To investigate the intervention effect of Guilingji on bleomycin-induced pulmonary fibrosis in mice and explore its underlying mechanisms.
Methods
Sixty 10-week-old male C57BL/6 mice were randomly divided into a control group and Guilingji group （30 mice in each）.The Guilingji group was further divided into Guilingji Group 1 and Guilingji Group 2 （15 mice in each），and both received intratracheal injection of bleomycin （5 mg/kg） to induce pulmonary fibrosis and were administered Guilingji orally starting on Day 1 or Day 29， respectively.The control group received only an equal volume of isotonic saline solution.Mice were sacrificed on Day 7， Day 28， and Day 90 to collect lung tissues.The left lung tissues were stained with HE and Masson's trichrome， while the right lung tissues were analyzed by enzyme-linked immunosorbent assay （ELISA） for the protein levels of p21， p53， β-catenin， transforming growth factor β1 （TGF-β1）， and hydroxyproline （Hyp）， and by realtime quantitative reverse transcription PCR （qPCR） for the mRNA expression of TGF-β1.Comparisons between different time points within the group were conducted using ANOVA， while comparisons between groups were performed using the LSD method.
Results
HE and Masson's staining showed normal lung tissues in the control group， while the Guilingji groups exhibited fibrosis at all time points，with the most severe fibrosis on Day 28 and a reduction on Day 90.The degree of fibrosis was lower in Guilingji Group 1 than in Guilingji Group 2.The expression levels of cellular senescence markers（p21， p53， β-catenin） and fibrosis markers （TGF-β1， Hyp） were elevated in the Guilingji groups， peaking on Day 28.On Day 90， the expression level of these markers were lower in Guilingji Group 1 than in Guilingji Group 2 （tp21=-8.713， tp53=-8.190， tβ-catenin=-10.276， tTGF-β1=-4.785， tHyp=-20.432； P ＜ 0.05）.The mRNA expression of TGF-β1 was also elevated in the Guilingji groups， with lower levels in Guilingji Group 1 compared to Guilingji Group 2 （t=4.676， P ＜ 0.05）.
Conclusion
Guilingji can ameliorate bleomycin-induced pulmonary fibrosis in mice， possibly through the inhibition of cellular senescence and fibrosis markers.
To compare the bowel cleansing effects of polyethylene glycol and sodium phosphate as bowel preparations in middle-aged and elderly populations， evaluate the consistency between clinical assessment of bowel preparation quality and endoscopic bowel cleanliness，and explore methods for clinically predicting bowel cleanliness before colonoscopy.
Methods
A total of 146 patients aged 50-75 years， scheduled for colonoscopy in Huadong Hospital Affiliated to Fudan University， were randomly divided into two groups： the polyethylene glycol group （69 patients） and the sodium phosphate group （77 patients） for bowel preparation.The study compared the following between the two groups： the characteristics of the last stool before colonoscopy， the endoscopic bowel cleanliness， the tolerability of the bowel cleansing agents， and their safety.The Kappa test was used to assess the consistency between clinical evaluations of bowel cleanliness and the endoscopic Boston Bowel Preparation Scale （BBPS） scores.
Results
Regardless of whether bowel cleanliness was assessed based on the characteristics of the last stool or the endoscopic BBPS scores， no statistically significant difference was observed between the polyethylene glycol group and the sodium phosphate group in terms of bowel cleanliness （P ＞ 0.05）.Using the characteristics of the last stool after bowel cleansing as a single clinical indicator of bowel quality showed poor consistency with the true bowel cleanliness assessed by colonoscopy.The Kappa values for the polyethylene glycol group and the sodium phosphate group were 0.348 and 0.224， respectively （P ＜ 0.05 or P ＜ 0.01）.However， combining the last stool characteristics with the total number of bowel movements as clinical indicators for pre-assessing bowel cleanliness improved the consistency with true bowel cleanliness as evaluated by colonoscopy.The Kappa values for the polyethylene glycol and sodium phosphate groups increased to 0.494 and 0.644， respectively （P ＜ 0.01）.Regarding tolerability， 49.30% of patients in the polyethylene glycol group were willing to use polyethylene glycol again for bowel cleansing，while 57.10% of patients in the sodium phosphate group accepted sodium phosphate for bowel cleansing.The difference was not statistically significant （P ＞ 0.05）.The incidence of adverse events was not significantly different between the two groups （P ＞ 0.05）， and no significant changes were observed in liver and kidney function or electrolyte levels before and after treatment in either group（P ＞ 0.05）.
Conclusion
The overall bowel preparation effect before colonoscopy was good for both bowel cleansing agents in middle-aged and elderly patients， with a high bowel cleanliness rate.Combining the total number of bowel movements and the characteristics of the last stool after the use of bowel cleansing agents can more accurately predict bowel cleanliness before colonoscopy.
To explore the effect of overground body weight support system on lower limb motor function and fear of falling in elderly patients with stroke.
Methods
A total of 74 elderly patients with lower limb motor dysfunction and fear of falling in the recovery period of stroke admitted to Zhejiang Hospital from October 2022 to June 2023 were selected and divided into a control group and an observation group by random number table method.The control group （37 cases） received conventional rehabilitation training intervention， and the observation group （37 cases） received overground body weight support system on the basis of the control group.After 4 weeks of intervention， Fugl-Meyer assessment scale （FMAS） of lower extremity， Berg balance scale （BBS）， timed up and go test （TUGT），modified Barthel index （MBI） and fear of falling questionnaire-revised （FFQ-R） were used to evaluate lower limb motor function， self-care ability， and fear of falling before and 4 weeks after the intervention.The intervention effects between the two groups were compared using an independent samples t-test.
Results
After the intervention， the lower limb FMA， BBS， and MBI scores of the observation group were significantly higher than those of the control group （t=5.293， 8.473， 5.976； P ＜ 0.01）， the TUGT time was significantly shorter than that of the control group （t=11.889， P ＜ 0.01）， and the FFQ-R score was significantly lower than that of the control group （t=7.147， P ＜ 0.01）.
Conclusion
Overground body weight supported training can improve the lower limb motor function of elderly stroke patients， reduce their fear of falls， enhance their self-care ability， and improve their quality of life.
To investigate the current status of catheter-associated urinary tract infections （CAUTI） in hospitalized patients in the geriatrics department， and analyze the risk factors for the occurrence of CAUTI.
Methods
Through the Xinglin Hospital Infection Monitoring System，data from 210 patients with urinary catheters in the geriatrics department of Suqian hospital from 2019 to 2023 were retrospectively collected.The patients were divided into infection group （n=10） and noninfection group （n=200） based on the occurrence of CAUTI.Analyze the catheter utilization rate， CAUTI incidence， and distribution of pathogenic microorganisms.Univariate analysis was employed to compare the relevant data between the two groups， and significant variables were included in multivariate logistic regression analysis to predict the risk factors for CAUTI.
Results
The urinary catheter utilization rate among hospitalized patients in the geriatrics department was 6.02%， with a CAUTI incidence rate of 4.36‰.CAUTI accounted for 16.39% of all infections and 47.62% of urinary tract infections.A total of 10 pathogenic strains were identified， including 6 fungal strains and 4 Gram-negative bacterial strains.Logistic regression analysis revealed that the use of glucocorticoids for ≥3 days was an independent risk factor for the occurrence of CAUTI （OR=5.173， 95%CI=1.007-26.561， P ＜ 0.05）.
Conclusion
The incidence of CAUTI in the geriatrics department of the hospital is high and shows an upward trend，with fungal infections being predominant.Patients using glucocorticoids for ≥3 days require particular vigilance for the occurrence of CAUTI.
Sarcopenia is an age-related systemic skeletal muscle degenerative disease that seriously affects the quality of life and health of the elderly.In recent years， there have been an increasing number of studies on the relationship between intestinal flora and sarcopenia.Among them， shortchain fatty acids （SCFA）， the metabolites of intestinal flora， play an important role in the pathogenesis of sarcopenia.SCFA are involved in muscle mass and composition， inflammaging aging and immune senescence， mitochondrial dysfunction and oxidative stress， insulin resistance， hepatic uptake and metabolism， and blood flow metabolism in skeletal muscle， which directly or indirectly affect the gut microbe-muscle axis.Based on the aforementioned effects of SCFA， modification of dietary and exercise regimens， and supplementation with probiotics and prebiotics may be able to serve as interventions for sarcopenia.This paper further explore the potential role of SCFA in the pathogenesis of sarcopenia， to provide new ideas for the treatment of sarcopenia.
In recent years， more and more studies have shown that epigenetic regulatory factors play an important role in bone development and bone diseases.Among them， the regulation of histone methylation level is one of the hot topics.Disrupter of telomeric silencing 1-like （DOT1L） is the only enzyme known to catalyze the methylation of histone H3K79.Recently， the role of DOT1L in bone metabolism and related diseases has received much attention.The abnormal expression of DOT1L often causes a series of bone diseases， such as osteoarthritis， osteoporosis and skeletal developmental disorders，which indicates that DOT1L plays an important role in maintaining bone development and functional homeostasis.In addition， there is also preliminary evidence for a potential role of DOT1L in bone tumorigenesis.In terms of mechanism， the pathogenesis of osteoarthritis is closely related to DOT1Lregulated Sirt1/Wnt pathway； the pathogenesis of osteoporosis is closely related to the regulation of oxidative environment and mir181-mediated KAT2B degradation by DOT1L.This article reviews the role of DOT1L in bone development and bone diseases， which provides a new target and treatment strategy for the treatment of bone diseases.
