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Objective To explore the therapeutic mechanism of cordycepin for acute kidney injury （AKI） based upon gene chips in gene expression omnibus （GEO） database, network pharmacology, molecular docking and in vitro experiments. Methods Targeted genes of AKI were obtained from two databases, GEO （GSE87025） and GeneCards. Cordycepin-related targets were retrieved from three databases of TargetNet, BATMAN and GeneCards. The common targets of AKI and cordycepin were screened by taking the intersection of two sets. Molecular docking was performed for cordycepin and key targets after gene ontology （GO） annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. Cell experiments were performed for control, hypoxia/reoxygenation and hypoxia/reoxygenation+cordycepin groups for experimental verifications of the relevant targets. Results There were 12 common targets of AKI and cordycepin. GO functional annotation results indicated that these targets participated predominantly in negative regulation of apoptotic signaling pathway and necroptosis process. KEGG enrichment analysis results showed that they played some roles in signaling pathways of Toll-like receptor, necroptosis, nucleotide-binding oligomerization domain （NOD）-like receptor, nuclear factor-κB （NF-kB）, tumor necrosis factor （TNF） and cell apoptosis, etc. Optimal binding energy between cordycepin and receptor interacting protein kinase 1 （RIPK1） in molecular docking was -7.1, denoting potent binding activity. Western blot indicated that cordycepin down-regulated the expressions of RIPK1, bcl-2 associated x protein （Bax） and caspase 3 and up-regulated B cell lymphoma/lewkmia-2（Bcl-2）. Cell immunofluorescence results revealed that cordycepin down-regulated the expression of RIPK1. Conclusion Cordycepin may alleviate hypoxia/reoxygenation-induced renal tubular epithelial cell injury through regulating RIPK1-mediated apoptosis. Thus it achieves the therapeutic efficacy for AKI.

Dendritic cells (DCs) play a crucial role in bridging innate and adaptive immune responses. They are widely distributed in various tissues and organs, including the eyes. In the ocular context, permanent DCs are present at the peripheral edge of the retina and the peripapillary area in an immature state. However, during the inflammatory process, DCs become activated and contribute to the development of uveitis. This review focuses on introducing the characteristics and status of DC-induced uveitis, exploring factors that can influence the status of DCs, and discussing feasible methods for treating DCs in both experimental autoimmune uveitis animal models and humans. It emphasizes the importance of further research on molecular pathways and signaling pathways that regulate the function of DCs. For example, investigating molecules such as cytotoxic T-lymphocyte-associated protein 4, which inhibits the B7-CD28 co-stimulatory interaction, can help improve immune homeostasis. The aim is to identify new therapeutic targets and develop targeted strategies for DCs, such as DC vaccine therapy or the use of immune modulators. These approaches can be tailored to the immune characteristics and disease manifestations of individual patients, enabling personalized treatment strategies. This may include the personalized design and precise medication of DC therapy, with the ultimate goal of improving treatment efficacy while minimizing adverse reactions.

Summary:. An 80-year-old male patient was admitted to the hospital due to swelling in the right lower limb with local blisters caused by a forced prone position for 9 hours after syncope. The patient got up in the middle of the night and fainted beside the bed due to a transient cerebral ischemia attack. The front of the right thigh and calf contacted the bed edge, presenting a forced prone position for 9 hours. The physical examination revealed swelling of the right lower limb, accompanied by local tension blisters, and the tension of the thigh and calf was increased. The patient had a history of diabetes, and no lower limb artery or vein thrombosis was found on B-ultrasound. Based on these findings, the patient was diagnosed with well leg compartment syndrome in the right thigh and calf. When the patient was admitted, the creatine phosphokinase level was 62,300 u/L, and the creatinine level was 2.66 mg/dL. Besides, the urea level of this patient was 11 mmol/L. He developed anuria with a high creatinine level, indicating acute kidney injury. Subsequently, temporary hemodialysis was performed for treatment. The patient underwent fasciotomy of the right thigh and calf, and the vacuum-assisted closure device was adopted for wound treatment. After 2 weeks of decompression, the wound was directly sutured under tension. After renal replacement therapy, the creatine phosphokinase level of this patient was 102 u/L, and the creatinine level was 95 mol/L, which tended to be normal.

Objective To understand the current status of humanistic care in clinical nursing teaching, and analyze its influencing factors. Methods Using the convenient sampling method, a total of 170 clinical nursing teachers were selected. Caring Ability Inventory and the general information questionnaire were used to investigate clinical nursing teachers. Results A total of 170 questionnaires were distributed, and 164 were effectively recovered, with an effective recovery rate of 96. 47%. The humanistic care behavior score of clinical nursing teacher was (100. 90±12. 97). Univariate analysis revealed that the dimension of respectful and connectedness was influenced by marital status, professional titles, years of working and years of clinical teaching(P＜0. 01), dimension of knowledge and skill was influenced by education level and whether having children(P＜0. 01), and dimension of assurance was influenced by marital status and whether having children(P＜0. 01). Multiple linear regression analysis showed that education level and whether having children were influencing factors of teachers’ knowledge and skill in humanistic care practice, which explained 4. 80% of the variation. Conclusion The level of humanistic care behavior in clinical nursing teacher is at a medium level, which is related to marital status. The level of humanistic care behavior in clinical nursing teacher is associated with whether having children, years of working, years of clinical teaching, professional titles, education level and other factors. Nursing managers should take targeted measures to strengthen the cultivation of humanistic care ability in clinical nursing teachers. (目的 了解临床护理带教人文关怀行为现状, 探究影响因素, 为提升临床护理人文关怀水平提供参考。方法 采用方便抽样法, 随机抽取170名临床护理带教老师为调查对象, 使用护理人文关怀量表、一般资料调查表等工具进行问卷调查。结果 共发放170份问卷, 有效回收164份, 有效回收率96. 47%, 临床护理带教人文关怀行为评分为(100. 90±12. 97)分。单因素分析显示, 尊重和联系维度与护士婚姻状况、职称、工作时长、参加带教工作时长有关(P＜0. 01), 知识和技能维度与护士文化水平、有无子女有关(P＜0. 01), 支持和保证维度与护士婚姻状况、有无子女有关(P＜0. 01)。多重线性回归分析显示, 文化水平及有无子女对护理人文关怀能力的知识和技能维度有显著影响, 可解释人文关怀能力知识和技能维度变异的4. 80%。结论 临床护理带教人文关怀行为水平处于中等水平, 与婚姻状况、有无子女、工作时长、带教时长、职称、文化水平等因素相关, 护理管理者应采取针对性的措施加强临床护理带教的人文关怀能力的培养。)

Abstract The overall picture of degloving skin and soft tissue injuries (DSTI) remains a blank space in China. Therefore, a retrospective study was designed to summarize the current situation of this injury. Patients diagnosed with DSTI hospitalized between 2013 and 2018 were identified from the Hospital Quality Monitoring System (HQMS) database, of whom demographics, injury characteristics, hospitalization and cost information were analyzed. A total of 62,709 patients were enrolled in this study. Male sex predominated, with a mean age of 43.01 ± 19.70 years. Peasants seemed to be the most vulnerable. East China and Hubei province had the most patients. The most and least frequently injured anatomic site were lower extremity and torso, respectively. Traffic-related accidents and summer accounted for the highest proportion in terms of injury mechanism and season. The operation rate of DSTI roughly showed a growing trend, and the average length of stay was 22.02 ± 29.73 days. At discharge, 0.93% of DSTI patients ended up in death. Medicine accounted mostly for hospitalization cost, while the proportion decreased year by year. More than half DSTI patients paid at their own charge. This study made a relatively detailed description of DSTI patients nationwide, and might provide enlightenments for better prevention and treatment.

Abstract Some low-coordination materials, including water, silica, and silicon, exhibit polyamorphism, having multiple amorphous forms. However, the microscopic mechanism and kinetic pathway of amorphous-amorphous transition (AAT) remain largely unknown. Here, we use a state-of-the-art machine-learning potential and local structural analysis to investigate the microscopic kinetics of AAT in silicon after a rapid pressure change. We find that the transition from low-density-amorphous (LDA) to high-density-amorphous (HDA) occurs through nucleation and growth, resulting in non-spherical interfaces that underscore the mechanical nature of AAT. In contrast, the reverse transition occurs through spinodal decomposition. Further pressurisation transforms LDA into very-high-density amorphous (VHDA), with HDA serving as an intermediate state. Notably, the final amorphous states are inherently unstable, transitioning into crystals. Our findings demonstrate that AAT and crystallisation are driven by joint thermodynamic and mechanical instabilities, assisted by preordering, occurring without diffusion. This unique mechanical and diffusion-less nature distinguishes AAT from liquid-liquid transitions.

Aim/Purpose: This study attempts to apply gamification to support the training of small business owners in business web development from a work-based learning perspective. Background: Web design describes the process of creating a website and embodies many different aspects, such as webpage layout, content production, and graphic design. However, there are many obstacles that small business owners face when developing their websites, such as time and budget constraints, lacking technical skills, and difficulties with content creation. Methodology: Based on the literature review, a gamified training program was developed for website development. The new website design and development training method was compared with the traditional lecture training method from small business owners' perspectives in the specific work-based learning context. Contribution: This study contributes to the field of work-based learning by developing an innovative gamified training program for small business owners in website development learning. Findings: The results confirm that the gamified training program improved learning outcomes and satisfaction. The results of this study help advance the understanding of work-based training program design and provide insights to support small business owners in learning new technologies. Recommendations for Practitioners: Results confirm that this new training system is superior to the traditional lecture training method. While much attention has been directed to website design and development learning or business activities of small business owners, this study emphasizes the need for work-based learning in such a context. Recommendation for Researchers: This study also shows a potential way for future research by combining technology education and small business owners' needs. Impact on Society: The results of this study show the advantages of gamified training programs. For their future training program selections, small business owners should pay more attention to gamified training and education systems in the market. Furthermore, gamified training and education systems not only help small businesses but also could be adopted by mid-size or even large companies in their training programs. Future Research: Future research should be conducted to investigate to what extent gamification improves work-based learning and how to design gamification to improve work-based learning.