Objective To investigate the effects of recombinant human tumor necrosis factor receptorⅡ-Fc fusion protein(rhTNFR:Fc ) on nuclear factor-κB(NF-κB)and tumor necrosis factor-α(TNF-α)protein expression in the rat brain tissue,and traumatic brain edema following acute traumatic brain injury(TBl).Methods The inju-ry rats were subjected to right lateral cortical impact injury caused by a free-falling object.In the rhTNFR:Fc group,rhTNFR:Fc was administered intraperitoneally(3.0 mg/kg)after 30 min of injury-and the rats of control and injury group administered with normal saline solution.The levels of TNF-α protein in rat brain were mensured by radio-im-munonssay(RIA).The NF-κB protein expression of rat brain was studied immunohistochemically.In the meantime,the water content of rat brain Was measured,and for the microscope and ultrastructure examinations by using electron-ic microscope respectively.Results Compared with control group,the levels of NF-κB and TNF-α protein and the water content of brain tissue were obvicously increased from 6 h following TBI(P<0.05,or P<0.01).Compared with injury group,the expression of NF-KB and TNF-α protein,and the brain water content were lower in rhTNFR:Fc group(P<0.05-P<0.01).The rhTNFR:Fc Can reduce the brain injury in electronic microscope examinations.Conclusion The expression of NF-κB and TNF-α,and the water content of rat brain increase significantly follow-ing acute traumatic brain injury.The rhTNFR:Fc can dramatically inhibit the expression of NF-κB and TNF-α,and alleviate rat brain edema after TBI.

Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.

Objective To investigate the effect of psychological abuse in childhood on the personality of undergraduates with depression as well as its possible mechanism, and thus provide scientific evidence for the intervention of depression in undergraduates. Methods Particinants were 733 undergraduates from a university in Henan Province. They were surveyed with Center for Epidemiological Studies-Depression scale (CES-D), childhood experience of care and abuse questionnaire (CECA. Q) and Eysenck personality theory (EPQ). Results the correlation between maternal antipathy and introversion-extroversion of personality;psychological abuse in childhood had apparently positive correlation with the depression in undergraduates (r = 0. 257, r = 0. 304, r =0. 243, P＜ 0. 01) and that of childhood maternal neglect to psychoticism (β = 0.206, P＜ 0.01) were positive and significant. The standard regression coefficients of paternal neglect to introversion-extroversion (β= -0. 143, P＜0. 01)were negative and significant . The scores of childhood paternal antipathy and maternal antipathy explained that childhood paternal antipathy had indirect effect via adulthood neuroticism on the depression in undergraduates,furthermore, the indirect effect demonstrated 59.8% of the total effect. Conclusion This study suggests that the personality of undergraduates with depression is affected directly by psychological abuse in childhood, and adulthood personality may mediate the relation between childhood psychological abuse and adulthood depression.

Objective To compare the cell-killing and sensitization effect of 6-gingerol on human hepatoma carcinoma (HepG-2) cell in normal mode versus hypoxia-hypoglycemia mode in chemotherapy.Methods The HepG-2 cells was cultured to logarithmic phase and treated with adriamyein doxorubicin hydrochloride (ADM) (5,10,15,20,40,60 mg/L) and 6-gingerol(25,50,100,200 μmol/L)in different concentrations.Then the cell counting kit (CCK-8) assay kit was used to determine the proliferation inhibition of HepG-2 cells.Cell apoptosis was detected by combining flow cytometry and AnnexinV-FITC PI double staining after treated with different drugs.The expressions of bcl-2,bax and birc-5 mRNA in HepG-2 cells was detected by real time fluorescence quantitative polymerase chain reaction(RT-PCR)assay.Results 6-gingerol and ADM had a certain degree of growth inhibition on HepG-2 cells.In two modes,the inhibition ratios of the 6-gingerol and ADM were both increased along with the increase of the concentration,which showed a dose-dependent manner.Flow cytometry analysis demonstrated that the apoptosis rate in the control group,6-gingerol group,ADM group and the 6-gingerol+ADM group in the normal mode was (7.98±0.76)％,(9.63 ± 1.00) ％,(12.70 ± 2.13) ％ and (19.92 ± 1.41) ％ respectively.The apoptosis rate in the control group,6-gingerol group,ADM group and the 6-gingerol+ ADM group in the hypoxia-hypoglycemia mode was (13.92 ± 2.02)％,(19.36 ±-1.22)％,(27.87 ± 0.99)％ and (38.63 ± 2.25)％ respectively.It demonstrated that the apoptosis rate was increased in the experimental groups as compared to the control group under the two culture conditions(the normal mode and the hypoxiahypoglycemia mode)(t=7.250,5.259,12.185,8.140,15.000,47.576,respectively,all P＜0.05,0.01 or 0.001).The combination group had the highest number of apoptosis cells,and the number of apoptosis cells was higher in hypoxia-hypoglycemia group than in normal culture group.Real-time PCR analysis showed that,compared with the control group,the expressions of bcl-2 and birc-5 mRNA were decreased and the expression of bax mRNA had no significant changes in experimental group under the normal culture conditions.The expressions of bcl-2 and birc-5 mRNA were significantly decreased and the expression of bax mRNA was increased in experimental group as compared with the control group under the hypoxia-hypoglycemia conditions.Under the hypoxiahypoglycemia environment,the expression of bcl-2 mRNA was significantly increased,the expressions of bax and birc-5 mRNA was significantly reduced,and the ratio of bcl-2 and bax was significantly increased as compared with the normal culture conditions.Conclusions 6 gingerol may decrease the inhibitory effect of survivin protein on tumor cells apoptosis by reduced the expression of birc-5,which generates the cell-killing and sensitizing effect on HepG-2 cell in chemotherapy.This performance is more obvious in the hypoxia-hypoglycemia environment.

Objective To investigate the impact of AG490 on the blood-brain barrier (BBB ) permeability and the expression of interleukin-6 (IL-6 )and tumor necrosis factor-α(TNF-α)after traumatic brain injury (TBI)in rats. Methods A total of 144 healthy male SD rats were randomly divided into a control group,a trauma group,and an AG490 intervention group (n=48 in each group). The rats in each group were redivided into four subgroups (4 h,1 d,3 d,and 7 d subgroups)according to the time points after cerebral injury (n=12 in each subgroup). A brain trauma models were induced by hydraulic shock method. Evans blue was used to determine the changes of the BBB permeability after cerebral injury in each group. Real-time fluorescence quantitative PCR was to detect the expression levels of TNF-αand IL-6 mRNA in rat brain tissue. Immunohistochemistry was used to detect the expression of human phospho tyrosine kinase (P-JAK2). Results (1)The permeability of BBB:The permeability of BBB increased at 4 h,1 d,3 d and 7 d after brain injury in the trauma group (Evans blue permeation:10. 4 ± 1. 2,16. 0 ± 1. 4,22. 3 ± 2. 0,and 8. 4 ± 0. 9μg/g,respectively). Compared with the control group, there were significant differences (all P<0. 01). The Evans blue permeation of the AG490 intervention group were 9. 1 ± 1. 0,12. 8 ± 1. 1,17. 5 ± 1. 4 and 7. 1 ± 0. 8μg/g,respectively at each time point,and they were all significantly lower than those of the trauma group (all P<0. 01). (2)The expression of IL-6 and TNF-α mRNA:The expression levels of IL-6 mRNA and TNF-α mRNA at 4 h,1 d,3 d and 7 d after traumatic brain injury in the trauma group were 2. 31 ± 0. 35,2. 73 ± 0. 35,3. 32 ± 0. 29,2. 14 ± 0. 24 and 7. 46 ± 1. 18,9. 42 ± 1. 54,13. 76 ± 1. 89,and 6. 28 ± 1. 00,respectively,they were all significantly higher than those of the control group (all P<0. 01). The expression levels of IL-6 mRNA and TNF-α mRNA of the AG490 intervention group were 1. 14 ± 0. 22,1. 54 ± 0. 23,1. 94 ± 0. 32,1. 26 ± 0. 21 and 5. 57 ± 0. 88, 7. 78 ± 1. 02,11. 51 ± 1. 29,and 5. 05 ± 0. 97,respectively,they were all lower than those of the trauma group,but they still higher than the control group. There were significant differences (all P<0. 01). (3 )The expression of P-JAK2:The expression levels of P-JAK2-positive cells at each time point after traumatic brain injury in the trauma group were significantly higher than the control group (all P<0. 01),they were 17. 4 ± 2. 7,56. 2 ± 6. 7,26. 1 ± 5. 4,and 15. 3 ± 2. 5,respectively;those of the AG490 intervention group were 12. 2 ± 1. 4,41. 5 ± 4. 6,19. 4 ± 4. 1,and 9. 6 ± 2. 0,respectively,they were all lower than those of the trauma group,but still higher than the control group. There were significant differences (all P<0. 01). Conclusion During the acute phase after TBI,AG490 may activate the factor signaling pathways by inhibiting the non-receptor tyrosine kinase/signal transduction and transcription,significantly inhibit the expression of brain tissue inflammatory cytokines IL-6 IL-6 and TNF-α,reduce the BBB damage,and help to reduce secondary brain injury.

Objective:To optimize the extraction technology of Fufang Jinsha Lidan granule. Methods:According to the properties of traditional Chinese medicines in the formula, orthogonal experiments were used to optimize the extraction process of Fufang Jinsha Li-dan granule. The volume of water, boiling time and boiling frequency were used as the three influencing factors with three different lev-els in the orthogonal experiments. Moreover, the content of paeoniflorin and the yield of extract were chosen as the evaluation indices. The orthogonal experiments were carried out according to the L9 (34 ) orthogonal table. Results:The optimal extraction process of Fu-fang Jinsha Lidan granule was as follows:boiled twice, and one hour per time with 12-fold amount of water ( soaked for 30 min with 14-fold amount of water for the first extraction process) . Conclusion:The extraction process has such properties as high extraction rate, stability, simple operation, high yield of extract and controllable quality, which is worthy of wide application.

Objective:To investigate the effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis (DVT) Scale used by nurses to assess the risk of deep venous thrombosis in surgical patients.Methods:Applied the way of PDCA, namely, raising questions, analyzing reasons, implementing measures, feeding back effects to professional explanate the difficulty in using the scale, moreover, training the nurses used level education method between August 2017 and December2018.The accuracy and consistency of the scale were compared before and after interventions.Results:A total 396 patients were evaluated in the study. There were significant differences in the consistency of evaluation among hospitalized, post-operative and discharged patients after intervention compared with before intervention ( P< 0.0167).The consistency of assessment of team members and responsible nurses increased from 68 to 120 cases, and the consistency of assessment reached 90.91%. The Kappa consistency of assessment of responsible nurses and team members increased from 0.354 before intervention to 0.879 after intervention. The effect was remarkable. Conclusions:PDCA cycle method is based on the problems found in clinical practice. It clarifies the professional terms and rules used in the scale, improves the accuracy and consistency of the Autar DVT scale used by nurses, correctly reflects the risk of thrombosis, ensures the safety of patients, and is worthy of promotion and reference.

With the continuous expansion of the enrollment of international medical students and the improvement of teaching quality, as well as the rapid development of rehabilitation medicine in China, rehabilitation medicine has become one of the required courses for in-ternational medical students. In view of the main problems suffered by the international medical undergraduate students in the study of reha-bilitation medicine, we mainly focused on the education concepts, teaching management and quality evaluation system, curriculum setting, construction of teaching materials, teacher training, teaching mode, teaching research and so on. The aim is to provide reference for improv-ing education quality in the course of rehabilitation medicine for the international medical students.

Objective To systematically evaluate the efficacy and compliance of domestic ketogenic diet(KD) for children with refractory epilepsy (RE),in order to provide the basis for further improving the curative effect and compliance by finding out the factors influencing efficacy and compliance. Methods The effect of KD on children with RE was investigated by systematically searching China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(CSTJ),Wanfang Data Knowledge Service Platform and PubMed database from January 1, 1989 to January 17,2018. The relevant literature R3. 0. 2 software was used to combine the retention rate and therapeu-tic effect in different periods,based on the systematic analysis of the therapeutic efficacy and compliance literature. Results A total of 11 eligible documents were included. (1)The methodological index for non - randomized studies (MINORS)scores of included literature were rated from 10 to 18 points. (2)A secondary analysis of 9 literatures on the description of the subject′s composition showed that the proportion of male to female in children with RE ranged from 1. 441. 00 to 2. 731. 00,and that of 9 literatures included a total of 331 samples,there were 212 male and 119 female,the ratio of male to female was 1. 781. 00. (3)The sources of the included literatures were from Beijing, Shanghai,Changsha,Shenzhen,Nanchang,Zhengzhou,Suzhou,Chongqing,Shenyang and Xi′an. (4)The retention rates of 1 month(5 studies),3 months(10 studies),6 months(7 studies)and 12 months (6 studies)were respectively 93％ [95％ confidence interval (CI):88％ - 98％],80％ (95％ CI:71％ - 98％),70％ (95％ CI:61％ - 78％) and 54％ (95％ CI:37％ - 71％). (5)According to the Meta - analysis,the effective rate of 1 month(6 studies), 3 months(10 studies),6 months(7 studies)and 12 months (7 studies)were respectively 57％ (95％ CI:34％ -79％),68％ (95％ CI:57％ - 79％),76％ (95％ CI:62％ - 89％)and 80％ (95％ CI:68％ - 93％). (6)Through analyzing the adverse reactions and the causes of termination,the literature showed that common adverse reactions in-volved digestive system (72 cases),infection (23 cases),urinary calculus (4 cases),and the metabolic disorder. The reason of treatment termination was that the children were not cooperative (26 cases)and the parents had poor comp-liance (24 cases). Conclusion KD is one of the effective methods for treating RE in children. Reducing or relieving adverse reactions in KD to improve the treatment compliance of children with RE and their families is a subject worthy of further study and attention.

Objective: To explore the effect of replacing rice bowls with trays on controlling the salt intake among school aged children, providing new evidence and insights for salt reduction intervention. Methods: From April to May 2024, 373 students from grades 4-9 at a boarding school in Guizhou Province were enrolled through stratified random cluster sampling, with one intervention class and one control class per grade. During the intervention period for one month, and the types of meals provided, pricing standards, and dining procedures shall remain consistent with daily operations, the intervention group ( n =181) compartmentalized trays for lunch and dinner, while the control group ( n =192) still used a rice bowl. Pre and post intervention assessments included 24 hour urine collection, questionnaire surveys, and physical measurements. The difference in differences analysis combined with multiple linear regression was used to analyze the changes in sodium intake and to evaluate the net effect of the intervention. Results: The post intervention 24 hour sodium intake in the intervention group was ( 2 222.6 ±1 013.6) mg, an increase of 94.6 mg from baseline, with no statistically significant difference ( t=1.10, P >0.05). In contrast, the post intervention 24 hour sodium intake in the control group was (2 080.5±895.7) mg, a decrease of 190.8 mg from baseline, showing a statistically significant difference ( t=-2.39, P <0.05). The difference in differences results indicated that after adjusting the model for factors such as gender, grade and dietary behaviors affecting sodium intake, the intervention group showed a net increase of 232.5 mg [ β(95%CI )=232.5(-40.3-505.2)] in 24 hour sodium intake compared to the control group, with no statistically significant net effect ( P >0.05). Conclusions Merely changing tableware is insufficient to control children s salt intake effectively. Based on continuous practical explorations and evidence based research grounded in the nudge theory, multi dimensional measures such as salt reduction education and the construction of a supportive environment should be integrated to form an intervention system that achieves synergistic and enhanced effects.