in Preoperative Preparation for Coronary Intervention

[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who underwent coronary intervention surgery from January to March in 2022 was sorted out,and the failure modes and causes in the preoperative management were analyzed.The priority risk value was calculated,and the top 6 failure modes were found out.Improvement measures were formulated according to the causes of failure modes.Two months after the implementation of the procedure,470 patients who underwent coronary intervention surgery from May to July in 2022 were selected as the intervention group,and the optimized preoperative preparation procedure by HFMEA was adopted.The decrease of risk priority number(RPN)and RPN value of two high-risk failure modes,as well as changes in the rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation were analyzed.[Results]The rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation in experimental groups were higher than those of the control group,and the difference was statistically significant(P<0.05).[Conclusions]Applying HFMEA to the management of preoperative preparation process for coronary intervention can effectively improve the timeliness and qualification rate of preoperative preparation for coronary intervention,and provide guarantee for the safe and smooth implementation of coronary intervention.

Effects of Early-stage Phased Rehabilitation Training on Acute Respiratory Distress Syndrome:A Systematic Review and Meta-analysis

[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.

Logistic Regression Analysis on the Correlation between Physical Diseases and Life Events and Depression in the Elderly

[Objectives]This study was conducted to explore the effects of physical diseases and life events on depression among urban elderly people.[Methods]Five hundred urban elderly people in Shiyan City were selected using a convenient sampling method to investigate and diagnose depression using the Geriatric Mental State Schedule and its accompanying computer diagnostic system.The Minimum Data Set(MDS)and related factor survey form were used to investigate physical diseases and life events,and statistical analysis was conducted using methods such as logistic regression analysis and factor analysis.[Results]The prevalence rates of angina,stroke,or partial paralysis,migraine,vision problems,hyperthyroidism or hypothyroidism,as well as the number of physical diseases were significantly higher in elderly depression patients than in objects free of depression.Stroke or partial paralysis[OR(95%CI)=6.389(1.684,24.237)],emotional trauma events[OR(95%CI)=1.438(1.069,1.934)]and adverse health and economic events[OR(95%CI)=1.652(1.099,2.483)]were risk factors for late life depression(LLD).[Conclusions]Some physical diseases and life events may affect the onset process of depression in urban elderly people,and various measures need to be taken to reduce the risk of physical diseases and life events on depression.

System Evaluation and Meta Analysis of Total Clinical Effective Rate of Acupuncture and Moxibustion in Treating Depression during 2019-2022

[Objectives]To systematically evaluate the total clinical effective rate of acupuncture treatment of depression,and provide clinical reference for the scheme design and selection of acupuncture treatment of depression.[Methods]By searching CNKI,Wanfang Data,CBM,VIP,Cochrane Library,Cochrane Central,Springer and other databases,randomized controlled experiment(RCT)on acupuncture and moxibustion treatment of depression from January 1,2019 to August 31,2022 was collected,to extract relevant data of total clinical effective rate and conduct methodological quality evaluation.ReviewManager 5.4.1 software was used for Meta analysis.[Results]22 RCTs were included,1602 patients in total.Among them,there were 804 cases in treatment group and 798 cases in control group.Meta analysis results displayed that acupuncture and moxibustion treatment of depression may be better than the control group in improving the total clinical effective rate,and the difference was statistically significant[MD=1.16,95%CI(1.11,1.21)].[Conclusions]Acupuncture and moxibustion can achieve a higher total clinical effective rate in the treatment of depression,which is worthy of clinical application.However,due to fewer studies included in this systematic evaluation,small sample size,and low quality,there was a high possibility of bias.Therefore,the above conclusions needed to be verified by high-quality,large-sample,and multi-center RCTs.

Clinical Observation of Chuanbai Antipruritic Lotion"Water Film"Wet Compress Combined with Chloramphenicol Prednisone Liniment in the Treatment of Acute Eczema

[Objectives]To observe and analyze the clinical efficacy and possible mechanism of Chuanbai antipruritic lotion"water film"wet compress combined with chloramphenicol prednisone liniment in the treatment of acute eczema.[Methods]A total of 76 acute eczema cases admitted to Shiyan Taihe Hospital from January 2022 to March 2023 were divided into Western medicine treatment group and integrated traditional Chinese and Western medicine group.In the Western medicine treatment group,chloramphenicol and prednisone liniment was applied to the skin lesions and oral administration of cetirizine hydrochloride.The course of treatment in both groups was 2 weeks(w).The levels of interferon-γ(IFN-γ),interleukin-4(IL-4)and the ratio of IFN-γ/IL-4 in the peripheral blood of patients before and 2 weeks after treatment,as well as serum immunoglobulin E(IgE),anti-IgE antibody and histamine(HA)level,and with skin lesions disappearing time,skin oil,transepidermal water loss(TEWL),eczema area and severity index(EASI)score,total effective rate,degree of pruritus and traditional Chinese medicine quality of life scale(EPQOLS)score to evaluate the efficacy.[Results]Compared with the Western medicine treatment group at 2 w,the disappearance time of skin lesions in the integrated traditional Chinese and Western medicine group was shortened,TEWL,itching degree and EASI score,serum IgE and HA,and peripheral blood IL-4 levels were all decreased(P<0.05).IFN-γand IFN-γ/IL-4 ratio,anti-IgE antibody,EPQOLS score and total effective rate were all increased(P<0.05),and the difference was statistically significant.[Conclusions]Chuanbai antipruritic lotion"water film"wet compress combined with chloramphenicol prednisone liniment is an optimized and safe and efficient method for the treatment of acute eczema,which can quickly relieve the symptoms of inflammatory damage of eczema and restore the skin barrier function,dry dampness and relieve itch.Inhibition of the release of histamine active substances and regulation of immunity may be the main mechanisms.

CircROBO1 promotes retinal Y79 cell tumor invasion by targeting KLF5

Objective:To explore the role of circROBO1 in promoting the invasion of retinal Y79 cells by targeting KLF5 and its possible regulatory mechanism.Methods:RNase R enzyme digestion and qRT-PCR experiments were used to detect the structural stability of circular circROBO1 in retinal Y79 cells;cytoplasmic and nuclear RNAs of retinal Y79 cells were extracted for localization analysis of circROBO1;The expression of circROBO1 in retinal Y79 cells were silenced by siRNA.The effect of circROBO1 on the migration and invasion ability of HT-29 cells was detected by scratch assay,Transwell cell invasion and migration assay.The target binding sites of circROBO1 and its downstream miRNA and that of miRNA and its downstream target gene KLF5 were predicted by CircInteractome and TargetScan online software respectively,and the target regulation relationship between them was verified by double luciferase reporter gene experiment.Western blot was used to detect the effect of siRNA silencing the expression of circROBO1 in Y79 cells on the expression of KLF5.Results:Compared with the control group without RNase R enzyme treatment,relative circROBO1 levels did not change significantly after treatment,while relative linear ROBO1 levels decreased significantly after treatment(t=16.18,P<0.05);the content of circROBO1 in the cytoplasm was significantly higher than that in the nucleus(P<0.05);compared with si-control group,the migration rate and the invasion and migration abilities of Transwell cells were all lower in the si-circROBO1 group(t=22.54,P<0.05);circROBO1 can adsorb miR-885-5p,and there is a target binding site between miR-885-5p and KLF5(t=11.39,P<0.05);compared with the si-control group,the KLF5 protein expression in the si-circROBO1 group was significantly decreased(t=17.26,P<0.05).Conclusions:circROBO1 promotes retinalY79 cell tumor invasion by targeting KLF5.

Intensive Training for Stroke: Evidence of Safety from Meta-analysis and Systematic Reviews

[Objectives] To investigate the safety of intensive training for stroke recovery. [Methods] A systematic electronic search was conducted up to December 1 st , 2022, and the number of falls and fall-related injuries, as well as other adverse events, were extracted. Odds ratios (ORs) were calculated to assess the two intervention methods, and a 95% confidence interval (95% CI) was calculated for each of them to ensure the statistical accuracy of the results. The heterogeneity of the included studies was also tested. [Results] Five moderate to high quality studies comprising a total of 184 participants were included in this review. All five randomized controlled trials reported adverse events, including falls that did not result in injury, pain in the joints, back, muscle, or chest, and skin injuries such as cuts, bruises, and scrapes. The pooled analysis of these trials showed no statistically significant differences between the intensive training and control groups in terms of falls ( P =0.35) , pain ( P =0.07), or skin injuries ( P =0.90). [Conclusions] This review provides good evidence to suggest that intensive training is safe and feasible as a novel intervention during the stroke recovery.