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Objective To explore the effects of permissive hypercapnia on postoperative cognitive function in elderly patients with diabetes mellitus.Methods Sixty elderly patients with diabetes mellitus scheduled for laparoscopic upper abdominal surgery under general anesthesia,were randomly divided into two groups:the permissive hypercapnia ventilation diabetes mellitus group(group DH)and the routine ven-tilation diabetes mellitus group(group DR),30 patients in each group.Another sixty elderly patients with non-diabetes mellitus scheduled for laparoscopic upper abdominal surgery under general anesthesia,were randomly divided into two groups:the permissive hypercapnia ventilation non-diabetes mellitus group(group NH)and the routine ventilation group(group NR),30 patients in each group.All patients in four groups were performed with tracheal intubation and mechanical ventilation after anesthesia induction.The respiratory parameters were adjusted to maintain PaCO2 in a range of 45-65 mmHg in groups DH and NH,and PaCO2 in a range of 35-45 mmHg in groups DR and NR.PETCO2 was recorded 5 minutes before pneu-moperitoneum,5,15,and 30 minutes after pneumoperitoneum.Blood samples were taken from the radial artery and jugular bulb for blood gas analysis 5 minutes before pneumoperitoneum,5,15,and 30 minutes after pneumoperitoneum.pH value and PaCO2 were recorded and arterial internal jugular vein bulbar oxygen difference(Da-jvO2)and cerebral oxygen extraction rate(CERO2)were calculated at the same time.The serum S100β protein concentration were detected before anesthesia induction and 3 days after operation.Montreal cognitive assessment(MoCA)scores and occurrence of postoperative cognitive dysfunction were recorded 1 day before operation,and 1 day,3 days and 7 days after operation.Results Compared with the baseline value 5 minutes before pneumoperitoneum,PETCO2 and PaCO2 were significantly increased,pH value,Da-jvO2 and CERO2 were significantly decreased 5,15,and 30 minutes after pneumoperitoneum in the four groups(P＜0.05).Compared with before anesthesia induction,the serum S100β protein concen-tration were significantly increased 3 days after operation in the four groups(P＜0.05).Compared with the last day before operation,MoCA scores were significantly decreased 1 day and 3 days after operation in the four groups(P＜0.05).Compared with group DR,PETCO2 was significantly increased,pH value,Da-jvO2,and CERO2 were significantly decreased 5 minutes before pneumoperitoneum,5,15,and 30 mi-nutes after pneumoperitoneum,the serum S100β protein concentration was significantly decreased 3 days af-ter operation,MoCA scores were significantly increased 1 day and 3 days after operation,the incidence rate of POCD was significantly decreased in group DH(P＜0.05).Compared with group NR,PETCO2 was sig-nificantly increased,pH value,Da-jvO2,and CERO2 were significantly decreased 5 minutes before pneu-moperitoneum,5,15,and 30 minutes after pneumoperitoneum,the serum S100β protein concentration was significantly decreased 3 days after operation,MoCA scores were significantly increased 1 day and 3 days af-ter operation,the incidence rate of POCD was significantly decreased in group NH(P＜0.05).Compared with group NH,Da-jvO2 and CERO2 were significantly increased 5 minutes before pneumoperitoneum,5,15,and 30 minutes after pneumoperitoneum,the serum S100β protein concentration was significantly in-creased 3 days after operation,MoCA scores were significantly decreased 1 day and 3 days after operation in group DH(P＜0.05).Conclusion Permissive hypercapnia can improve the cerebral oxygen metabolism during operation,reduce postoperative serum S100β protein concentration and reduce the incidence rate of POCD in the elderly patients with diabetes mellitus.

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Objective @#To explore the related factors for the unilateral flap and bilateral flap by changing the original operation plan in the extraction of maxillary impacted mesiodens. @*Methods @#81 patients with impacted mesiodens in the middle of the maxillary were retrospectively analyzed. The primary outcome variables were planned surgery (unilateral flap)and unplanned surgery (bilateral flap) . The secondary outcome variables consisted of operation time and postoperative swelling. The predictive variables were as follows:the differential value of the shortest distance from the supernumerary tooth to the labial and palatal bone plates , which was divided into≥1. 5 mm group and < 1. 5 mm group ; the ratio of the distance from the adjacent tooth apex to the nasal floor, compared to the length of the supernumerary teeth , was recorded as≥1 and < 1 . A statistical software SPSS 20 was used to complete the statistical analysis. @*Results @#When the differential value was less than 1. 5 mm , the possibility of unplanned surgery increased , and the probability of planned surgery was 0. 085 times than that of unplanned surgery. With age growing each 1 ⁃year, the probability of planned surgery gradually decreased , HR = 0. 745. The postoperative swelling of the palatal approach was only 0. 374 times than that of the labial approach. With age increasing , the operation time increased gradually , B = 1. 213. The ratio of the distance from the adjacent tooth apex to the nasal floor to the length of the supernumerary teeth did not affect the change of the surgical plan during the operation. @*Conclusion @#The shortest distance difference between the supernumerary teeth and the labial and palatal bone plates can be used as a reference for the selection of surgical approach for the extraction of maxillary impacted mesiodens.

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BACKGROUND: Blended learning is being integrated into undergraduate nursing education at all levels and from all directions. Cognitive engagement is not only an embodiment and guarantee of students' engagement into the curriculum from a cognitive level, deep engagement and high-level thinking, but also an important indicator of whether students are effectively engaged in the blended learning curricula. However, no studies have been seen to investigate the cognitive engagement of nursing undergraduates in the blended learning curricula and its influential factors. OBJECTIVES: To explore nursing undergraduates' cognitive engagement during the blended learning curricula and its influential factors. DESIGN: A convergent parallel mixed-methods was used. Data were collected between November 2021 and May 2022, inclusive. SETTINGS AND PARTICIPANTS: The study was carried out in the nursing school at a university in China. Participants including students undertaking entry to the blended learning curricula. METHODS: In the quantitative component (n = 142), participants' cognitive engagement was investigated and factors associated with it were examined using univariate analysis, correlation analysis and multiple regression analysis. During this period, personal, semi-structured interviews were conducted with a subset of these participants (n = 15) to understand participants' cognitive engagement experiences. RESULTS: The cognitive engagement of nursing undergraduates was at a moderate level and the cognitive engagement experiences were reflected in the four themes of Reconstitution, Connection, Elaboration and Retention. The influential factors of cognitive engagement were learning activities (ß = 0.226, p = 0.004), autonomy (ß = 0.158, p = 0.047), academic self-efficacy (ß = 0.311, p < 0.001, ß = 0.271, p < 0.001) and social interaction (ß = 0.358, p < 0.001). CONCLUSIONS: The cognitive engagement of nursing undergraduates in the blended learning curricula needs to be improved. To maximize promote cognitive engagement of nursing undergraduates in the blended learning curricula, educators should design diverse learning activities, engage in high quality social interactions with students, and maximize students' autonomy and self-efficacy.

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AIM: This meta-analysis aimed to systematically evaluate the effectiveness of auricular acupressure on pain management during labor. METHODS: Six English and three Chinese electronic databases were comprehensively searched from inception to 6 November 2021. The PRISMA checklist was followed. The methodological quality of the included studies was assessed with the Cochrane Collaboration Bias Risk Assessment Tool. The meta-analysis was performed using Review Manager 5.3 software. Heterogeneity between studies was calculated using I2 . RESULTS: Five studies comprising 312 participants were included. The labor pain scores of the auricular acupressure group were significantly lower than those of the usual care group at cervix dilations of 6, 8, and 10 cm, with mean differences (95% confidence intervals) of -1.05 (-1.41, -0.69), -1.44 (-2.07, -0.82), and -1.96 (-3.30, -0.61), respectively. Auricular acupressure can thus effectively improve the labor pain perception at cervix dilations of 6, 8, and 10 cm. Moreover, auricular acupressure shortened the active phase, and had the trend of shortening the second and third stages of labor. There was no evidence that auricular acupressure had an effect on the rate of cesarean section or the 1 and 5 min Apgar scores. CONCLUSION: Effective labor pain relief, better labor pain perception, and the lack of adverse effects support the use of auricular acupressure. More high-quality and rigorous trials are needed to verify our findings before we can make strong recommendations.

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Objective This paper summarizes the research progress of biosynthesis and pharmacological effects of podophyllotoxin drugs,in order to provide reference for the wide application of these drugs.Methods The plant source,chemical structure,action mechanism and synthesis pathway of podophyllotoxin drugs were summarized.The pharmacological and toxicological characteristics and mechanisms of these drugs were discussed,and the research progress of new dosage forms of podophyllotoxin drugs was reviewed.Results Podophyllotoxin and its derivatives are important chemical constituents in the plants of the podophyllum,such as Dysosma versipellis,Diphylleia sinensis,Sinopodophyllum hexandrum.This kind of drug has few natural sources and can be artificially produced through chemical and biosynthetic pathways.Podophyllotoxin drugs have pharmacological effects such as anti-inflammatory,anti-tumor and anti-virus,but their toxic effects need to be paid attention to.Drugs can be transported by carriers to reduce toxicity and increase effect.Conclusion Podophyllotoxin drugs have broad clinical application prospects,and will be further studied and applied in the fields of anti-inflammatory,anti-tumor and anti-virus in the future.

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Background:Duodenal neuroendocrine tumors(DNETs)are rare tumors,their disease characteristics are currently not well understood.At present,there are no research data on non-ampullary region DNETs in China.Aims:To analyze the clinical characteristics of patients with non-ampullary region DNETs in order to guide clinical practice.Methods:The clinical data ofnon-ampullary region DNETs diagnosed in the First Affiliated Hospital of Air Force Military Medical University from June 2011 to July 2022 were collected.Using the method of retrospective study,analyze the clinical characteristics of patients.Results:Twenty-two non-ampullary region DNETs patients were screened.Among them,8(36.4%)patients'tumor diameter<2 cm,14(63.6%)patients'tumor diameter≥2 cm.When non-ampullary region DNETs were diagnosed,the main clinical symptoms were abdominal distension(59.1%),followed by abdominal pain(41.0%).When diagnosed,half(50%)of patients with non-ampullary DNETs with tumor diameter<2 cm have no clinical symptoms.The clinical symptoms of non-ampullary DNETs patients with tumor diameter≥2 cm were mainly abdominal distension(85.7%),followed by abdominal pain(57.1%),and a few(14.3%)patients had no clinical symptoms.After diagnosed,the survival time of patients with tumor diameter<2 cm was longer than that of patients with tumor diameter≥2 cm(P=0.048).By the end of follow-up,the median survival time of patients with non-ampullary region DNETs was 451.0 months.Six patients had died,all of their tumor diameter were≥2 cm at diagnosis.Three of patients who died had stage Ⅳ at diagnosis,and all had liver metastases.Patients with tumor diameter<2 cm underwent surgical treatment and all survived after surgery.Conclusions:Abdominal distension is the main clinical manifestation of non-ampullary region DNETs patients,and the organ that is more likely to metastasize is the liver.The survival time of patients with non-ampullary region DNETs with tumor diameter<2 cm was longer than that of patients with tumor diameter≥2 cm.

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Objective To identify the differentially expressed proteins in different liver tissues in the mouse model of cystic echinococcosis (CE), so as to provide insights into the research and development of therapeutic drugs targeting CE. Methods Female Kunming mice at ages of 6 to 8 weeks were randomly assigned into the CE group and the control group. Mice in the CE group were intraperitoneally infected with 2 000 Echinococcus multilocularis protoscoleces, while mice in the control group were injected with the same volume of physiological saline. All mice in both groups were sacrificed after breeding for 350 d, and the lesions (the lesion group) and peri-lesion specimens (the peri-lesion group) were sampled from the liver of mice in the CE group and the normal liver specimens (the normal group) were sampled from mice in the control group for data independent acquisition (DIA) proteomics analysis, and the differentially expressed proteins were subjected to Gene Ontology (GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Results A total of 26 differentially expressed proteins were identified between the lesion group and the normal group and between the peri-lesion group and the normal group, including 8 up-regulated proteins and 18 down-regulated proteins. GO term enrichment analysis showed that these differentially expressed proteins were predominantly enriched in endoplasmic reticulum membrane (biological components), oxidoreductase activity (molecular function) and oxoacid metabolic process and monocarboxylic acid metabolic process (biological processes). KEGG pathway enrichment analysis revealed that the differentially expressed protein Acyl-CoA oxidase 1 (Acox1), which contributed to primary bile acid biosynthesis during the fatty acid oxidation, was involved in peroxisome signaling pathway, and the differentially expressed protein fatty acid binding protein 1 (Fabp1), which contributed to fatty acid transport, was involved in the peroxisome proliferator-activated receptor (PPAR) signaling pathway. Conclusion Differentially expressed proteins are identified in the liver specimens between mouse models of CE and normal mice, and some differentially expressed proteins may serve as potential drug targets for CE.

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Objective To identify the differentially expressed proteins in different liver tissues in the mouse model of alveolar echinococcosis using high-resolution mass spectrometry with data independent acquisition (DIA), and to identify the key proteins contributing to the pathogenesis of alveolar echinococcosis. Methods Protoscoleces were isolated from Microtus fuscus with alveolar echinococcosis and the experimental model of alveolar echinococcosis was established in female Kunming mice aged 6 to 8 weeks by infection with Echinococcus multilocularis protoscoleces. Mice were divided into the experimental and control groups, and animals in the experimental group was injected with approximately 3 000 protoscoleces, while mice in the control group were injected with the same volume of physiological saline. Mouse liver specimens were sampled from both groups one year post-infection and subjected to pathological examinations. In addition, the lesions (the lesion group) and peri-lesion specimens (the peri-lesion group) were sampled from the liver of mice in the experimental group and the normal liver specimens (the normal group) were sampled from mice in the control group for DIA proteomics analysis, and the differentially expressed proteins were subjected to bioinformatics analysis. Results A total of 1 020 differentially expressed proteins were identified between the lesion group and the normal group, including 671 up-regulated proteins and 349 down-regulated proteins, and 495 differentially expressed proteins were identified between the peri-lesion group and the normal group, including 327 up-regulated proteins and 168 down-regulated proteins. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed that these differentially expressed proteins were involved in peroxisome, peroxisome proliferator-activated receptor (PPAR) and fatty acid degradation pathways, and the peroxisome and PPAR signaling pathways were found to correlate with liver injury. Several differentially expressed proteins that may contribute to the pathogenesis of alveolar echinococcosis were identified in these two pathways, including fatty acid binding protein 1 (Fabp1), Acyl-CoA synthetase long chain family member 1 (Acsl1), Acyl-CoA oxidase 1 (Acox1), Enoyl-CoA hydratase and 3-hydroxyacyl CoA dehydrogenase (Ehhadh) and Acetyl-Coenzyme A acyltransferase 1B (Acaa1b), which were down-regulated in mice in the experimental group. Conclusion A large number of differentially expressed proteins are identified in the liver of the mouse model of alveolar echinococcosis, and Fabp1, Acsl1, Acox1, Ehhadh and Acaa1b may contribute to the pathogenesis of alveolar echinococcosis.

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Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on emergence agitation in the patients undergoing thoracoscopic surgery.Methods:Eighty patients of both sexes, aged 25-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective thoracoscopic surgery under general anesthesia, were divided into 2 groups ( n=40 each) by a random number table method: TEAS group (group T) and control group (group C). In group T, the Hegu (L14), Zusanli (ST36) and Sanyinjiao (SP6) were stimulated starting from 30 min before induction of anesthesia until the end of operation, with a frequency of 2/100 Hz and disperse-dense waves.The intensity of stimulation was the maximum current that patients could tolerate.In group C, stimulating electrodes were placed at the same acupoints before induction, but no electrical stimulation was applied.Ramsay sedation score and VAS score were recorded.and emergence agitation was assessed using RSS agitation score.Blood samples from the median cubital vein or internal jugular vein were collected before anesthesia induction (T 1), at the end of surgery (T 2), immediately after removal of tracheal tube (T 3) and at 15 min after removal of tracheal tube (T 4) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The intraoperative consumption of propofol, remifentanil and sufentanil was recorded.Adverse reactions such as tachycardia, bradycardia, hypertension, hypotension, respiratory depression, delay of awakening and nausea and vomiting were recorded after operation. Results:Compared with group C, the amount of intraoperative remifentanil consumed was significantly decreased, serum IL-6 concentrations were decreased, and the serum IL-10 concentration was increased T 2-4, Ramsay sedate score was increased, and the incidence of agitation was decreased in group T ( P<0.05). There was no significant difference in VAS score and incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:TEAS can reduce the development of emergence agitation in the patients undergoing thoracoscopic surgery, which is related to inhibition of inflammatory responses.

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Background: The efficacy of ustekinumab (UST) in the treatment of patients with inflammatory bowel disease (IBD) has been affirmed abroad, but its efficacy and safety have not been reported in China due to its short term of use. Aims: To analyze the clinical efficacy and safety of UST in the treatment of IBD. Methods: The clinical data of IBD patients treated with UST from November 2020 to June 2022 in the First Affiliated Hospital of Air Force Medical University were analyzed retrospectively. Results: A total of 46 patients with IBD treated with UST were enrolled, including 41 patients with Crohn’s disease (CD) and 5 patients with ulcerative colitis (UC). At the 8

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To develop a magnetic nanoparticle chemiluminescence immunoassay (CLIA) for the determination of type Ⅰ procollagen N-terminal peptide (PINP) in human serum, we expressed a recombinant PINP-α1 protein in Corynebacterium glutamicum and used it as an immunogen to immunize BALB/c mice. We obtained three hybridoma cell lines that stably secret antibody against PINP-α1 protein. After further pairing and screening, we chose a monoclonal antibody 8C12 coupled with biotin as the capture antibody, and a monoclonal antibody 1F11 labeled horseradish peroxidase as the detection antibody. The antibodies combined with the serum samples, forming a sandwich complex which was used to detect the concentration of PINP in serum. After optimizing the conditions, we determined that the best working concentration of the capture antibody and the detection antibody were 3 μg/mL, and the incubation time was 30 minutes. The quantitative assay had a detection range of 5-1 100 ng/mL, with recovery rates between 93%-107% and the minimum detection limit of 1.22 ng/mL achieved. The intra-and inter-assay precisions were lower than 10%. The correlation coefficient of PINP results between this CLIA method and the Roche electrochemiluminescence immunoassay system was 0.906 2. Therefore, this CLIA method is specific and can be used to quantitatively detect the content of PINP in serum, which has the potential to become an auxiliary approach for bone disease examination.

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The global incidence of breast cancer has increased year by year. Breast cancer has the highest mortality rate in female patients with malignant tumors. Traditional Chinese medicine（TCM） has made great contribution to health of human being， improving the overall curative effect， reducing the patients' pain， improving the quality of life and alleviating adverse reactions in patients. TCM and its active compounds can inhibit the proliferation of breast cancer cells by inducing cell cycle arrest， invasion， metastasis and reversing multidrug resistance. The effect of the compounds in TCM is obvious on inducing the arrest of the breast cancer cells cycle. It′s a novel method to fight against breast cancer by influencing the progress of the breast cancer cell cycle and inducing the cell cycle arrest in breast cancer cells. Lots of studies have shown that the G2/M phase checkpoint which transition from gap-phase （G2 phase） to mitotic phase （M phase） in the cell cycle is the key point for cell survival or death. Many antitumor drugs can inhibit the proliferation of tumor cells through the cell cycle arrest. We summarized the domestic and foreign literatures in recent years， and comprehensively explained the research progress on the related regulatory molecules in G2/M arrest. In addition， we summarized and sorted out the researches on the methods and ways of alkaloids， polysaccharides， terpenes， flavonoids， saponins and other active compounds of TCM in inducing the G2/M arrest of human breast cancer cells. By summarizing the active compounds of various Chinese medicines in inducing G2/M arrest of breast cancer cells， and reviewing the research progress on mechanism of active TCM compounds for inhibiting the proliferation of breast cancer cells， we will， in this paper， investigate the mechanism of active TCM compounds for inhibiting the proliferation of breast cancer cells through inducing G2/M arrest of human breast cancer cells， so as to provide a scientific basis for in-depth research on the anti-breast cancer mechanism of the active compounds in TCM.

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Objective:To analyze the association between CRHR1 gene(rs1876828)polymorphism and the effect of inhaled corticosteroids(ICS)in children with bronchial asthma.Methods:A total of 60 children with moderate persistent asthma who were treated in the Department of Pediatrics of the First Affiliated Hospital of Harbin Medical University from January 2018 to June 2019 were included.The CRHR1 gene rs1876828 locus in children with asthma was detected by Sanger sequencing.The children were divided into TT genotype group(TT group) and CC genotype group(CC group)according to the different base sequences of gene loci.There were 22 cases in TT group(36.7%)and 38 cases in CC group(63.3%). Both groups were given aerosol inhalation of ICS and symptomatic treatment.Clinical symptoms and signs were observed and scored before and after treatment for 3d, 10d and 30d, and the days required for complete disappearance of symptoms and signs were recorded.Results:After 3d of treatment, clinical symptoms and signs of TT group and CC group were improved to a certain extent, but there was no statistical significant difference between two groups( P>0.05). At 10d and 30 d after treatment, the recovery of the two groups was better than that at 3d, and the improvement degree of the TT group was significantly better than that of the CC group, with statistical significance( P<0.05). The time of complete remission of symptoms and signs in TT group and CC group was(8.68±7.42)d and(16.21±7.82)d; the difference was statistically significant( P<0.01). Conclusion:There is a polymorphism of CRHR1 rs1876828 locus in children with bronchial asthma, which manifests as TT genotype and CC genotype, and CC genotype is the majority.The polymorphism of CRHR1 gene rs1876828 in asthmatic children is associated with the efficacy of ICS.The efficacy of ICS in children with TT genotype is better than that of CC genotype.

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To systematically evaluate the clinical efficacy and safety of Danhong Injection combined with conventional therapy in improving diabetes mellitus complicated with coronary heart disease. Based on the online literature database(CNKI, Wanfang, VIP, PubMed, Web of Science, Cochran Library), the Chinese and English papers about the randomized controlled trial(RCT) of Danhong Injection in the treatment of diabetes mellitus complicated with coronary heart disease were searched comprehensively from the establishment of the databases to January 1, 2020. The papers were screened strictly according to the inclusion and exclusion criteria. Based on Jadad scale, the risk assessment of literature was carried out, and Meta-analysis was performed by STATA 12.0 software. Seventeen RCTs were included, involving 1 453 patients. The results of Meta-analysis showed that the combination of Danhong Injection and conventio-nal treatment could improve the clinical comprehensive effective rate(RR=1.47, 95%CI[1.38, 1.58], P<0.000 1), electrocardiogram(ECG) efficiency(RR=1.30, 95%CI[1.16, 1.46], P<0.000 1), efficiency of the angina pectoris(RR=1.41, 95%CI[1.25, 1.58], P<0.000 1), cholesterol level(SMD=-1.05, 95%CI[-1.95,-0.16], P=0.02), low-density lipoprotein(LDL) level(SMD=-0.50, 95%CI[-0.79,-0.21], P<0.000 1), coronary angina attack frequency(SMD=-3.71, 95%CI[-4.05,-3.36], P<0.000 1) and duration of angina pectoris(SMD=-2.96, 95%CI[-3.25,-2.66], P<0.000 1), with statistically significant differences. But the differences in fasting plasma glucose(FPG)(SMD=-0.19, 95%CI[-0.45, 0.08], P=0.16), plasma glucose of two hours after meal(2 hPG)(SMD=0.19, 95%CI[-0.11, 0.49], P=0.22), and high-density lipoprotein(HDL) level(SMD=0.10, 95%CI[-0.30, 0.49], P=0.62) after treatment were not statistically significant. Compared with the control group, there was no significant difference in adverse reactions(SMD=-2.96, 95%CI[-3.25,-2.66], P=0.75). The existing evidence shows that the combination of Western medicine and Danhong Injection can improve the clinical effect for diabetes mellitus complicated with coronary heart disease and has no obvious adverse reactions. However, due to the low level of overall literature evidence, high risk and some kind of publication bias, it still needs more high-quality randomized controlled trials and low-bias studies for further verification.

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Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the sleep quality after cesarean section and postpartum depression in parturients with sleep disorder.Methods:A total of 225 parturients, aged 20-45 yr, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cesarean section, were enrolled in this study.The Pittsburgh Sleep Quality Index (PSQI) scale was used to investigate the sleep quality before operation.PSQI score<7 was defined as having no sleep disorder, and the patients were included in the non-sleep disorder group (NSD group, n=76). PSQI score≥7 was defined as having sleep disorder, and the patients were randomly divided into sleep disorder group (SD group, n=73) and TEAS group ( n=76). Routine combined spinal-epidural anesthesia was performed in NSD group and SD group.In TEAS group, Neiguan, Baihui, Zusanli and Sanyinjiao acupoints were selected for performing TEAS from the completion of combined spinal-epidural anesthesia to the end of operation, and TEAS was performed for 30 min on the 1st and 2nd days after operation.Patient-controlled intravenous analgesia was applied after operation in the three groups.The blood samples were taken from the cubital vein before operation and at 1 and 2 days after operation for determination of the plasma melatonin and prolactin concentrations (by enzyme-linked immunosorbent assay). The Leeds Sleep Evaluation Questionnaire (LSEQ) was used to evaluate the quality of sleep before operation and at 1, 2 and 7 days after operation.The Edinburgh Postpartum Depression Scale was used to evaluate the postpartum depression at 6 weeks after operation. Results:Compared with NSD group, LSEQ scores were significantly decreased at each time point after operation, the incidence of postpartum depression was increased, and the concentrations of plasma melatonin and prolactin were decreased, and the lactation initiation time was prolonged in SD group ( P<0.05). Compared with SD group, LSEQ scores were significantly increased at each time point after operation, the incidence of postpartum depression was decreased, and the concentrations of plasma melatonin and prolactin were increased, and the lactation initiation time was shortened in TEAS group ( P<0.05). Conclusion:TEAS can raise the the sleep quality after cesarean section and reduce the occurrence of postpartum depression in the parturients with sleep disorders.

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This paper was aimed to explore the potential pharmacodynamics effect of Euonymus alatus in the treatment of nephritis based on integrated chemomics and network biology. The chemical constituent database of E. alatus was constructed by consulting litera-ture and using online database. The chemical constituents were identified by UPLC-Q-TOF/HRMS~E and UNIFI software. On this basis, a series of comparisons, molecular docking studies and in-depth analysis of the chemical constituents and nephritis disease targets were carried out with use of network biology method, and the potential pharmacodynamic effect of E. alatus for the treatment of nephritis was investigated by reviewing the existing. In this study, 62 chemical constituents were collected in the database of chemical consti-tuents of E. alatus, and 24 chemical constituents were identified by mass spectrum. Subsequently, based on the network biology me-thod, 22 important chemical constituents and 5 key targets were obtained by reverse screening. Molecular docking study showed that a total of 11 chemical constituents such as quercetin, kaempferol, and catechinmay be the potential material basis for E. alatus in the treatment of nephritis. Starting with chemomics and using the technology of network biology, we established a network interaction model between drug components and disease targets in this study. Through the interaction between targets in complex networks, we can find the key targets easily and quickly. By docking the key targets with small drug molecules, we can screen out the potential pharmacodynamic components, providing a reference for the follow-up study of active ingredients.

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Objective::Based on LC-MS and molecular docking strategy, to study the pharmacodynamic material basis of Jinqi Jiangtang tablets in the treatment of type 2 diabetes mellitus(T2DM). Method::UPLC-Q-TOF-MS was used to identify the chemical constituents of Jinqi Jiangtang tablets. On this basis, the disease targets were screened based on the online disease target database and protein-protein interaction(PPI). The molecular docking technology was used to verify the relationship between the chemical constituents and disease targets in Jinqi Jiangtang tablets, so as to find out the potential pharmacodynamic basis of Jinqi Jiangtang tablets in the treatment of T2DM. Result::Based on UPLC-Q-TOF-MS, 51 chemical constituents were identified in Jinqi Jiangtang tablets, including 31 astragalus, 16 coptis and 4 honeysuckle. The key targets of catalase from micrococcus lysodeiktic(CAT) receptor, peroxisome proliferative actived receptor(PPARG) receptor and insulin(INS) receptor were identified by CTD database, topological analysis and related literature. Based on LC-MS and molecular docking technology, we found that magnoflorine, coptisine, epiberberine, astragaloside Ⅳ, caffeic acid, palmatine, berberine, jateorhizine, berberubine, berberastine, groenlandne, lycoranine B, demethyleneberberine, isomucrontolula-7-O-glucoside and calycosin-7-O-glucoside were used to treat type 2 diabetes potential pharmacodynamic material basis of urinary diseases. Conclusion::Protein interaction and network topology analysis are helpful for the rapid localization of core targets. In addition, molecular docking technology can realize large-scale virtual screening of potential candidate compounds. The integration of LC-MS and molecular docking technology can facilitate and quickly find the potential pharmacodynamic substance basis in traditional Chinese medicine prescriptions, and provide a reference for subsequent drug activity screening experiments.

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Background: The incidence of inflammatory bowel disease (IBD) is increasing in China in recent years, and the impact of psychological factors on IBD has been widely concerned. Aims: To investigate the psychological status of IBD patients and the influencing factors for anxiety and depression disorders. Methods: A total of 358 inpatients with IBD admitted from Oct. 2018 to Dec. 2019 at the Xijing Hospital were recruited; 170 patients with colonic polyps were served as controls. The presence of anxiety and depression were determined using the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), respectively. Demographics, disease characteristics, and medication information were also collected. Influencing factors for anxiety and depression disorders were analyzed by logistic regression model. Results: (1) The prevalence of anxiety and depression disorders, as well as the score of SAS and SDS were higher in IBD patients than in controls (P<0.05). (2) CD was associated with a higher prevalence of comorbid depression as compared with UC (P<0.05). (3) SAS and SDS score in active CD were higher than those in remission stage (P<0.05). (4) SAS and SDS score in active IBD increased in parallel with the increase of disease activity (P<0.05). (5) College education or above (OR=8.888, 95% CI: 1.714-46.095, P=0.009 for anxiety; OR=3.831, 95% CI: 1.039-14.760, P=0.008 for depression), and the severe active disease (OR=12.293, 95% CI: 1.501-100.679, P=0.041 for anxiety; OR=3.230, 95% CI: 1.051-5.506, P=0.040 for depression) were risk factors for anxiety and depression, while serving as a office clerk was a protective factor for depression (OR=0.620, 95% CI: 0.113-0.928, P=0.043). (6) SAS and SDS score decreased after 3 months of medication in IBD patients (P<0.05); SDS score of infliximab treatment group was lower than that of 5-aminosalicylic acid and steroid treatment groups (P<0.05). Conclusions: The prevalence of anxiety and depression disorders in IBD patients is considerably high. The degree of anxiety and depression is closely related to the disease activity. After standard treatment, the degree of anxiety and depression decreased. IBD patients at risk for anxiety and depression disorders should be screened for psychological comorbidities and appropriate psychotherapy should be offered.

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Objective:To evaluate the effect of inhaled aerosolized budesonide and salbutamol on lung function during one-lung ventilation (OLV) in rabbits.Methods:Thirty-two healthy male New Zealand white rabbits, aged 5-6 months, weighing 2.5-3.0 kg, were randomized into 4 groups ( n=8 each) using a random number table method: two-lung ventilation (TLV) group, OLV group, inhalation of aerosolized budesonide group (group B) and inhalation of aerosolized budesonide and salbutamol group (group B+ S). Bilateral lungs were ventilated for 3 h in group TLV, the left lung was ventilated for 2 h followed by 1-h TLV in OLV, B and B+ S groups, aerosolized budesonide 1 mg (diluted to 2 ml in normal saline) was inhaled before OLV in group B, and aerosolized salbutamol 0.15 mg/kg plus budesonide 0.5 mg was inhaled before OLV in group B+ S.The equal volume of aerosolized normal saline was delivered in TLV and OLV groups.Volume-controlled ventilation was used in all groups.Arterial blood samples were obtained for blood gas analysis before aerosol inhalation (T 0), 15 min and 1 h after aerosol inhalation (T 1, 2), and at the end of ventilation (T 3). Oxygenation index was calculated.Mixed venous blood samples were collected to determine the corresponding parameters.The pulmonary shunt (Qs/Qt) was calculated.Peak airway pressure (P peak), airway platform pressure (P plat), airway resistance (Raw), and lung compliance (C dyn) were continuously monitored and recorded at T 0-T 3. Results:Compared with group TLV, the concentration of lactic acid was significantly increased at T 2, 3, oxygenation index and C dyn were decreased at T 1-3, and Qs/Qt, Raw, P plat and P peak were increased in OLV, B and B+ S groups ( P<0.05). Compared with group OLV, the concentration of lactic acid was significantly decreased at T 2, 3, oxygenation index and C dyn were increased at T 1-3, and Qs/Qt, Raw, P plat and P peak were decreased in B and B+ S groups ( P<0.05). Compared with group BD, the C dyn was significantly increased at T 1-3, and Qs/Qt, Raw and P peak were decreased in group B+ S ( P<0.05). Conclusion:Inhaled aerosolized budesonide and salbutamol can effectively improve lung function during OLV in rabbits.

RESUMEN

Objective: To study the clinical effects of minimally invasive corticotomy, Piezocision, as an adjunct to orthodontic treatment for the cases with missing mandibular first molar. Methods: 29 patients without mandibular first molar were devided into 2 groups and treated by orthodontic treatment with Piezocision (group A, n = 14) and routine orthodontic treatment (group B, n = 15) respectively. The movement distance and periodontal status of mandible second molar after force loading were compared between the 2 groups. Results: At 14, 28, 56, 84 days after add force loading, the movement distance of mandible second molar in group A were longer than in group B (P ＜ 0. 05) . 84 days after force loading, there was no significant difference (P＞ 0. 05) about the periodontal indices in group A compared with those before force loading. Bleeding index (BI) and periodontal depth (PD) in group B were increased 84 days after loading (P ＜ 0. 05) . There was no significant (P＞ 0. 05) of periodontal indices between the 2 groups at 84 days after force loading.Conclusion: Piezocision can accelerate orthodontic tooth movement of mandible second molar and can enture the periodontal health.