Objective To evaluate the effects of pyruvate Ringer' s solution on erythrocyte deformation function in the patients undergoing cardiopulmonary bypass (CPB) in vitro.Methods Thirteen patients of both sexes,aged 25-64 yr,of ASA physical status Ⅱ or Ⅲ (NAHY Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement under CPB were enrolled in the study.At 10 and 60 min of CPB (T1,2) and 60 min after termination of CPB (T3),blood samples 18 ml were drawn from the radial artery and each patient's blood sample was equally divided into 6 parts (3 ml per part).The blood samples were divided into 3 groups (n =13 each):control group (group C),lactated Ringer's solution group (group R),and pyruvate Ringer's solution group (group P).In C,R and P groups,normal saline 1 ml,lactated Ringer's solution 1 ml,and pyruvate Ringer's solution 1 ml were added,respectively,and then the erythrocytes were incubated for 60 min at 37 ℃.At 30 and 60 min of incubation,the erythrocyte rigidity index (ERI) and erythrocyte deformation index (EDI) were detected.Results Compared with C and R groups,the ERI was significantly decreased at 30 and 60 min of incubation at T1,the EDI was decreased at 30 min of incubation at T1,2,and no significant change was found in ERI at T2,3 or in EDI at T3 in group P.There was no significant difference in ERI and EDI at different time points of incubation within groups.Conclusion Pyruvate Ringer's solution can enhance erythrocyte deformation function in the patients undergoing CPB.

Objective To investigate the effect of the focus intervention on the rehabilitation of patients with total hip replacement. Methods From March 2014 to March 2016, selected 166 cases of elderly patients with total hip replacement, the patients were divided into observation group (89 cases) and control group (77 cases) according to admission orders, 77 cases from March 12014 to February 282015 are classified as the control group, whereas 89 cases from March 12015 to February 292016 are classified as the experimental group. The observation group was treated with focus intervention, and the control group received routine nursing care, observed two groups postoperative rehabilitation effect, the incidence of postoperative lower extremity venous thrombosis and infection, and patient satisfaction with care, etc. Results The postoperative recovery of hip function in the observation group was better than that in the control group (Z=-2.787, P<0.05), the excellent and good rate was 88.76％(79/89), and the excellent and good rate in control group was 80.52％(62/77). The incidence of postoperative lower extremity venous thrombosis and infection in the observation group were 3.37％(3/89) and 2.25％(2/89), significantly lower than the control group12.99％(10/77)and 10.39％(8/77), the difference was statistically significant (χ2=5.289 and 4.835, P<0.05). The VAS scores of the observation group and the control group were (2.43 ± 0.84) points and (2.59 ± 0.91) points, the difference was not statistically significant(t=-1.177, P>0.05). The nursing satisfaction in observation group was 92.13％(82/89), significantly higher than that in the control group72.73％(56/77), the difference was statistically significant (χ2=11.089, P < 0.05). Conclusion The focus intervention on the functional recovery of patients with total hip replacement may have some help, reduce complications and improve patient satisfaction.

Objective To explore the effects of the multidisciplinary integrated program on outpatient follow-ups in patients with limb fractures. Methods Totally 43 patients with limb factures who were admitted and treated in He'nan Provincial People's Hospital from June 2012 to December 2013 were selected as a control group, who received traditional follow-up management, while another 42 patients with limb fractures admitted and treated between January 2014 and July 2015 were selected as an observation group, who received multidisciplinary integrated follow-up management. The Johner-Wruh functional classification, incidence of complications and patients' satisfaction one year after intervention were compared between the patients in the two groups. Results After one year's follow-up, the rate of good cases of the patients in the observation group and the control group was 95.23% and 81.40%, respectively; the incidence of complications in the observation group and the control group was 16.66% and 37.21%, respectively; and the statisfaction with follow-ups among the patients in the observation group and the control group was 95.23% and 72.09%, respectively (χ2=3.922, 4.543, 8.273; P< 0.05). Conclusions The multidisciplinary integrated follow-up management can help to reduce the incidence of complications, improve clinical efficacy and enhance satisfaction in patients with limb factures, and therefore can be clinically expanded and applied further.

Objective:To observe the clinical effect of wheat grain-sized cone moxibustion combined with fire needle therapy in the treatment of dorsal wrist ganglion (DWG). Methods:A total of 63 patients with DWG were randomized into a treatment group (n=32) and a control group (n=31). Cases in the control group were treated with fire needle therapy. Based on the therapy given to the control group, cases in the treatment group were additionally given wheat grain-sized cone moxibustion therapy. Then the therapeutic efficacies and recurrence rate were evaluated. Results:After treatment, the overall effective rate was 93.8% in the treatment group, versus 77.4% in the control group, and the between-group comparison showed a statistical significance (P<0.05); 6 months after the treatment, the recurrence rate in the treatment group was obviously lower than that in the control group (P<0.05). Conclusion:The long-term and short-term effects of wheat grain-sized cone moxibustion combined with fire needle therapy in the treatment of DWG are better than those of fire needle therapy alone, and therefore, worth popularizing.

Exosomes are extracellular vesicles that regulate various signaling pathways in the body by mediating the release of proteins, nucleic acids and lipids, thus playing an important role in pathophysiological processes such as inflammation, tumor, immunity and nervous system. More and more studies have shown that exosomal non-coding RNA (ncRNA) plays a crucial role in pancreatic diseases. This article reviews the role of exosome ncRNA in the occurrence, diagnosis and treatment of pancreatic diseases such as acute pancreatitis and pancreatic cancer, in order to provide a reference for clinical practice.

Objective To explore the professionalization model of nursing management team in an international medical center in a provincial public tertiary hospital.Methods Through literature research and Delphi method,a three-person nursing management team was established respectively in three nursing units:outpatient,first-ward,and second-ward of the center,and then trained professionally to define management boundaries and responsibilities.The training effect was verified by applying the professionalization management in the international medical center.The three nursing teams(nine nurses totally)were compared in terms of leadership,patient satisfaction,and nursing discipline construction before and after the training.Results Following the training,the three teams all exhibited a significant improvement in leadership as well as its dimensions(P＜0.05),and pa-tient satisfaction(P＜0.05).Additionally,care quality,scientific research capacity,and innovation ability were all elevated across the three groups.Conclusion The establishment of a nursing management team and performance of professional training can effectively promote the concept of professionalization management,improve the leadership of nurses,cultivate talent eche-lons,drive the overall development of disciplines and teams,and expand the connotation of nursing culture.For all these bene-fits,this model is suitable for promotion and application among clinical departments.

OBJECTIVE:To establish the method for simultaneous determination of berberine hydrochloride and baicalin in Jianpi zhixiening granules. METHODS:HPLC switching walvelength method was adopted. The determination was performed on Hypersil BDS C18 column with mobile phase consisted of methanol-0.45％ phosphoric acid solution-triethylamine(50:49:1,V/V/V) at the flow rate of 1.0 mL/min. The detection wavelength was set at 265 nm(berberine hydrochloride)and 280 nm(baicalin). The column temperature was set at 30 ℃,and sample size was 10 μL. RESULTS:The linear range of berberine hydrochloride and baicalin were 60.3-312.8 ng(r=0.9997)and 81.5-368.9 ng(r=0.9999). The limits of quantitation were 0.6668,0.7740 ng,andthe limits of detection were 0.2226,0.2580 ng,respectively. RSDs of intermediate precision,stability and repeatability tests were all lower than 1.0％. The recoveries were 96.48％-99.30％(RSD=1.06％,n=6) and 95.20％-99.39％(RSD=1.66％,n=6), respectively. RSDs of durability test were all lower than 2.0％. CONCLUSIONS:The method is simple, precise, stable, reproducible,accurate and durable. It can be used for simultaneous determination of berberine hydrochloride and baicalin in Jianpi zhixiening granules.

Objective To investigate the correlation between uterine globulin associated protein 1(UGRP1)and Fas mediated apoptosis pathway in hashimoto thyroiditis(HT).Methods The expression of UGRP1 in thyroid cells of normal people and HT patients was detected by immunohistochemistry(IHC).FRTL-5 cells were transfect-ed by plasmids in vitro,and control group,UGRP1 group,Fas group were established respectively.Real-time fluo-rescent quantitative reverse transcription PCR(RT-qPCR)was used to detect the expression of Fas and UGRP1 mRNA in each group.Results UGRP1 expression was positive in thyroid cells of HT patients and negative in that of normal people.There were no significant differences between control group and UGRP1 group in Fas gene ex-pression(1.085 0±0.124 9 vs 1.021 0±0.113 9).Compared with the control group,the expression of UGRP1 gene increased significantly in Fas group(P＜0.000 1,5.807 0±0.323 2 vs 0.752 7±0.076 0).Conclusion The high expression of UGRP1 in HT may be related to apoptosis pathway mediated by Fas.

Objective:To observe the expression changes of microRNA(miR)-122 in liver tissue of rats infected with Clonorchis sinensis and its correlation with expression level of inflammatory cytokines. Methods:Totally 24 SPF grade Wistar male rats were selected and randomly divided into a control group (100 μl physiological saline gavage), a 4-week infection group (100 Clonorchis sinensis metacercariae gavage), and an 8-week infection group (100 Clonorchis sinensis metacercariae gavage) based on body weight (100-120 g) using a random number table method, with 8 rats in each group. Starting from the third week of infection, rat feces were collected and directly smeared with physiological saline for identification of Wistar rat animal models infected with Clonorchis sinensis. After 4 and 8 weeks of infection, the rats in the 4- and 8-week infection groups were euthanized, while 4 rats in the control group were euthanized, respectively. The heart blood and left lobe liver tissue and serum samples were collected from each group of rats. Using hematoxylin-eosin (HE) staining to observe liver pathological damage under the light microscope, real-time fluorescence quantitative PCR to detect the expression level of miR-122 in liver tissue, and Luminex 200 liquid suspension chip to detect the expression levels of serum inflammatory cytokines [tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6 (IL-6)]. The correlation between miR-122 and inflammatory cytokines was analyzed using Pearson correlation. Results:Under the light microscope, the morphology of hepatocytes in control group was normal, and no inflammatory cell infiltration was observed. There was inflammatory cells such as lymphocyte, eosinophil and other inflammatory cell infiltration around the portal area in the 4-week infection group. The hepatocytes of the 8-week infected rats were arranged in a disordered manner, with varying degrees of swelling, loose and lightly stained cytoplasm, and some hepatocytes showed watery degeneration; additionally, bile duct dilation and thickening of the bile duct wall were observed in the liver tissue. There were statistically significant differences of liver miR-122 (1.00 ± 0.32, 2.57 ± 0.60, 3.63 ± 1.63), serum TNF-α [(0.14 ± 0.06), (0.43 ± 0.09), (0.61 ± 0.10) ng/ml], and IL-6 expression levels [(0.03 ± 0.01), (1.06 ± 0.24), (1.48 ± 0.33) ng/ml] in control group, 4- and 8-week infection groups ( F = 13.36, 69.99, 82.23, P < 0.001). There was no statistically significant difference in expression level of IL-1β between different groups ( F = 2.15, P = 0.141). The Pearson correlation analysis showed that the expression level of miR-122 was positively correlated with the expression levels of inflammatory cytokines TNF-α and IL-6 ( r = 0.67, 0.80, P < 0.001). Conclusion:Clonorchis sinensis infection can increase the expression of miR-122 in the host liver tissue, and the miR-122 is closely related to the expression levels of inflammatory cytokines TNF-α and IL-6.

Objective : To investigate the correlation of uteroglobulin⁃related protein 1 (UGRP1) with latent autoimmune diabetes in adults (LADA) . Methods: 124 participants were selected , including 45 LADA patients as LADA group ,41 type 2 diabetes mellitus (T2DM) patients as T2DM group and 38 healthy people without diabetes as control group. General information , diabetes related indicators and serum UGRP1 levels were compared among the three groups. Spearman correlation was used to analyze the relationship between serum UGRP1 and diabetes related indicators. Binary logistic regression was used to analyze whether UGRP1 could be an independent risk factor for LADA. The diagnostic value of UGRP1 in LADA was discussed by ROC curve analysis. Results: There were significant differences in BMI , systolicpressure , diastolicpressure , fasting blood glucose , 2h postprandial blood glucose , fasting C ⁃peptide , 2h postprandial C ⁃peptide , HbA1 c , diabetes antibodies( GADAb , IA⁃2 , ZnT8) among the three groups (P < 0. 05) . The level of serum UGRP1 in LADA group was significantly higher than that in control group and T2DM group (P < 0. 05) . Spearman correlation analysis showed that the serum UGRP1 level of diabetes patients was related to fasting C ⁃peptide , 2h postprandial C ⁃peptide , GADAb , the number of positive diabetes antibodies. Binary Logistic regression analysis showed that serum UGRP1 level was an independent risk factor for LADA. ROC curve analysis results suggested that UGRP1 could be used as a better assistant indicator for the diagnosis of LADA. Conclusion UGRP1 may be involved in the pathogenesis of LADA.