Objective To study effects of low molecular weight heparin on liver fibrosis and the serum levels of TGF-?_1 in patients with chronic hepatitis B virus.Methods 45 patients with chronic hepatitis B virus were randomized into control group(the routine strategy)and trial group(the routine strategy + low molecular weight heparin).The period of treatment is 3 weeks.Serum hepatic fibrosis indices before and after heparin treatment were examined by RIA,the levels of serum TGF-?_1 before and after heparin treatment were examined by ELISA.Results Hepatic functions became significantly better in trial groups,serum PⅢP and type IV collage levels and the levels of serum TGF-?_1 in trial group decreased significantly after treatment.Conclusions The mechanism of anti-fibrosis action of LMWH may inhibited production of TGF-?_1 in patients with HBV.

Aim To investigate the effect of SA on induction of ERK1/2 activity in rat pulmonary smooth muscle cells(PASMCs).Methods Western blot analysis was employed to identify the activation of ERK1/2 stimulated by SA at different time points and concentrations in cultured rat PASMCs.Results An unexpected observation showed that ERK1/2 phosphorylation was seen after treatment of SA for 2h at a high concentration(30 ?mol?L-1) but not at lower concentration(from 1 nmol?L-1 to 1 ?mol?L-1).Activation of ERK1/2 pathway could be inhibited by an ERK1/2 inhibitor PD98059 or a protein kinase A(PKA) activator isoproterenol.Conclusion Together,these results suggest that SA has a strong dual regulating effect upon ERK1/2 through PKC and/or PKA pathways in rat PASMCs.

Objective To measure the concentration of serum transthyretin (TTR) of patients with different stages of diabetic retinopathy (DR).Methods A total of 176 patients with diabetes mellitus were included in this study.There were 104 males and 72 females.The patients aged from 21 to 74 years,with the mean age of(56± 11) years.The diabetes duration raged from 1 to 30 years,with the mean diabetes duration of (10 ± 7) years.The HbA 1C was 5.2％-14.1％,with the mean HbA 1C of (8.6 ± 2.0)％.According to the fundus examination,58 patients had DR (33.0％),but the other 118 patients not (67.0％).For these DR patients,10 patients were in stage Ⅰ (5.7％),26 patients in stage Ⅱ (14.8％),8 patients in stage Ⅲ (4.5％),and 14 patients in stage Ⅳ (8.0％).The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit.The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR.Results The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were (224.96±65.47),(383.68± 102.99),(247.44±63.21),(228.2 ± 45.89),(189.34± 70.12) mg/L,respectively.The difference between different DR stages was statistically significant (F=14.690,P＜ 0.001).Bivariate analysis showed that the concentration of TTR was correlation to DR (r=0.179,P=0.017).There was no correlation between the concentration of TTR and diabetes duration (r=-0.027,P=0.727),hypertension (r=0.018,P=0.810),hyperlipoidemia (r=0.101,P=0.182),and the use of insulin (r=-0.032,P=0.675).Conclusion The concentration of serum TTR was increased in early DR patients,and gradually decreased with the progression of DR.The concentration of TTR is correlated to DR.

Objective To investigate the high risk factors for wheezing of low birth weight premature infants with wheezing.Methods A cohort study of 143 premature infants,whose gestation less than 37 weeks and birth weight less than 2 500 g,were collected from Neonatal Intensive Care Unit of Kunming Children's Hospital,from December 2012 to November 2013.Follow-up investigation was conducted,and those with wheezing were enrolled in the study.Many possible factors causing wheezing were analyzed,such as general conditions in the neonatal period,family conditions,and treatment.SPSS 17.0 statistical software was used to analyze the data.Single factor analysis was used by x2 test and rank sum test to evaluate the possible risk factors.Multiple factors analysis was made by Logistic regression analysis.P ＜ 0.05 was viewed as having statistical difference.Results (1) The risk factors for wheezing in the premature infants were:continuous positive airway pressure (CPAP) noninvasive ventilation (x2 =8.531,P =0.003),ventilation (x2 =4.800,P =0.028),caesarean section (x2 =6.787,P =0.009),the use of pulmonary surfactant (x2 =5.455,P =0.020),using antibiotics used at hospital (x2 =5.192,P =0.023),father smoking(x2 =5.406,P =0.020),maternal smoking (x2 =8.531,P =0.003),maternal allergic history (x2 =8.297,P =0.004),compatriot history of allergies (x2 =8.297,P =0.004) or asthma (x2 =9.774,P =0.002),family environment with dust and excitant gas (x2 =12.831,P =0.000) were the risk factors for the wheezing in the low birth weight premature infants.(2)Multi-factor classification Logistic regression analysis showed that CPAP (OR =58.414,95 ％ CI:3.317-1 028.646,P =0.005),mother smoking during pregnancy (OR =11.953,95 ％ CI:1.309-109.120,P =0.028),compatriot history of allergies (OR=135.769,95％ CI:4.914-3 751.419,P =0.004),family environment(OR =83.738,95％ CI:4.416-1 587.982,P =0.003),were independent risk factors for wheezing in low birth weight premature infants;natural labor was protective factor for wheezing in low birth weight premature infants (OR =0.045,95％ CI:0.004-0.574,P =0.017).(3)The sensitivity and specificity of risk factors were analyzed.The highest sensitivity was estimated for the father's history of allergy(83.3％).The highest specificity was estimated for the use of antibiotics at hospital (76.7％).Conclusions The study shows that CPAP noninvasive ventilation,mother smoking during pregnancy,allergy history of their brothers and sisters,family environment with dust and excitant gas are independent risk factors for wheezing in the low birth weight premature infants.There is no single risk factor with both high sensitivity and high specificity.

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

Objective:To investigate the influencing factors for pancreatic endocrine and exocrine insufficiency after pancreaticoduodenectomy.Methods:The retrospective case-control study was conducted. The clinicopathological data of 168 patients who underwent pancreaticoduodenectomy in the Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2016 to December 2017 were collected. There were 96 males and 72 females, aged (64±13)years, with a range from 38 to 75 years. Of the 168 patients, 36 had pancreatic endocrine insufficiency while 8 had pancreatic exocrine insufficiency preoperatively. All patients underwent pancreaticoduodenectomy. Observation indications: (1) surgical situations and follow-up; (2) analysis of influencing factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy; (3) analysis of influencing factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy. Follow-up using out-patient examination and telephone interview was performed to detect postoperative condition of blood glucose control, diet and nutrition, tumor recurrence and metastasis up to June 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were described as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. Results:(1) Surgical situations and follow-up: all the 168 patients underwent pancreaticoduodenectomy successfully and recovered well after operation. All patients were followed up for 6 months. The level of fasting and postprandial blood glucose of the 168 patients after surgery were 7 mmol/L(range, 5-9 mmol/L) and 10 mmol/L(range, 7-14 mmol/L), respectively. The defecation frequency was (2.4±1.2)times per day. No tumor recurrence or metastasis occurred in either patient. One hundred and thirty-two of the 168 patients were included in the study excepting patients with pancreatic endocrine insufficiency before operation. At postoperative 6 months, 47 patients developed pancreatic endocrine insufficiency, with an incidence of 35.61%(47/132). One hundred and sixty of the 168 patients were included in the study excepting patients with pancreatic exocrine insufficiency before operation. At postoperative 6 months, 68 patients had pancreatic exocrine insufficiency, with an incidence rate of 42.50%(68/160). (2) Analysis of influencing factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy. Results of univariate analysis showed that gender, metabolic syndrome, chronic pancreatitis, excision point, and postoperative chemotherapy were the related factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy ( χ2=5.300, 6.270, 4.473, 4.392, 5.397, P<0.05). Results of multivariate analysis revealed that male and metabolic syndrome were independent risk factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy [ hazard ratio ( HR)=5.252, 5.364, 95% confidence interval ( CI): 1.362-6.382, 1.891-12.592, P<0.05)]. (3) Analysis of risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy. Results of univariate analysis showed that body mass index (BMI), chronic pancreatitis, total bilirubin, excision point, postoperative pancreatic fistula as grade B or C, and pancreatic fibrosis were related factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy ( χ2=1.691, 4.910, 7.763, 5.605, 4.663, 7.700, P<0.05). Results of multivariate analysis showed that BMI<18.5 kg/m 2, chronic pancreatitis, total bilirubin ≥171 μmol/L were independent risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy ( HR=3.695, 5.231, 7.623, 95% CI: 1.232-7.324, 2.161-6.893, 1.562-5.235, P<0.05). Conclusions:Male and metabolic syndrome are risk factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy. BMI<18.5 kg/m 2, chronic pancreatitis, and total bilirubin ≥171 μmol/L are risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy.

Objective:To build a training and promotion model for traditional Chinese medicine nursing tourism project in Zhejiang Province, promoting homogeneous management and standardized promotion of traditional Chinese medicine nursing tourism project.Methods:From July 2022 to June 2023, purposive sampling was used to select 20 experts from ClassⅢ traditional Chinese medicine hospitals in Zhejiang Province for Delphi expert consultation. Two rounds of consultation were conducted via email to construct a training and promotion model for traditional Chinese medicine nursing tourism project in Zhejiang Province.Results:In the two rounds of expert consultation, the effective response rate of the questionnaire was 100% (20/20), the familiarity coefficient of the experts was 0.89, the judgment coefficient was 0.94, and the authority coefficient of the experts was 0.92. The Kendall harmony coefficients for two rounds of consultation were 0.268 and 0.105, respectively, with statistically significant differences ( P<0.001). The training and promotion model for traditional Chinese medicine nursing tourism project in Zhejiang Province included six first-level indicators, 22 second-level indicators, 74 third-level indicators, and 28 fourth-level indicators. Conclusions:The construction process of the training and promotion model for traditional Chinese medicine nursing tourism project in Zhejiang Province is rigorous and standardized, providing reference for training and helping to promote innovation and sustainable development of traditional Chinese medicine nursing.

Objective:To investigate the unqualified hepatitis C virus (HCV) detection result of blood donors from the served area of blood institutions.Methods:The data related to HCV markers detected of the first and repeat blood donors were collected from the system of practice comparison for the Chinese mainland blood institutions from 2017 to 2021. The anti-HCV reactive rate and the rates of anti-HCV negative but HCV-RNA reaction and all the relationship between rates and the annual, regional and different blood donors were statistically analyzed.Results:During 2017-2021, the number of anti-HCV reactive per 100 000 blood donors decreased from 444.3 to 250.44 in the served area of 22 blood institutions ( χ2=49.677, P<0.05). The number of HCV RNA detected positive per 100 000 anti-HCV negative increased from 0.69 to 2.05 year by year, but there was no statistical significance ( χ2=0.643, P>0.05). The anti-HCV unqualified rate was significantly different among regions ( χ2=3 260.283, P<0.05). The anti-HCV unqualified rate of the first blood donors was significantly higher than that of the repeated blood donors ( F=130.993, P < 0.05). The annual number of HCV RNA detected positive per 100 000 anti-HCV negative blood samples from donors ranged from 0 to 17.28. Conclusions:The anti-HCV unqualified rate of blood donors in the served area of 22 blood institutions decreased year by year. Compared with repeated blood donors, HCV infection should be emphasized in first-time blood donors. The implementation of HCV RNA test can detect out much more HCV infections and reduce the risk of transfusion transmitted infectious HCV.

Objective:To analyze the detection strategy and basic detection situation of markers of infectious diseases transmitted by transfusion in blood testing laboratories of blood stations in China.Methods:Based on the data of practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021, the data on the testing strategies and the basic detection information of the markers for the transmission of infectious diseases through transfusion in the member laboratories of the practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021 were collected, and the situation of the selection for testing markers, testing strategy and the testing method and other relevant aspects were sorted out and analyzed by charts.Results:The selection of the testing markers was consistent, but HTLV testing item was added in some member laboratories. The detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously was adopted in 47 member blood stations; 3) NAT method was dominated by mini pool-NAT in member laboratories. The number of members adopting mini-pools of 8 (MP8)-NAT decreased from 17 in 2017 to 14 in 2021, while the number of members adopting mini-pools of 6 (MP6)-NAT increased from 13 in 2017 to 22 in 2021; Roche NAT system accounted for the largest proportion.Conclusions:In order to ensure blood safety and avoid missing detection, the blood stations still adopt the detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously; Meanwhile, in order to increase the NAT positive rate, the proportion of mini pool-NAT mainly decreased year by year despite its dominating role, while the proportion of individual donation-NAT increased year by year; NAT method is transiting from mini-pools of 8 (MP8) to mini-pools of 6 (MP6); The proportion of imported NAT system used in NAT laboratory is relatively large.