Objective To investigate the regeneration and differentiation of HOCs in the 2-AAF/PHx rat models. To explore the expression of Cyr61and its mechanism in differentiation of HOCs in vitro. Methods In 2-AAF/PHx rats model,induction and expansion of HOCs were detected by immunochemistry and HE staining. West-ern blot was used for observing the expression of Cyr61. Furthermore,the expression of Cyr61 andβ-catenin were detected by Western blot in differentiation of WB-F344 cells in vitro. Results Cyr61 protein level increased as a re-sult of HOCs in rats livers after 2-AAF/PHx. In addition,the expression of Cyr61 and β-catenin significantly in-creased during WB-F344 cells differentiation in vitro. Conclusions Cyr61 might play an important role as a signal-ing mediator in HOCs response and closely correlate with Cyr61 andβ-catenin in proliferation and differentiation of HOCs.

OBJECTIVE:To evaluate the quality of Bombyx batryticatus medicinal materials in the market by multi-index,and provide reference for clinical rational drug use. METHODS:Referring to the Chinese Pharmacopoeia (2015 edition,part 1),the appearance characters of samples were observed,moisture and the total ash were detected,Fourier transform infrared spectroscopy was adopted to identify the medicinal materials,UV-Visible spectrophotometry and potassium permanganate titration were respec-tively used to determine the contents of active ingredient protein and ammonium oxalate. RESULTS:The moisture ranged in 2.84%-4.07%(RSD<5%,n=3),total ash in 7.79%-34.32%(RSD<5%,n=3),UV and FTIR spectra were basically similar, and both can reflect the characteristic peaks of protein peptides. Protein content ranged in 29.87%-57.19%(RSD<0.5%,n=3), ammonium oxalate content in 0.27%-4.77%(RSD<5%,n=3). CONCLUSIONS:The 10 batches of samples are authentic and processed products,moisture fits the requirement in pharmacopoeia while total ash does not;and the main ingredient is protein pep-tides. However,effective protein polypeptide content shows great differences as well as ammonium oxalate.

Objective To understand the current status of primary hospital clinical nurses ’ critical thinking ability and self-learning ability and to explore the relationship between them , so as to provide theoretical basis and reference for continuing medical education .Methods Totals of 345 clinical nurses in three county hospitals were surveyed by general information questionnaire , Critical Thinking Disposition Inventory-Chinese Version ( CTDI-CV ) and nurse self-learning ability rating scale .Results The total score of clinical nurses ’ critical thinking ability was (276.08 ±34.31), and the self-learning ability score was (121.40 ±18.42). Based on the above results , Except that cognitive maturity had no significant correlation with task analysis , self-monitoring and regulation , critical thinking ability was positively related to self -learning ability and other dimensions (P <0.05).Conclusions The critical thinking and self-learning ability of clinical nurses in primary hospital need to be improved .Because of their mutual positive impact , nursing managers should take a variety of measures to develop and improve these abilities .

【Objective】 To explore the clinical value of thromboelastogram (TEG) in monitoring coagulation function in patients with COVID-19. 【Methods】 Patients diagnosed with COVID-19 in our hospital from January 20 to March 1, 2020 were enrolled and divided into mild group (mild type, common type) and severe group (severe type, critical group). The TEG, platelet count and routine blood coagulation function were compared between the two groups to analyze the coagulation characteristics of the patients. 【Results】 A total of 66 cases were studied, including severe (n=33) and mild (n=33), male(n=39)and female(n=27), hypertension (n=9) and diabetes mellitus (n=11) cases. 28 (84.8%) severe and 24 (72.7%) mild patients had at least one hypercoagulable TEG parameter. K value of TEG in the severe group was lower than that in the mild group (P<0.05), Angel and CI increased (P<0.05). The fibrinogen (Fib) and D-dimer increased in routine coagulation function test (P<0.05). 【Conclusion】 Patients with COVID-19 showed hypercoagulability in TEG parameter, which was related to the severity of this disease. TEG may be more valuable for COVID-19 patients with hypercoagulable status and thrombosis risk, and help to develop anticoagulation strategies.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.