This article proposes the integrated outline of excessive heat accumulated in chest syndrome from the view of Fu-viscera disease of sanjiao based on numbers of clinical experiences,which can prove that the objective existence and theory of sanjiao fu-viscera has specific significance.

Objective:To investigate the therapeutic effect of stroke patients received rehabilitation treatment at different medical units in the Rehabilitation Medical Association.Method:Totally 183 stroke patients were recruited from October 12,2012 to February 5,2016 by Shenzhen Rehabilitation Medical Association(SRMA).SRMA consists of 4 members,including the Second People's Hospital of Shenzhen,Shenzhen Nan'ao People's Hospital,Shenzhen Baoxing Hospital and Community Healthcare Center in Futian District,which belong to tertiary hospital,secondary hospital,and primary healthcare unit,respectively.According to the time of onset of stroke,all the patients were divided into recovery phase or sequelae phase.The rehabilitation facilities were standardized.All patients received rehabilitation treatment for 4 weeks,which included functional rehabilitation training of limb,functional electrical stimulation training,activities of daily living training.Fugl-Meyer Assessment(FMA),balance subscale of the Fugl-Meyer test(FMB),National Institute of Health Stroke Scale(NIHSS) and modified Barthel Index(MBI) before and after rehabilitation treatment were used to evaluate the effects.Result:The scores of FMA,FMB,NIHSS and MBI were significantly improved in all the groups after rehabilitation treatment(P ＜ 0.05).There was no significant difference in all assessments among the groups(P＞ 0.05).Conclusion:Based on the standardized rehabilitation treatment programs,the stroke patients come from the members of Rehabilitation Medical Association can achieve homogeneous effects after rehabilitation treatment.

Objective Resveratrol can improve nonalcoholic fatty liver disease , but its action mechanisms remain unclear . This study aimed to investigate the protective effect of resveratrol against the free fatty acid ( FFA)-induced apoptosis of human hepatic L02 cells and its possible mechanisms . Methods Human hepatic L02 cells were incubated with FFA and resveratrol for 24 hours.The prepared cells were divided into a blank control , an FFA ( 2 mmol/L) , and a resveratrol group ( 50 μmol/L resveratrol +2 mmol L/FFA).After treatment, we measured the triglyceride (TG), glutathi-one (GSH), and malonaldchyde (MDA) contents and caspase3 ac-tivity in the hepatocytes , determined the apoptosis of the cells by flow cytometry , and detected the protein expression of silent information regulator 1 (SIRT1) by Western blot as well as the mRNA expressions of catalase (CAT), Mn superoxide dismucase (MnSOD), Bcl-2, and Bax by qRT-PCR. Results The TG content and caspase 3 activity in the hepatocytes were significantly increased in the FFA ([3518.±64.2] μmol/L and [5.97 ±0.78] U/g) and the resveratrol group ([201.1 ±60.1] μmol/L and [3.60 ±0.73] U/g) as compared with those of the blank control ([40.2 ±7.4] μmol/L and [2.56 ±0.49] U/g) (both P<0.05), but the caspase3 ac-tivity was markedly decreased in the resveratrol group in comparison with that of the FFA group (P<0.05).Both early and late apop-tosis rates of the hepatocytes were remarkably higher in the FFA ([6.75 ±0.81]%and [8.52 ±0.54]%) and the resveratrol group ([4.94 ±0.44]%and [6.52 ±0.61]%) than those in the blank control ([3.38 ±0.33]% and [2.72 ±0.19]%) ( both P<0.05), with statistically significant differences between the former two groups (P<0.05).The resveratrol group showed significant differences in the GSH content ([100.2 ±8.8] nmol/g), the MDA level ([2.36 ±0.82] mg/g), and the relative expression of SIRT1 (0.84 ±0.04) from the FFA group ([73.8 ±13.1] nmol/g, [3.77 ±0.92] mg/g, and 0.61 ±0.07) and the control ([113.7 ±13.8] nmol/g, [1.85 ±0.41] mg/g, and 0.90 ±0.02) (all P<0.05).The resveratrol group also exhibited statistically significant differences in the relative expressions of the MnSOD , CAT, and Bax genes from the FFA and control groups (P<0.05). Conclusion Resveratrol attenuates FFA-induced apoptosis of human hepatic L 02 cells by activating SIRT1 and reducing the oxidative stress of hepatocytes .

Highly conjugated linear molecular wires are one of the basic elements for constructing molecular electronic devices. Among these conjugated compounds, ferrocene-terminated compounds as well as their derivatives have been widely studied because of their ideal electrochemical activity. Based on these, a new ferrocene-terminated phenylethynyaniline ( Fc-NH2 ) was synthesized by Sonogashira cross coupling reaction. The structure of the target compound was identified by infrared ( IR) , nuclear magnetic resonance ( NMR) , mass spectra ( MS) and cyclic voltammetry ( CV) . Combined the graphene-chitosan ( GH-CS) and Fc-NH2 , a new composite of GH-CS/Fc-NH2 was prepared and then used for immobilization of Cytc to prepare the GH-CS/Fc-NH2/Cytc/GCE. It was found from the CV result that a pair of peaks near-0. 2 V appeared which can be attributed to Cytc. The GH-CS/Fc-NH2/Cytc modified GCE showed good catalysis towards NaNO2 , and good linear relationship was found in the range of 1 ×10-7-1. 5 ×10-4 mol/L,and the determination limit was bellow 4×10-8 mol/L. Therefore, cytochrome c (Cytc) can be immobilized on the GH-CS/Fc-NH2 and the direct electron transfer can be realized between the electrode and solution and shows good prospect for detection of NaNO2 .

Objective Glycodelin-A is one of glycoproteins secreted from endometrial epithelial cells , and it plays an im-portant role in embryo implantation , inhibition of reject reaction and pregnancy maintenance .Glycodelin-A will become an important potential marker in evaluating the endometrial receptivity and predicting the pregnancy outcome .The aim of this study was to investigate the correlation of glycodelin-A detected on the day of HCG and endometrial receptivity and the effects of glycodelin -A on the pregnancy outcome in the intrauterine insemination (IUI) period. Methods One hundred and seven woman patients with bilateral unobstruct-ed tubes and without endometrial lesions , endometrial polyps or intrauterine adhesions from Oct 2012 to Feb 2014 in our hospital were recruited in this study .Serum glycodelin-A in women receiving IUI on the day of HCG was measured by ELISA .Serum estradiol (E2), progesterone (P), and corpus luteum (LH) levels were measured by immunochemiluminometric assays .The condition of the endometrium was examined by transvaginalultrasonography . Results The serum glycodelin-A level on the day of HCG was higher in pregnant group [(1.47 ±0.38)ng/mL] than that in nonpregnant group ([0.62 ±0.13]ng/mL).The serum glycodelin-A level on the day of HCG was higher in endometrial thickness ≥7 mm group ([1.53 ±0.49]ng/mL) than endometrial thickness <7 mm group ([0.51 ±0.17]ng/mL). Conclusion The serum glycodelin-A level on the day of HCG may reflect endometrial receptivity to a cer-tain extent , which might have prognosis value for pregnancy following IUI .

Objective To observe the expression of PAX-2 and PTEN in different types of endometrial lesions, and to study their relationship with endometrial intraepithelial neoplasia (EIN). Methods 60 cases of endometrial hyperplasic lesions and 70 cases of endometrial carcinoma were enrolled. All cases were reclassified by using the diagnostic criteria of EIN, and PAX-2 and PTEN were stained to compare the difference among them. Results The deletion rates of PAX-2 in benign hyperplasia, EIN and endometrial carcinoma were 39.5 % (15/38), 72.7 % (16/22) and 78.6 % (55/70), respectively, and there was a statistical difference (χ2= 21.664, P= 0.000). The deletion rates of PTEN in benign hyperplasia, EIN and endometrial carcinoma were 47.4%(18/38), 54.5%(12/22) and 75.7%(53/70), respectively, and there was no statistical difference (χ2=2.878, P=0.411). Conclusion The staining of PAX-2 could be considered as a reliable adjuvant diagnostic method in the diagnostic criteria of EIN, however, the loss of PTEN just should be regarded as a suggestion of EIN, not a confirmed diagnostic basis.

Objective To investigate the duodenum absorptive character of monosialotetrahexosylganglioside sodium (GM1) in rats.Methods The contents of phenolsulfonphthalein (as indicators) and GM1 were determined with ultraviolet-visible (UV) method and high performance liquid chromatography (HPLC) method in rats with in situ cycle intestinal perfusion model.Results The ratio of duodenum absorption of GM1 was 10％ in 2 h after cycle and 22％ in 6 h after cycle,respectively.The Ka was (0.030± 0.012)h,and absorption t1/2 was (25.50 ± 8.56)h in 8 h after cycle.Conclusions GM1 is absorption in rat duodenum,and the accumulate absorption of GM1 is almost linearly related to the cycle time.The absorption dynamics of GM1 may be first-order kinetic process.

Objective:To construct a scientific and objective evaluation system for the in-service training of "double-qualified" clinical nursing teachers.Methods:From August 2020 to March 2021, the framework was preliminarily constructed through literature analysis, and the evaluation system was constructed by Delphi method and analytic hierarchy process.Results:The authority coefficients of the two rounds of expert consultation are 0.82 and 0.81 respectively, and the overall coordination coefficients are 0.24 and 0.21 respectively. As a result, we construct the evaluation system for the in-service training of "double-qualified" clinical nursing teachers, included 8 first-level indicators, 39 second-level indicators and 39 groups of grading rules.Conclusions:The evaluation index system for the on-the-job training of "dual-teacher" clinical nursing teachers constructed in this study can provide a reference for the reform of the current "dual-teacher" clinical nursing teachers′ on-the-job training, and improve the quality of teacher training, and guarantee the quality of nursing teaching.

To summarize the nursing experience of a patient with inhalation of nitric acid fumes treated by veno-venous extracorporeal membrane oxygenation combined with continuous renal replacement therapy.The key points of nursing include:to pay close attention to the changes of respiratory function,to strictly implement lung protective ventilation strategy;to timely remove airway secretions to ensure effective respiratory;to prevent and control infection;to optimize fluid management to facilitate tissue perfusion;to prevent thrombosis and reduce the risk of bleeding;prevention and treatment of blood transfusion reaction,the postoperative nursing of complicated with upper gastrointestinal bleeding.After active treatment and careful nursing,the patient was discharged from the hospital in a stable condition.After 6 months of follow-up after discharge,the patient recovered well with no pulmonary complications.

Objective:To establish a mortality risk prediction model of severe bacterial infection in children and compare it with the pediatric early warning score (PEWS), pediatric critical illness score (PCIS) and pediatric risk of mortality score Ⅲ (PRISM Ⅲ).Methods:A total of 178 critically ill children were selected from the PICU of the Children's Hospital of Nanjing Medical University from May 2017 to June 2022. After obtaining the informed consent of the parents/guardians, basic information such as sex, age, height and weight, as well as indicators such as heart rate, systolic blood pressure and respiratory rate were collected from all children. A standard questionnaire was used to score the child 24 h after admission to the PICU. The children were divided into the survival and death groups according to their survival status at 28 d after admission. A mortality risk prediction model was constructed and nomogram was drawn. The value of the mortality risk prediction model, PEWS, PCIS and PRISM in predicting the risk of death was assessed and compared using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).Results:Among the 178 critically ill children, 11 cases were excluded due to severe data deficiencies and hospitalization not exceeding 24 h. A total of 167 children were included in the analysis, including 134 in the survival group and 33 in the death group. A mortality risk prediction model for children with severe bacterial infection was constructed using pupillary changes, state of consciousness, skin color, mechanical ventilation, total cholesterol and prothrombin time. ROC curve analysis showed that the AUCs of mortality risk prediction model was 0.888 ( P<0.05). The AUCs of PEWS, PCIS and PRISM Ⅲ in predicting death in children with severe bacterial infection were 0.769 ( P< 0.05), 0.575 ( P< 0.05) and 0.759 ( P< 0.05), respectively. Hosmer-Lemeshow goodness-of-fit test showed the best agreement between risk of death and PEWS predicted morbidity and mortality and actual morbidity and mortality (χ 2 = 5.180, P = 0.738; χ 2 = 4.939, P = 0.764), and the PCIS and PRISM Ⅲ predicted mortality rates fitted reasonably well with actual mortality rates (χ 2= 9.110, P= 0333; χ 2 = 8.943, P= 0.347). Conclusions:The mortality risk prediction model for predicting the death risk has better prognostic value than PEWS, PCIS and PRISM Ⅲ for children with severe bacterial infection.