Objective To investigate the effect of intermittent low flow oxygen inhalation on cognitive function in patients with vascular dementia. Methods 116 cases of vascular dementia were divided into treatment group (n=58) and control group (n=58). Both groups received the routine drugs, and the treatment group received intermittent low flow oxygen inhalation in addition. They were assessed with the Mini Mental Statement Examination (MMSE) and Activity of Daily Living Scale (ADL) before and 8, 16 weeks after treatment. Results There was not significant difference between groups in scores of MMSE and ADL 8 weeks after treatment, but was 16 weeks after treatment (P<0.01). Conclusion Intermittent low flow oxygen inhalation can improve the cognitive function and quality of life in patients with vascular dementia.

ABSTRACT:Objective To explore the changes of serum cytokine interleukin-17 (IL-17)in patients with chronic hepatitis B of different clinical types and its clinical significance.Methods We selected 30 cases of mild chronic hepatitis B,34 cases of moderate one,29 cases of severe one,38 cases of liver cirrhosis,and 21 cases of acute on chronic liver failure.Another 30 cases over the same period served as the healthy control group.Cytokine IL-1 7 level in peripheral blood was detected in each group,and all the groups except the control group were detected for liver function and HBV-DNA.These related serum markers were detected and the results were statistically analyzed.Results ① IL-17 in the peripheral blood was (8.103±2.061)ng/mL in healthy control group;(25.551 ±7.078)ng/mL,(45.442±18.358)ng/mL and (75.378±19.05)ng/mL in the groups with mild,moderate and severe chronic hepatitis B;and (97.16±17.066)ng/mL in acute on chronic liver failure group.Its levels gradually increased with the severity;and there were significantly different among the five groups and between every two groups (P<0.01).The peripheral blood level of IL-17 was (8.103±2.061)ng/mL in the healthy control group, (34.517±8.905)ng/mL in compensatory cirrhosis group,and (45.615±15.623)ng/mL in the decompensated cirrhosis group.These three groups had pairwise comparison,and the difference between every two groups was significant (P<0 .0 1 ).The peripheral blood level of IL-1 7 in the decompensated cirrhosis group increased compared with that in the compensatory group.③ In the 1 5 2 cases detected,serum IL-1 7 level and serum ALT,AST,TBIL,HBV-DNA levels were positively correlated,and serum PTA had negative correlation with the level of IL-1 7 .④ In the 2 1 cases of acute on chronic liver failure,the peripheral blood level of IL-1 7 did not significantly differ between antigen-e positive and negative groups (P=0.654).⑤ In 21 patients with chronic on acute liver failure,the level of IL-1 7 in peripheral serum and MELD scores showed a positive correlation by Pearson correlation analysis (r=0.533,P=0.013).Conclusion In patients with chronic hepatitis B,the level of IL-17 in peripheral serum increased with disease severity.Moreover,the level of IL-1 7 in peripheral blood may play a role in promoting the progression of cirrhosis and the development of acute on chronic liver failure.

To observe the influence of the placental apoptosis on the expression of Bax,Bcl-2, Fas, FasLand TNF-α during the second trimester of pregnancy, mice of experimental group were intraperitoneal injected with 100 purified Toxoplasma gondii tachyzoites added in 0.2mL of PBS, while those of the control group were injected with 0.2 mL of sterile PBS (0.01 mol/L, pH 7.4) in the 8-th day of pregnancy. During the 12, 14, 16 and 18-th days of pregnancy, 5 mice both in experimental and control group were randomly killed and the expression levels of the apoptosis-related proteins Bax, Bcl-2, Fas, FasL and TNF-α in the placental tissues were determined by means of immunohistochemical methods. It was showed that the apoptosis-related protein expressed both in villus and decidua of the placenta, most of which were expressed in syneytiotrophoblast (ST). The positive cells with expression of Bax, Fas, FasL and TNF-α increased along with the increase of the pregnant days in both the experimental group and the control group, and the positive cells with expression of Bcl-2 decreased along with the increase of the pregnant days. It was also demonstrated that the positive cells with expression of Bax, Fas, FasL and TNF-α of the experimental group showed a higher percentage of expression than that of the control group on the same pregnant days, but the positive cells with Bcl-2 expression of the experimental group were fewer than that of the control group. It is concluded that the expression of apoptosis-related protein Bax, Bcl-2, Fas, FasL and TNF-α in the placenta were altered when the pregnant mice were infected with Toxoplasma gondii during the second trimester, which may induce the apoptosis through the endogenic and ectogenic pathway.

Objective:To construct an early comfort assessment and management plan for ICU patients with high flow nasal cannula, and to provide reference for clinical nursing practice and management.Methods:The domestic and foreign databases were retrieved, and the literatures on high flow nasal cannula were obtained and evaluated. The first draft of the early evaluation and management scheme of nasal high-flow humidification oxygen therapy was developed. Two rounds of expert consultation were conducted by Delphi method.Results:The early comfort assessment and management plan for ICU patients with high flow nasal cannula was formed, including 3 primary indicators, 12 secondary indicators, and 32 tertiary indicators. The authoritative coefficients of 2 rounds of expert consultation were 0.915 and 0.931, respectively. The coordination coefficients were 0.221, 0.130 and 0.278( χ 2 values were 8.000, 27.140, 163.824, P<0.05 or 0.01). Conclusions:The early comfort assessment and management plan of ICU patients with high flow nasal cannula are consistent with the advice of experts at all levels. The enthusiasm and authority of the experts is high, which provides a basis for the scientific management of ICU patients with nasal high-flow humidification oxygen therapy.

Objective To investigate the effect of health education for discharged patients, and to explore the reasons and effective countermeasures on the health education. Methods Through the question-naire survey, convenient sampling method was used to evaluate the effect of the hospital health education. The existing problems and corresponding countermeasures taken for continuous improvement were analyzed. SPSS 17.0 statistical software was applied for data processing, the count data was expressed by rate and Statistical methods using chi-square test. Results The hospital health education satisfaction rate rose to 95.21%from 54.17%after intervention, and differences between the two groups was statistically significant (P<0.05). The satisfaction rate of the department of internal medicine, surgery department, and the department of gynaecology and pediatrics was significantly improved than before. Conclusion By improving health education importance, strengthening learning and training of specialized subject knowledge, rationally allo-cating human resources and establishing health education quality control system, the health education for discharged patients was effectively improved with satisfaction.

OBJECTIVE: To explore the genetic basis for a juvenile with maturity-onset diabetes of the young type 12(MODY12). METHODS: High-throughput sequencing was carried out to screen for the variants. Candidate variant was verified by Sanger sequencing. Pathogenity of the variant was predicted by searching the genetic databases and analysis by using bioinformatic software. RESULTS: Genetic testing indicated that the patient and his mother have both carried a heterozygous c.3976G>A variant (p.Glu1326Lys) in exon 32 of the ABCC8 gene. Prediction of the protein structure suggested the variant to be deleterious. Based on the guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be uncertain significance. CONCLUSION Whether the c.3976G>A variant of the ABCC8 gene is the cause of the disease in this patient or not depends on the functional studies and more case data. Above finding has enriched the spectrum of ABCC8 gene variants.
Diabetes Mellitus, Type 2/genetics* ; Genetic Testing ; Genomics ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation

Mitochondria are the main places of cellular respiration as well as the citric acid cycle and oxidative phospho‐rylation .It plays an important role in controlling the life and death of cells .Mitochondrial dysfunction leads to a series of human diseases such as ischemia‐reperfusion injury ,sepsis and diabetes .Mitochondrial become an attractive target for drug transporters strategy and therapeutic targets for neurodegeneration .Although the molecular mechanisms responsible for mitochondria media‐ted disease processes are not fully elucidated yet ,the oxidative stress appears to be critical .Accordingly ,strategies are being de‐veloped for the targeted delivery of antioxidants to mitochondria .The prospect of development of mitochondrial targeted drugs with anti‐oxidative stress protection is tempting .Mitochondrial targeting antioxidants were the antioxidant drugs which took mi‐tochondria as the target site .In this review ,weintroduced the conception and classification of mitochondrial targeted antioxidants and the research progress of disease treatment by mitochondrial targeted antioxidants .

Objective:To investigate the effects of evidence-based precision nursing in patients with sarcopenia undergoing total knee arthroplasty (TKA) .Methods:By convenience sampling, totally 41 TKA patients with sarcopenia treated in the Department of Orthopedics at The First Affiliated Hospital of Zhengzhou University from August 2021 to February 2022 were selected as the control group, and 41 TKA patients with sarcopenia treated from March 2022 to March 2023 as the observation group. Patients in the control group received conventional nursing care, while patients in the observation group received an evidence-based precision nursing plan. The differences in muscle mass, grip strength, physical activity ability, knee joint function, and quality of life between the two groups before and after the intervention were compared.Results:After the intervention, the total muscle mass, affected limb skeletal muscle mass, limb skeletal muscle mass, limb skeletal muscle mass index, and grip strength in the observation group were significantly higher than those in the control group ( P< 0.05). The scores on the Short Physical Performance Battery, Lysholm Score, and Sarcopenia Quality of Life Scale in the observation group were also significantly higher than those in the control group ( P<0.05) . Conclusions:Evidence-based precision nursing can improve postoperative muscle mass and strength, enhance physical activity ability and joint function, and improve the quality of life in TKA patients with sarcopenia.

Objective:To explore the neuroprotective effect and molecular mechanism of sulforaphane (SFN) on acute carbon monoxide poisoning (ACOP) in rats.Methods:A total of 135 healthy adult male Sprague-Dawley (SD) rats were randomly divided into normal control group, ACOP model group, and SFN intervention group, with 45 rats in each group. The ACOP animal model was reproduced using carbon monoxide (CO) inhalation in a hyperbaric oxygen chamber, while the normal control group was allowed to breathe fresh air freely. The rats in the SFN intervention group received intraperitoneal injection of SFN at a dose of 20 mg/kg once daily starting 2 hours after CO poisoning and continuing until euthanasia. The normal control group and the ACOP model group received equivalent volume of saline injection. Three rats from each group were sacrificed 1 day after intervention to observe the changes in the ultrastructure of neuronal mitochondria in brain tissues under transmission electron microscopy. Six rats from each group were evaluated for cognitive function using neurobehavioral test 7 days after intervention. Brain tissues of 6 rats in each group were collected 1, 3, and 7 days after intervention, and the expressions of phosphorylated-adenosine monophosphate-activated protein kinase (p-AMPK), mitofusin 2 (MFN2), and dynamin-related protein 1 (DRP1) were detected using immunohistochemistry staining and Western blotting. Linear regression analysis was performed to assess the correlations between the expression levels of above proteins.Results:In the normal control group, the rats did not exhibit any abnormalities in cognitive function or the ultrastructure of neuronal mitochondria in brain tissues. ACOP induced cognitive impairment and ultrastructural injury to neuronal mitochondria in rats. However, SFN significantly improved cognitive function in poisoned rats and mitigated the extent of neuronal mitochondrial damage. Over poisoning time, the expression levels of p-AMPK and MFN2 in the brain tissues of ACOP rats were gradually decreased, while the expression level of DRP1 was gradually increased. Compared with the normal control group, the ACOP model group showed significant differences in the expressions of p-AMPK, MFN2, and DRP1. After SFN intervention, the expression levels of above proteins were significantly reversed. Compared with the ACOP model group, the SFN intervention group exhibited a marked increase in the expressions of p-AMPK and MFN2 [p-AMPK positive expression ( A value): 0.226±0.003 vs. 0.177±0.033, p-AMPK protein (p-AMPK/GAPDH): 1.41±0.05 vs. 0.89±0.05, MFN2 positive expression ( A value): 0.241±0.004 vs. 0.165±0.007, MFN2 protein (MFN2/GAPDH): 1.33±0.04 vs. 0.79±0.03, all P < 0.05], along with a significant decrease in DRP1 expression [DRP1 positive expression ( A value): 0.103±0.002 vs. 0.214±0.011, DRP1 protein (DRP1/GAPDH): 1.00±0.03 vs. 1.50±0.03, both P < 0.05]. Linear regression analysis revealed a strong negative linear correlation between DRP1 protein expression and MFN2, p-AMPK protein expressions ( R2 values were 0.977 and 0.971, both P < 0.01), and a positive linear correlation between p-AMPK protein expression and MFN2 protein expression ( R2 = 0.985, P < 0.01). Conclusion:SFN can help maintain neuronal mitochondrial homeostasis by activating the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, thereby alleviating neuronal injury caused by ACOP.

Objective:This study collected a real-world data on survival and efficacy of gemcitabine-containing therapy in advanced breast cancer. Aimed to find the main reasons of affecting the duration of gemcitabine-base therapy in advanced breast cancer patients.Methods:Advanced breast cancer patients who received gemcitabine-base therapy from January 2017 to January 2019 were enrolled(10 hospitals). The clinicopathological data, the number of chemotherapy cycles and the reasons for treatment termination were collected and analyzed. To identify the reasons related with continuous treatment for advanced breast cancer and the factors which affect the survival and efficacy.Results:A total of 224 patients with advanced breast cancer were enrolled in this study, with a median age of 52 years (26-77 years), 55.4%(124/224) was postmenopausal. Luminal type were 83 cases, TNBC were 97 cases, and human epidermal growth factor receptor 2 (HER's-2) overexpression were 44. At the analysis, 224 patients who received the gemcitabine-based regimens were evaluated, included 5 complete reponse (CR), 77 partial response (PR), 112 stable disease (SD) and 27 progressive disease (PD). The objective response rate (ORR) was 36.6%(82/224). Seventy patients had serious adverse diseases, including leukopenia (9), neutrophilia (49), thrombocytopenia (15), and elevated transaminase (2). The median follow-up time was 41 months (26~61 months), and the median PFS was 5.6 months. The reasons of termination treatment were listed: disease progression were 90 patients; personal reasons were 51 patients; adverse drug reactions were 18 patients; completed treatment were 65 patients. It was found that progression-free survival (PFS) was significantly longer in patients receiving >6 cycles than that in patients with ≤6 cycles (8.2 months vs 5.4 months, HR=2.474, 95% CI: 1.730-3.538, P＜0.001). Conclusions:Gemcitabine-based regimen is generally well tolerated in the Chinese population and has relatively ideal clinical efficacy in the real world. The median PFS is significantly prolonged when the number of treatment cycles are appropriately increased.