Objective To study the effect of temporary closure of venous pressure clamp on blood coagulation during duct rinsing in heparin free dialysis.Methods One hundred and forty cases of heparin free dialysis were divided into the control group and observation group according to the singular times dialysis and dual time dialysis,the control group (74 cases with singular times heparin free dialysis) and observation group (66 cases with dual times heparin free dialysis).The rinsing operation of the control group was consistent with the routine dialysis process.In the observation group,the venous pressure clamp was closed before the start of rinsing,and then the venous pressure clamp was opened at the end of this process.The times of alarm,blood pump suspension period,incidence rate and degree of blood coagulation were compared between the two groups to assess the degree of comfort and compliance of all patients during the process.Results The differences between the two groups in terms of times of alarm and blood pump suspension period were statistically significant ((5.7±1.8) times vs.0 times,(9.1±4.0) s vs.0s,P=0.001),the incidence rate of blood coagulation,the degree of blood coagulation above degree Ⅱ and the rate of operation completion ahead of time in the two groups were detected ((70.3% (52/74) vs.7.6% (5/66),21.6% (16/74) vs.0,8.1% (6/74) vs.0).The difference of blood coagulation degree between the two groups was statistically significant (Z=-9.185,P=0.000).Patients in the observation group had a higher grade of comfort degree((4.8±1.0) points vs.(4.2±0.63) points,P=0.001).Conclusion In the operation of heparin free dialysis,the temporary closure of venous pressure clamp can reduce the incidence rate of interruption,prolong the service life of the filter,ensures the dialysis time and treatment effect,and improve the patients' degree of comfort.

OBJECTIVE:To observe the efficacy and safety of moxifloxacin combined with Jiehe pill in the treatment of muilt drug-resistant tuberculosis(MDR-TB). METHODS:116 patients with MDR-TB were randomly divided into control group and ob-servation group. Control group was given Moxifloxacin hyohochloride tablet 0.4 g once a day,observation group was additionally given Jiehe pill 9 g,twice a day,and 2 groups were given rifapentine,albendazole isoniazid,amikacin,pasiniazide,pyrazin-amide,p-amino salicylic acid and other conventional treatment. The treatment course for both groups was 18 months. The clinical efficacy,and T cell subsets (CD3+,CD4+,CD4+/CD8+),interferon(INF)γ,interleukin(IL)4 levels before and after 6,12 and 18 months,and incidence of adverse reactions in 2 groups were recorded. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,CD3+,CD4+,CD4/CD8 and INF-γ level in 2 groups were significantly higher than before and gradually increased by time,and observation group was high-er than control group;IL-4 level was significantly lower than before and graually decreased by time,and observation group was lower than control group,the differences were statistically significant(P<0.05). There was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the coventional treatment,moxifloxacin combined with Jiehe pill has better efficacy than moxifloxacin in the treatment of MDR-TB,with similar safety.

A mouse model for acute hepatitis B virus (HBV) infection was established by using the hydrodynamical injection of mouse tail vein, in which the immunocompetent BALB/c mice were hydrodynamically injected with a competent replication plasmid pAAV-HBV1.2 having 1.2 fold over-length of HBV DNA. On day 1, 2, 4, 6 and 8 after injection, the levels of HBsAg, HBeAg and HBV DNA in blood serum were detected by using ELISA and fluorogenic quantitative PCR assay (FQ-PCR). And on day 8. HBsAg and HBeAg in liver tissue were assayed by immunohistochemical staining. It was found that HBsAg in blood serum could be detected on day 1 after infection in 14 of 16 mice (85.7%) injected with pAVV-HBV1.2 by using ELISA assay and the peak levels of HBsAg and HBeAg were attained during the first day after injection and then it dropped down gradually up to day 8 following injection. The titer of HBV DNA in blood serum attained its peak on day 2 and maintained a high level later on. On day 8 after injection, its titer was 1.9×10~4 copies/mL. The percentage of HBcAg-positive hepatocytes and HBsAg-positive hepatocytes in liver tissues were 5% and 2% respectively. Thus, by using the hydrodynamic injection with the competent replication plasmid, a mouse model for acute HBV infection is successively developed.

Objective To study the effect of evidence-based nursing in patients with cerebral apoplexy in ICU by blind bedside spiral nasointestinal tube application.Methods To choose between September 2016 and September 2017 in our hospital ICU were 140 cases of patients with cerebral apoplexy as analysis object,randomly divided into two groups,two groups all use bedside blind spiral nose long intestinal tube technology,the control group using conventional nursing method for nursing,observation group using evidence-based nursing intervention,compared two groups of a success rate of catheter,accident to take off the tube (unscheduled decannulation rate),reflux hiccups,vomiting incidence of aspiration and patient satisfaction.Results The success rate of catheterization in the observation group was higher than that in the control group,and the incidence of accidental catheterization was lower than that in the control group.The incidence of reflux hiccup and vomiting aspiration was significantly lower than that in the control group,and the patient satisfaction was higher than that in the control group (all P＜0.05).Conclusion For patients with cerebral apoplexy in the ICU bed of blind plug spiral nasal bowel technology combined evidence-based nursing intervention,clinical effect is remarkable,improve the success rate of catheter,reduces the surprise success rate of tube,unscheduled tube drawing number,reduces the incidence of reflux hiccups,vomiting aspiration,improve patient satisfaction and quality of life.

Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Demyelination of the central nervous system often occurs in neurodegenerative diseases， such as multiple sclerosis （MS）. The myelin sheath， a layer of myelin membrane wrapping the axon， plays a role in the rapid conduction and metabolic coupling of impulses for neurons. The exposure of the axon will lead to axonal degeneratio， and further neuronal degeneration， which is the main cause of dysfunction and even disability in patients with demyelinating neurodegenerative diseases. In addition to the demyelination of mature myelin sheath， remyelination disorder is also one of the major reasons leading to the development of the diseases. The myelin sheath is composed of oligodendrocytes （OLs） derived from oligodendrocyte progenitor cells （OPCs） which are differentiated from neural stem cells （NSCs）. The process of myelin regeneration， i.e.， remyelination， is the differentiation of NSCs into OLs. Recent studies have shown that this process is regulated by a variety of genes. MicroRNAs， as important regulators of neurodegenerative diseases， form a complex regulatory network in the process of myelin regeneration. This review summarizes the main molecular pathways of myelin regeneration and microRNAs involved in this process and classifies the mechanisms and targets. This review is expected to provide a theoretical reference for the future research on the treatment of demyelinating diseases by targeting the regulation of microRNAs.