Selection and evaluation of quality markers (Q-markers) of vladimiriae radix extract for cholestatic liver injury based on spectrum-effect relationship, pharmacokinetics, and molecular docking.

ETHNOPHARMACOLOGICAL RELEVANCE: As a representative local medicinal herb produced in China, Vladimiriae Radix (VR) has been proven to exert hepatoprotective and choleretic effects, with particular therapeutic efficacy in cholestatic liver injury (CLI), as demonstrated by the VR extract (VRE). However, the quality markers (Q-markers) of VRE for the treatment of CLI remain unclear. AIM OF THE STUDY: A new strategy based on the core element of "efficacy" was proposed, using a combination of spectrum-effect relationship, pharmacokinetics, and molecular docking methods to select and confirm Q-markers of VRE. MATERIAL AND METHODS: First, the HPLC fingerprinting of 10 batches of VRE was studied, and the in vivo pharmacological index of anti-CLI in rats was determined. The spectrum-effect relationship was utilized as a screening method to identify the Q-markers of VRE. Secondly, Q-markers were used as VRE pharmacokinetic markers to measure their concentrations in normal and CLI rat plasma, and to analyze their disposition. Finally, molecular docking was utilized to predict the potential interaction between the identified Q-markers and crucial targets of CLI. RESULTS: The fingerprints of 10 batches of VRE was established. The in vivo pharmacological evaluation of rats showed that VRE had a significant therapeutic effect on CLI. The spectrum-effect correlation analysis showed that costunolide (COS) and dehydrocostus lactone (DEH) were the Q-markers of VRE anti-CLI. The pharmacokinetic results showed that AUC(0-t), Cmax, CLZ/F, and VZ/F of COS and DEH in CLI rats had significant differences (P < 0.01). They were effectively absorbed into the blood plasma of CLI rats, ensuring ideal bioavailability, and confirming their role as Q-markers. Molecular docking results showed that COS, DEH had good affinity with key targets (FXR, CAR, PXR, MAPK, TGR5, NRF2) for CLI treatment (Binding energy < -4.52 kcal mol-1), further verifying the correctness of Q-marker selection. CONCLUSIONS: In this study, through the combination of experimental and theoretical approaches from the aspects of pharmacodynamic expression, in vivo process rules, and interaction force prediction, the therapeutic effect of VRE and Q-markers (COS、DEH) were elucidated. Furthermore, a new idea based on the principle of "efficacy" was successfully proposed for screening and evaluating Q-markers.

Research trends and hotspots of polyphyllin in high-incidence cancers: A bibliometric analysis.

Background: Polyphyllin, a natural compound derived primarily from the Paris genus, manifests its anticancer properties. Extensive research on its therapeutic potential in cancers has been reported. However, there is no systematical analysis of the general aspects of research on polyphyllin by bibliometric analysis. The aim of this study is to visualize emerging trends and hotspots and predict potential research directions in this field. Methods: In this study, we collected relevant research articles from the Web of Science Core Collection Bibliometrics. Using R-bibliometrix, we analyzed the research status, hotspots, frontiers, and development trends of polyphyllin in high-incidence cancers. To conduct a comprehensive visual analysis, CiteSpace and VOSviewer were used for visual analysis of authors, countries, institutions, keywords, and co-cited references within the published articles. Results: A total of 257 articles focusing on the research of polyphyllin in high-incidence cancers were retrieved from the WOSCC database, covering the period from 2005 to 2023. The analysis revealed a consistent increasing trend in annual publications during this timeframe. Notably, China emerged as the most productive country, with Tianjin University leading the institutions. The Journal of Ethnopharmacology stood out as the most prominent journal in this field, while Gao WY emerged as the most prolific author. Polyphyllin VI, polyphyllin II, and polyphyllin VII have emerged as the latest research hotspots. Additionally, the investigation of autophagy and its associated mechanisms has gained significant attention as a novel research direction. Conclusion: This study presents a novel visualization of the research on polyphyllin saponins in the field of highly prevalent cancers using bibliometric analysis. The investigation of polyphyllin D has emerged as a primary focus in this field, with lung cancer, breast cancer, and liver cancer being the key areas of current research. Lastly, polyphyllin saponins show potential application in the field of cancer.

Diversity and limitations of electroencephalogram and event-related potential applications in nursing research: A scoping review.

AIMS: This scoping review was conducted to provide a comprehensive summary of how electroencephalogram (EEG) and event-related potentials (ERPs) have been used in nursing research, with the goal of mapping the themes and methods of nursing research involving EEGs or ERPs as a measurement tool. METHODS: The eligibility criteria were determined according to the Population, Concept, and Context principle. A systematic electronic search of articles in the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases was carried out for the period from database establishment to November 21, 2022. The included studies were analyzed using descriptive statistics and content analysis. RESULTS: The review process culminated in 45 articles, evidencing an increasing trend and dispersion characteristics of EEG in nursing research and reflecting five thematic domains of inquiry related to nursing. There was a deficiency of detailed reports of EEG recording and data analysis parameters in nursing research. The common EEG bands in nursing research were Delta, Theta, Alpha, Beta, Gamma. The ERP components used frequently were P3, P2, N1, N2, P1, N170, and feedback-related negativity. CONCLUSIONS: The wide variety of EEG components used show broad potential for studying nursing questions. In the future, it will be necessary to increase the depth of the research content, the repeatability of the experiment and the standardization of the report. Nursing researchers should give full play to the characteristics of nursing and establish a systematic and complete EEG research system for nursing.

Dendrobium Nobile Alcohol Extract Extends the Lifespan of Caenorhabditis elegans via hsf-1 and daf-16.

Dendrobium nobile is a traditional Chinese herb with anti-inflammatory, antioxidant, and neuroprotective properties. However, its antiaging effects are unclear. Herein, we studied the aging-related functions and the mechanism of action of the alcohol extract of Dendrobium nobile (DnAE) in the model organism Caenorhabditis elegans. The results indicated that 1 mg/mL DnAE slowed lipofuscin accumulation, decreased the levels of reactive oxygen species, elevated superoxide dismutase activity, enhanced oxidative and heat stress resistance, extended the lifespan of nematodes, protected their dopamine neurons from 6-hydroxydopamine-induced neurodegeneration, and reduced Aß-induced neurotoxicity. DnAE upregulated the mRNA expression of the transcription factors DAF-16 and HSF-1, promoted the nuclear localization of DAF-16, and enhanced the fluorescence intensity of HSP-16.2. However, it had no effect on the lifespan of DAF-16 mutants. Thus, DnAE can significantly extend lifespan, enhance heat stress tolerance, and delay age-related diseases through a DAF-16-dependent pathway.

Müller cells under hydrostatic pressure modulate retinal cell survival via TRPV1/PLCγ1 complex-mediated calcium influx in experimental glaucoma.

Glaucoma, an irreversible blinding eye disease, is currently unclear whose pathological mechanism is. This study investigated how transient receptor potential cation channel subfamily V member 1 (TRPV1), 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase gamma-1 (PLCγ1), and P2X purinoceptor 7 (P2X7) modulate the levels of intracellular calcium ions (Ca2+ ) and adenosine triphosphate (ATP) in Müller cells and retinal ganglion cells (RGCs) under conditions of elevated intraocular pressure (IOP). Müller cells were maintained at hydrostatic pressure (HP). TRPV1- and PLCG1-silenced Müller cells and P2X7-silenced RGCs were constructed by transfection with short interfering RNA (siRNAs). RGCs were cultured with the conditioned media of Müller cells under HP. A mouse model of chronic ocular hypertension (COH) was established and used to investigate the role of TRPV1 in RGCs in vivo. Müller cells and RGCs were analyzed by ATP release assays, intracellular calcium assays, CCK-8 assays, EdU (5-ethynyl-2'-deoxyuridine) staining, TUNEL staining, flow cytometry, and transmission electron microscopy. In vivo changes in inner retinal function were evaluated by hematoxylin and eosin (H&E) staining and TUNEL staining. Western blot analyses were performed to measure the levels of related proteins. Our data showed that HP increased the levels of ATP and Ca2+ influx in Müller cells, and those increases were accompanied by the upregulation of TRPV1 and p-PLCγ1 expression. Suppression of TRPV1 or PLCG1 expression in Müller cells significantly decreased the ATP levels and intracellular Ca2+ accumulation induced by HP. Knockdown of TRPV1, PLCG1, or P2X7 significantly decreased apoptosis and autophagy in RGCs cultured in the conditioned media of HP-treated Müller cells. Moreover, TRPV1 silencing decreased RGC apoptosis and autophagy in the in vivo model of COH. Collectively, inhibition of TRPV1/PLCγ1 and P2X7 expression may be a useful therapeutic strategy for managing RGC death in glaucoma.

Application of eye-tracking in nursing research: A scoping review.

AIMS: To map the themes and methods of nursing researches involving eye-tracking as a measurement, and offer suggestion for future nursing research using eye-tracking. DESIGN: We conducted a scoping review following the methodology outlined in the JBI Manual for Evidence Synthesis on scoping reviews. METHODS: Eligibility criteria were established based on Population (involving nursing or nursing students), Concept (utilizing eye-tracking as a research method), and Context (in any setting). Articles were retrieved from the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases, spanning from database inception to November 17, 2023. The included studies were analysed using descriptive statistics and content analysis. RESULTS: After duplicates were removed, 815 citations were identified from searches of electronic databases and other resources, and 66 met the inclusion criteria finally. Thirty-eight studies were conducted in a simulated environment. Five application domains were identified, and most of the studies (N = 50) were observational. The domains found in our review did not cover all topics of nursing research in the same depth. Additionally, 39 studies did not solely explicate eye-tracking data but instead integrated behavioural measures, scales/questionnaires, or other physiological data. CONCLUSIONS: Eye-tracking emerges as a significant research tool in uncovering visual behaviour, particularly in nursing research focused on nursing education. This study not only summarized the application and interpretation of eye-tracking data but also recognized its potential in advancing clinical nursing research and practice. To effectively harness the capabilities of eye-tracking in elucidating cognitive processes, future research should aim for a clearer grasp of the theoretical underpinnings of the addressed research problems and methodological choices. It is crucial to emphasize the standardization of eye-tracking method reporting and ensuring data quality. No Patient or Public Contribution.

Frequency of metastases within the hypothalamic-pituitary area and the associated high-risk factors in patients with brain metastases.

Objective: Brain radiotherapy often results in impairment of hypothalamic-pituitary (HT-P) function, which in turn causes secretory dysfunction of related hormones. In this paper, the frequency of metastasis in the HT-P area and its high-risk factors in patients with brain metastasis were retrospectively analyzed, and thus provide experimental evidence for protecting HT-P area during whole brain radiotherapy (WBRT). Methods: A retrospective analysis was performed on the data of patients with brain metastasis diagnosed by cranial magnetic resonance imaging (MRI) at the First Hospital of Lanzhou University from 2017 to 2020. The anatomical positions of the hypothalamus and pituitary were delineated, followed by their expansion by 5 mm outwards, respectively, in the three-dimensional direction, and the hypothalamus +5 mm and pituitary +5 mm were obtained as the avoidance area, in which the frequency of brain metastasis was evaluated. Univariate and multivariate logistic regression models were used to analyze the high risk factors of brain metastasis in HT-P area. Results: A total of 3,375 brain metastatic lesions from 411 patients were included in the analysis. The rates of brain metastasis in the hypothalamus +5 mm and pituitary +5 mm in the whole group of cases were 2.9% (12/411) and 1.5% (6/411) respectively; the frequency of lesions was 0.4% (13/3375) and 0.2% (6/3375) respectively. Univariate and multivariate analyses showed that the number of brain metastases (OR = 14.946; 95% CI = 4.071-54.880; p < 0.001), and the occurrence of brain metastasis in the pituitary (OR = 13.331; 95% CI = 1.511-117.620; p = 0.020) were related to brain metastasis in the hypothalamus, and that the only relevant factor for brain metastasis in the pituitary was the occurrence of that in the hypothalamus (OR = 0.069; 95% CI = 0.010-0.461; p = 0.006). There was no correlation between tumor pathological types, the maximum diameter, the total volume of brain metastatic lesions and the risk of brain metastasis in hypothalamus and pituitary. Conclusion: The frequency of brain metastasis in the HT-P area is extremely low. The risk of brain metastases in the hypothalamus is correlated with their number. The larger the number of metastatic lesions, the higher the frequency of brain metastasis. Protection of the HT-P area during WBRT may be unlikely to compromise the tumor recurrence rate for patients with a relatively small number of brain metastases.

Revisiting Supersaturation of a Biopharmaceutical Classification System IIB Drug: Evaluation via a Multi-Cup Dissolution Approach and Molecular Dynamic Simulation.

As a subclass of the biopharmaceutical classification system (BCS) class II, basic drugs (BCS IIB) exhibit pH-dependent solubility and tend to generate supersaturation in the gastrointestinal tract, leading to less qualified in vitro-in vivo correlation (IVIVC). This study aims to develop a physiologically based multi-cup dissolution approach to improve the evaluation of the supersaturation for a higher quality of IVIVC and preliminarily explores the molecular mechanism of supersaturation and precipitation of ketoconazole affected by Polyvinylpyrrolidone-vinyl acetate copolymer (PVPVA) and hydroxypropyl methyl-cellulose (HPMC). The concentration of ketoconazole in each cup of the dynamic gastrointestinal model (DGIM) was measured using fiber optical probes. Molecular interactions between ketoconazole and PVPVA or HPMC were simulated by Materials Studio. The results demonstrated that PVPVA and HPMC improved and maintained the supersaturation of ketoconazole. PVPVA exhibited superior precipitation inhibitory effect on ketoconazole molecule aggregation due to slightly stronger van der Waals forces as well as unique electrostatic forces, thereby further enhancing in vitro drug absorption, which correlated well with in vivo drug absorption. Compared with a conventional dissolution apparatus paddle method, the DGIM improved the mean prediction error through the IVIVC from 19.30% to 9.96%, reaching the qualification criteria. In conclusion, the physiologically based multi-cup dissolution approach enables improved evaluation of supersaturation in gastrointestinal transportation of BCS IIB drug ketoconazole, enabling screening screen precipitation inhibitors and achieving qualified IVIVC for drug formulation studies.

Synergistic effect of berberine hydrochloride and dehydrocostus lactone in the treatment of ulcerative colitis: Take gut microbiota as the target.

Ulcerative colitis (UC) is a difficult-to-cure and recurrent inflammatory bowel disease, and it is difficult to maintain long-term results with a single drug. Inspired by clinical medication in traditional Chinese medicine, we used berberine hydrochloride (BBH) and dehydrocostus lactone (DEH) in combination for the first time and focused on studying their mechanism of treating UC based on gut microbiota. Therefore, we evaluated the therapeutic effects of BBH and DEH on DSS-induced UC mice using ELISA, HE and AB-PAS staining, 16s rDNA amplicon sequencing technology, and fecal transplantation experiments (FMT). In this study, the combination of BBH and DEH significantly relieved symptoms, colonic inflammation, and intestinal barrier damage of DSS-induced UC mice, and they did not show antagonism. In addition, the co-administration of BBH and DEH altered the composition and function of gut microbiota, with BBH increasing the abundance of key beneficial bacterial genus Akkermansia and DEH aiming to enhance species diversity and supplying intestinal proteins to prevent overconsumption. Furthermore, our data showed that BBH and DEH improve the levels of short-chain fatty acids, which also proved the positive regulation of gut microbiota by BBH and DEH. Finally, the FMT confirmed the strong correlation between BBH, DEH, and the gut microbiota. In conclusion, the co-administration of BBH and DEH protected the intestinal barrier and reduced inflammatory damage by regulating gut microbiota, targeting the key beneficial bacterial genus Akkermansia, and maintaining a normal supply of intestinal proteins.

Microglia Sirt6 modulates the transcriptional activity of NRF2 to ameliorate high-fat diet-induced obesity.

BACKGROUND: Microglia play a pivotal role in neuroinflammation, while obesity triggers hypothalamic microglia activation and inflammation. Sirt6 is an important regulator of energy metabolism in many peripheral tissues and hypothalamic anorexic neurons. However, the exact mechanism for microglia Sirt6 in controlling high-fat diet-induced obesity remain unknown. METHODS: Microglia Sirt6 expression levels under various nutritional conditions were measured in the hypothalamus of mice. Also, microglia Sirt6-deficient mice were provided various diets to monitor metabolic changes and hypothalamic inflammatory response. Besides, RNA-seq and Co-IP of microglia with Sirt6 alterations were conducted to further investigate the detailed mechanism by which Sirt6 modulated microglia activity. RESULTS: We found that Sirt6 was downregulated in hypothalamic microglia in mice given a high-fat diet (HFD). Additionally, knockout of microglia Sirt6 exacerbated high-fat diet-induced hypothalamic microglial activation and inflammation. As a result, mice were more prone to obesity, exhibiting a decrease in energy expenditure, impaired glucose tolerance, insulin and leptin resistance, and increased food intake. In vitro, Sirt6 overexpression in BV2 cells displayed protective effects against oleic acid and palmitic acid treatment-derived inflammatory response. Mechanically, Sirt6 deacetylated and stabilised NRF2 to increase the expression of anti-oxidative genes and defend against reactive oxygen species overload. Pharmacological inhibition of NRF2 eliminated the beneficial modulating effects of Sirt6 on microglial activity. CONCLUSION: Collectively, our results revealed that microglial Sirt6 was a primary contributor of microglial activation in the central regulation of obesity. Thus, microglial Sirt6 may be an important therapeutic target for obesity.

The influence of pterygium on corneal densitometry evaluated using the Oculus Pentacam system.

Purpose: To assess the effect of pterygium on corneal densitometry (CD) values. Methods: One hundred and nine patients (155 eyes) with primary pterygium were divided into a severe pterygium group (79 eyes) and a mild-to-moderate pterygium group (76 eyes) according to pterygium severity. Among them, 63 patients had monocular pterygium; and 25 patients (38 eyes) underwent pterygium excision combined with conjunctival autograft follow-up. A Pentacam anterior segment analyzer was used to obtain the CD values and corneal morphological parameters, including central corneal thickness (CCT), flat-axis keratometry (K1), steep-axis keratometry (K2), corneal astigmatism, irregular astigmatism, and spherical aberration. CD was subdivided into four concentric radial regions based on corneal diameter and three layers according to depth. Results: CD values at 0-12 mm of the anterior 120 µm layer, 0-10 mm of the center layer and full thickness, and 2-6 mm of the posterior 60 µm layer were significantly higher in eyes affected by pterygium than in the contralateral unaffected eyes (all P < 0.05). CD values were significantly higher in the severe pterygium group than in the mild to moderate pterygium group (all P < 0.05). Corneal astigmatism, irregular astigmatism, K1, K2, CCT, and spherical aberration correlated with CD values in eyes with pterygium (all P < 0.05). CD values at 6-10, 0-12 mm in the anterior 120 µm layer and full thickness, 10-12 and 0-12 mm in the center layer were significantly decreased 1 month after pterygium surgery compared with those before surgery (all P < 0.05). Conclusion: Patients with pterygium had increased CD values, particularly in the anterior and central layers. CD values were correlated with pterygium severity grading and corneal parameters. Pterygium surgery partially reduced the CD values.

The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis.

BACKGROUND: The main aim of this systematic review was to determine the effectiveness of postoperative rehabilitation interventions that include breathing exercises as a component to prevent atelectasis in lung cancer resection patients. METHODS: In this review, we systematically and comprehensively searched the Cochrane Library, PubMed, EMBASE, and Web of Science in English and CNKI and Wanfang in Chinese from 2012 to 2022. The review included any randomized controlled trials focusing on the effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer patients. Participants who underwent anatomic pulmonary resection and received postoperative rehabilitation interventions that included breathing exercises as a component were included in this review. The study quality and risks of bias were measured with the GRADE and Cochrane Collaboration tools, and statistical analysis was performed utilizing RevMan 5.3 software. RESULTS: The incidence of atelectasis was significantly lower in the postoperative rehabilitation intervention group (OR = 0.35; 95% CI, 0.18 to 0.67; I2 = 0%; P = 0.67) than in the control group. The patients who underwent the postoperative rehabilitation program that included breathing exercises (intervention group) had higher forced vital capacity (FVC) scores (MD = 0.24; 95% CI, 0.07 to 0.41; I2 = 73%; P = 0.02), forced expiratory volume in one second (FEV1) scores (MD = 0.31; 95% CI, 0.03 to 0.60; I2 = 98%; P < 0.01) and FEV1/FVC ratios (MD = 9.09; 95% CI, 1.50 to 16.67; I2 = 94%; P < 0.01). CONCLUSION: Postoperative rehabilitation interventions that included breathing exercises decreased the incidence rate of atelectasis and improved lung function by increasing the FVC, FEV1, and FEV1/FVC ratio.

Effects of different types of interference on nurses' working memory: An ERP study.

AIM: To explore the effects of different types of interference on nurses' working memory, and the role of attention control. DESIGN: A repeated measures design. METHODS: A single-factor, four-level within-subjects design was adopted. Thirty-one nurses completed a delay-recognition task with four blocks in September 2020: Interrupting Stimulus (stimuli requiring attention), Distracting Stimulus (stimuli to-be-ignored), No Interference and Passively View. Behavioural responses of the participants and EEG data were recorded. MATLAB 21b and EEGLAB 21b were used for electroencephalogram data preprocessing and data extraction. RESULTS: Firstly, when nursing information system was used as task material, the accuracy rate and false alarm rate of primary tasks under interruption condition was statistically significantly different with that of distraction and no interference condition. There is a statistically significant difference in electroencephalogram measurement between correct and wrong response under interruption. Secondly, the role of attention control was different under interruption and distraction. There was a statistically significant positive correlation between the average amplitude distraction attention control index and task accuracy, and statistically significant negative correlation between the latency interruption attention control index and the accuracy of working memory task. CONCLUSIONS: There were different effects of interruptions and distractions on nurses' working memory and the role of attention control were also different. Measures can be designed according to these results to reduce the negative impact of interference on nurses, so as to improve work efficiency and reduce patient risk. IMPACT: This study has implications for clinical nursing during human-computer interaction. Resumption of the speed of the target information after an interruption affected task performance. Therefore, interventions should be designed to reduce the time needed for nurses to extract task information after an interruption, such as providing key clues in the information system interface. PATIENT OR PUBLIC CONTRIBUTION: Registered nurses participated in the study as subjects.

Comprehensive quality evaluation of two different geography originated Angelica sinensis Radix based on potential production area development and resource protection.

Angelica sinensis Radix (ASR) is mainly produced in the southern region of Gansu, China, and is a famous edible and medicinal herb. Noticeably, Aba region in Sichuan, China has similar geographical and climatic conditions to the southern region of Gansu, China, and has the potential to further develop the ASR planting industry chain. This study was the first to use an innovative method that combines GC-MS, HPLC-DAD fingerprints, and stoichiometric analysis to compare and explore the feasibility of using the Aba region as a source of high-quality ASR supplements. GC-MS analysis showed that the composition of ASR essential oil(AEO) in these two regions was highly similar (>99%). The HPLC data showed that the main sources of differences in ASR components between the two regions were coniferyl ferulate, E-ligustilide, Z-ligustilide, and Butylidenephthalide, which have great potential in anti-depression, regulating gut microbiota, and other aspects. The ASR in Aba region was rich in these components, and its biological activity might be higher to some extent than that in southern Gansu. This study confirmed the potential of the Aba region in Sichuan to become a high-quality production area for ASR, which was conducive to the expansion of ASR resources and the development of related industrial chains.

[Summary of evidence for threshold setting of multi-parameter electrocardiograph monitor in intensive care unit].

OBJECTIVE: To retrieve the evidence for threshold setting of multi-parameter electrocardiograph (ECG) monitors in intensive care unit (ICU), and summarize the best evidence. METHODS: After literature retrieval, clinical guidelines, expert consensus, evidence summary and systematic review that met the requirements were screened. Guidelines were evaluated by the appraisal of guidelines for research and evaluation II (AGREE II), expert consensus and systematic review were evaluated by the Australian JBI evidence-based health care center authenticity evaluation tool, and evidence summary was evaluated by the CASE checklist. High-quality literature was selected to extract evidence related to the use and setup of multi-parameter ECG monitors in the ICU. RESULTS: A total of 19 literatures were included, including 7 guidelines, 2 expert consensus, 8 systematic reviews, 1 evidence summary, and 1 national industry standard. After evidence extraction, translation, proofreading and summary, a total of 32 pieces of evidence were integrated. The included evidence involved the environmental preparation for the application of the ECG monitor, the electrical requirements of the ECG monitor, ECG monitor use process, ECG monitor alarm setting principles, ECG monitor alarm heart rate or heart rhythm monitoring setting, ECG monitor alarm blood pressure monitoring setting, ECG monitor alarm respiratory and blood oxygen saturation threshold setting, alarm delay warning time setting, adjusting alarm setting method, evaluating alarm setting time, improving the comfort of monitoring patients, reducing nuisance alarm report the occurrence, alarm priority processing, alarm intelligent processing and so on. CONCLUSIONS: This summary of evidence involves many aspects of the setting and application of ECG monitor. According to the latest guidelines and expert consensus, it is updated and revised to guide healthcare workers to monitor patients more scientifically and safely, and aims to ensure patient safety.

Insights into CD154-mediated pathways in ocular hypertensive glaucoma: The role of Müller cells and P2X7 in retinal neuroprotection and therapeutic potential.

An elevation of pathologic intraocular pressure (IOP) is the greatest risk factor for glaucoma. CD154 has been reported to bind to CD40 expressed by orbital fibroblasts and be involved in immune and inflammatory responses. However, the function and mechanism of CD154 in ocular hypertensive glaucoma (OHG) are not fully understood. We isolated and characterized Müller cells and subsequently examined the effect of CD154 on ATP release from those cells. After being cocultured with CD154-pretreated Müller cells, retinal ganglion cells (RGCs) were treated with P2X7 siRNAs or a P2X7 inhibitor. Furthermore, mouse models of glaucoma (GC) were injected with P2X7 shRNA. p21, p53, and P2X7 expression were examined, and cellular senescence and apoptosis were detected by ß-Gal and TUNEL staining, retinal pathology was examined by H&E staining, and CD154 and ß-Gal expression were detected by ELISA. CD154 induced ATP release from Müller cells and accelerated the senescence and apoptosis of RGCs that had been cocultured with Müller cells. We also found that treatment with P2X7 could attenuate the senescence and apoptosis of RGCs mediated by Müller cells pretreated with CD154. In vivo studies in GC model mice verified that P2X7 silencing attenuated pathological damage and prevented the senescence and apoptosis of retinal tissue. The study demonstrates how CD154 accelerates the aging and apoptosis of RGCs by co-cultivating Müller cells pretreated with CD154 in OHG. The research implies that CD154 has the potential to become a new therapeutic target for ocular hypertension glaucoma, providing a new research direction for its treatment.

Intra-articular delivery system of methotrexate for rheumatoid arthritis therapy: An in-suit thermosensitive comprehensive gel of polysaccharide from Aconitum carmichaelii Debx.

The polysaccharides (FP) extracted from the lateral roots of Aconitum carmichaelii Debx. (Fuzi) are natural compounds, which have effective therapy for rheumatoid arthritis (RA). Methotrexate (MTX) is the first-line drug for RA, but its application is greatly limited to the toxicity in liver and kidney and drug resistance. In this study, an attempt is made to apply oxidized FP (OFP) as a polymer carrier based on intra-articular delivery system loaded MTX. The FP could be modified and used as comprehensive gel carriers with biocompatibility and degradability for therapy of RA. Firstly, OFP-chitosan-poloxamer 407 in situ gel (OFP-CS-F407-MTX gel) was prepared by natural non-toxic cross-linking agents. Physicochemical characterization was performed by using 1H NMR and FTIR spectroscopic techniques to assess the successful functionalization of OFP. TGA, SEM and rheological experiment of OFP-CS-F407-MTX gel were investigated. Notably, we loaded MTX into OFP-CS-F407-MTX gel which had remarkable therapeutic efficacy and biosafety for RA. Therefore, OFP-CS-F407-MTX in situ gel delivery system can potentially reduce systemic toxicity and irritation of oral administration of MTX but hold a controlled release of drug for a long period of time.

Identification of Vitis vinifera MYB transcription factors and their response against grapevine berry inner necrosis virus.

BACKGROUND: The myeloblastosis (MYB) superfamily is the largest transcription factor family in plants that play diverse roles during stress responses. However, the biotic stress-responsive MYB transcription factors of the grapevine have not been systematically studied. In China, grapevine berries are often infected with the grapevine berry inner necrosis virus (GINV), which eventually reduces the nutritional quality and commodity value. RESULTS: The present study identified and characterized 265 VvMYB or VvMYB-related genes of the "Crimson seedless" grapevine. Based on DNA-binding domain analysis, these VvMYB proteins were classified into four subfamilies, including MYB-related, 2R-MYB, 3R-MYB, and 4R-MYB. Phylogenetic analysis divided the MYB transcription factors into 26 subgroups. Overexpression of VvMYB58 suppressed GINV abundance in the grapevine. Further qPCR indicated that among 41 randomly selected VvMYB genes, 12 were induced during GINV infection, while 28 were downregulated. These findings suggest that VvMYB genes actively regulate defense response in the grapevine. CONCLUSION: A deeper understanding of the MYB TFs engaged in GINV defense response will help devise better management strategies. The present study also provides a foundation for further research on the functions of the MYB transcription factors.

The Effectiveness of Telemedicine in Patients with Rheumatoid Arthritis: An Overview of Systematic Reviews and Meta-Analysis.

Introduction: Although telemedicine is widely used in the field of rheumatoid arthritis (RA), many systematic reviews have evaluated telemedicine, but we still have no clear effect on RA and no evidence summary. Our aim is to determine the effectiveness of telemedicine on different health outcomes of RA. Methods: The following sources were used: PubMed, Cochrane, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Embase. The publication period was from the establishment of the database to May 12, 2022. Methodological and reporting qualities were assessed using A Measurement Tool to Assess Systematic Reviews 2 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Each intervention's evidence of effect was graded in accordance with the Grades of Recommendations Assessment, Development and Evaluation standards. The comparison of systematic reviews and the investigation of the impact of telemedicine on various outcomes were carried out through a meta-analysis of original studies. Results: Eight systematic reviews were included. The results showed that telemedicine imparted significant improvements in patients with RA in terms of disease activity, function, physical activity, self-efficacy, and knowledge. Conclusions: Telemedicine can improve the overall standard of care for patients with RA. In the future, standardized telemedicine processes should be developed to protect patients.