Viral hepatitis is an important cause of liver cirrhosis and liver cancer， which has become a major public health problem in the world. Traditional Chinese medicine has unique advantages in treating viral hepatitis， which can inhibit virus replication and enhance immunity. It can effectively prevent liver fibrosis and canceration， improving liver function and symptoms significantly with definite clinical curative effects， a high level of safety， and seldom drug resistance. In addition， it reduces the side effects of western medicine， achieving the effect of synergy and attenuation while reducing the recurrence rate of patients after drug withdrawal. Attention has been paid to the research on the treatment of viral hepatitis with traditional Chinese medicine， and great progress has been made in experimental research and clinical practice. In this paper， the research progress of traditional Chinese medicine in the treatment of viral hepatitis at home and abroad in recent five years was systematically reviewed. Modern research has confirmed that traditional Chinese medicine can play a role in the treatment of viral hepatitis by directly or indirectly inhibiting the virus， anti-inflammatory， anti-fibrosis， anti-oxidation， regulating immunity， regulating autophagy， and other signal pathways. In clinics， traditional Chinese medicine compound or combined with western medicine is often adopted to ameliorate the clinical symptoms of patients such as fatigue and loss of appetite， improve the immune mechanism of the body， enhance the antiviral ability， shorten the treatment course of patients and improve their quality of life. The research provides a reference for pharmacological research， clinical research， and new drug development for viral hepatitis.

BACKGROUND:Current studies have confirmed that Ganoderma lucidum polysaccharides can promote nerve regeneration in neurodegeneration-related diseases.The occurrence of neurodegenerative diseases is closely related to mitochondrial dysfunction,but the role of Ganoderma lucidum polysaccharides on the regulation of apoptosis and mitochondrial function in neurodegenerative diseases is not yet clarified. OBJECTIVE:To explore the regulatory effects and mechanisms of Ganoderma lucidum polysaccharides on apoptosis and mitochondrial dysfunction in H2O2-induced SH-SY5Y cells. METHODS:SH-SY5Y cells were divided into three groups:control group,H2O2 group,and Ganoderma lucidum polysaccharides group.Cells in the control group were normally cultured.Cells in the H2O2 group were treated with 300 μmol/L H2O2 for 24 hours.In the Ganoderma lucidum polysaccharides group,the intervention with 300 μg/L Ganoderma lucidum polysaccharides was conducted first for 1-2 hours,followed by the addition of 300 μmol/L H2O2 for 24 hours.The mitochondrial membrane potential was detected by JC-1 kit.Apoptosis was detected by TUNEL staining kit.The activities of malondialdehyde and superoxide dismutase were detected by malondialdehyde test kit and superoxide dismutase test kit,respectively.The apoptosis and expression of mitochondrial dynamics-related proteins were detected by immunofluorescence staining and western blot assay. RESULTS AND CONCLUSION:(1)Compared with the control group,the mitochondrial membrane potential and superoxide dismutase activity were significantly reduced,as well as apoptotic rate and malondialdehyde levels were significantly increased in the H2O2 group(P<0.05).After treatment with Ganoderma lucidum polysaccharides,the membrane potential and superoxide dismutase activities were significantly increased,and apoptotic rate and malondialdehyde levels were significantly reduced compared with the H2O2 group(P<0.05).(2)The expression levels of pro-apoptotic proteins Bax and Caspase-3 were significantly increased,but the expression of anti-apoptotic protein Bcl-2 was significantly decreased in the H2O2 group compared with the control group(P<0.05).Compared with the H2O2 group,the levels of Bax and Caspase-3 were significantly decreased,but the expression of anti-apoptotic protein Bcl-2 was significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(3)Compared with the control group,the expression of mitochondrial splitting proteins Fis1 and p-Drp1 was significantly increased,but the expression of mitochondrial fusion proteins OPA1,Mfn1,and Mfn2 was decreased in the H2O2 group(P<0.05).Compared with the H2O2 group,Fis1 and p-Drp1 expression was significantly reduced,but the expression levels of OPA1,Mfn1,and Mfn2 were significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(4)The above results confirm that Ganoderma lucidum polysaccharides can attenuate H2O2-induced oxidative stress damage and apoptosis in SH-SY5Y cells by ameliorating mitochondrial dysfunction.

Objective:To compare the policies and literature on scope of nurse practice in various countries, so as to provide reference for optimizing the expansion of scope of nurse practice in China.Methods:Literature on nurse practice was systematically searched on PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Data, and nursing policy organization websites in various countries. The search period was from database establishment to June 2023.Results:A total of 19 articles from six countries were included. There were elements such as registration types and requirements, practice methods, prescription authority, supervision departments, and relevant laws. The inspiration for the hierarchical management of nurses in China mainly included four aspects: improving the hierarchical registration and management system, clarifying the job responsibilities of nurses; guiding the reasonable flow of nursing talents, encouraging multi-site practice in nurses; cultivating nurses' prescription ability and granting them prescription authority; improving supervision and legal protection to ensure that nurses practiced in accordance with the law.Conclusions:It is urgent to expand the practice scope of the nursing team in our country, supplement grassroots medical and health talents, undertake the functions of case management for chronic patients, improve the quality of life of patients, and meet the important task of community and family nursing needs.

Objective:To gain a deep understanding of the current cognition and training needs of nursing undergraduates regarding their emergency response teamwork skills, and to provide reference for the development of courses on emergency response teamwork among nursing undergraduates.Methods:From September to October 2023, purposive sampling was used to select 15 senior nursing undergraduates from Peking Union Medical College, Beijing University of Chinese Medicine, and Beijing City University as subjects for semi-structured interviews. Colazizzi 7-step analysis method was used to summarize and extract themes.Results:Three themes were extracted, including insufficient cognition and skill in emergency response, lack of emergency response teamwork cultivation, and the need for systematic and comprehensive training courses.Conclusions:Universities, hospitals, and other training institutions should work together to develop a systematic emergency response teamwork training course for nursing undergraduates, to cultivate the skills of nursing undergraduates and reserve talents for high-quality emergency response nursing teams.

Objective:To observe the effect of Yi Jin Jing(Sinew-transforming Qigong Exercises)intervention on anxiety in asymptomatic patients with Corona Virus Disease 2019(COVID-19)infection during quarantine.Methods:A total of 160 asymptomatic patients with COVID-19 infection were stratified by gender and divided into an observation group and a control group by the stratified randomization method,with 80 cases in each group.The control group was given basic nursing in the cabin,and the observation group was given additional Yi Jin Jing exercises once a day,20 min each time,and trained continuously until 1 d before leaving the cabin.The Hamilton anxiety scale(HAMA)score was compared between the two groups.Results:A total of 154 cases were included for data analysis in this study,including 74 cases in the observation group and 80 cases in the control group.After intervention,the HAMA scores in both groups increased(P<0.05),while the score in the observation group was lower than that in the control group(P<0.05).In the control group,the HAMA score of females after intervention was higher than that of males.The scores of mental anxiety and somatic anxiety in both groups were higher than those before intervention,while the score of mental anxiety in the observation group was significantly lower than that in the control(P<0.05).However,there was no statistical difference in the somatic score between the two groups(P>0.05).Conclusion:Patients with COVID-19 infection will get anxious during quarantine.Yi Jin Jing exercise can effectively reduce the aggravation of anxiety in asymptomatic patients with COVID-19 infection during concentrated quarantine.

Objective:To understand the clinical application status of the best evidence for airway clearance in Intensive Care Unit (ICU) patients, analyze the barriers and enablers in the process of evidence application, so as to provide reference for formulating transformation strategies.Methods:The literature on airway clearance in ICU patients was systematically searched in domestic and foreign databases and association websites. The best evidences were summarized based on the included literature, and corresponding review indicators were constructed based on the best evidence for clinical baseline review. From July to August 2022, convenience sampling was used to select 30 nurses and 30 patients from ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. We conducted barriers and transformation strategy analysis based on the review results.Results:A total of 33 review indicators were formulated. The clinical execution rate of the review indicators was 0 to 100%, with 60.6% (20/33) of the review indicators having a clinical execution rate of <60%. The main barriers were that the specialized team for airway clearance involved great personnel and was difficult to organize, nurses had insufficient awareness and importance of airway clearance knowledge, the department lacked corresponding evaluation tools and equipment, the implementation standards for airway clearance treatment within the department were not sound, and the health education materials for airway clearance were incomplete. The transformation strategy mainly included strengthening leadership support, conducting knowledge training on airway clearance, introducing tools and equipment related to airway clearance, improving the implementation standards of airway clearance and health education materials for airway clearance.Conclusions:There is a significant gap between the best evidence for airway clearance in ICU patients and clinical practice. Timely improvement should be made on relevant barriers to promote the conversion of best evidence into clinical practice and improve patient clinical outcomes.

Objective:To analyze the horizontal scientific research projects from 2015 to 2019 by the provincial Centers for Disease Control and Prevention (CDC) in China, and to compare the regional differences, in order to provide the suggestion on the scientific management of CDC.Methods:The horizontal scientific research projects from 2015 to 2019 were retrospectively analyzed by questionnaire survey. Multiple linear regression models were adopted to examine the trend, and variance analyses were used to test the differences in horizontal scientific research projects among the Eastern, Central, and Western regions.Results:From 2015 to 2019, provincial CDC have received RMB 124.3 million of horizontal scientific research project funds totally, of which 51.9% were funded by enterprises, and 86.9% were undertaken by provincial CDC themselves. There were no statistical significance in the change of research project funds obtained by provincial CDC ( F=0.46, P = 0.764) during this period.The number of horizontal scientific research projects undertook or participated by provincial CDC in the Eastern region were more than that of the Central and Western region ( F = 5.85, P = 0.004; F = 5.03, P = 0.008). Conclusions:The horizontal scientific research projects obtained by the provincial CDC remained stable in recent years while distribution was unbalanced in the region areas. It is suggested to innovate the management mode of scientific research projects with strengthening the trans-agency, trans-department and trans-regional cooperation.

Objective:To explore the current status and influencing factors of venous thromboembolism (VTE) knowledge among nurses of hospitals in Tibet, so as to provide guidance for VTE nursing in Tibet.Methods:From November to December 2019, convenience sampling was used to conduct a VTE knowledge survey of 1 117 nurses in 59 hospitals from 7 cities (regions) of the Tibet Autonomous Region using the VTE Knowledge Questionnaire for Clinical Nurses. Binary Logistic regression analysis was used to explore the influencing factors of VTE knowledge scores among nurses.Results:Among nurses of the Tibet Autonomous Region, the total VTE knowledge score was (36.70±15.17) , of which the basic knowledge dimension score was (7.13±2.99) , and the risk assessment dimension score was (14.75±7.61) , and the basic prevention dimension score was (3.92±1.99) , and the physical prevention dimension score was (4.73±2.62) points, and the drug prevention dimension score was (1.96±1.29) , and the VTE post-processing dimension score was (4.22±2.35) . The average score rate of VTE knowledge among nurses in Tibet was 48.94%, and the knowledge of nurses was at an intermediate to low level. In the use of preventive measures, nurses had insufficient knowledge, including physical prevention score rate of 36.38%, drug prevention score rate 39.20%. Logistic regression analysis showed that professional title, hospital level, and whether or not they had participated in training were independent factors influencing the qualification of nurses' VTE knowledge score ( P<0.05) . Conclusions:The nurses in Tibet have insufficient knowledge of VTE. Managers need to carry out targeted training for nurses with different characteristics and the deficiencies of knowledge, to promote nurses to apply what they have learned to clinical practice effectively, and to ensure the quality of VTE care.

Objective:To explore the genetic and environmental effects on alcohol intake.Methods:Data on 9 231 pairs of adult twins of the same sex was collected from the Chinese National Twin Registry (CNTR), between 2015 and 2018 and used in this study. Structural equation model was used to estimate the effects of genetic and environmental factors on alcohol intake.Results:A total of 9 231 pairs of twins were included in the analysis, of which 6 085 pairs were monozygotic (MZ). The average age of MZ was (36.91±13.07) years old, and males accounted for 56.80 %. The average age of dizygotic twins (DZ) was (35.22±12.48) years old, and males accounted for 55.91 %. There were 350 pairs of alcohol-drinking twins were with high-risk, accounting for 1.90 % and another 367 pairs (1.99 %) were with medium-risk. Alcohol-drinkers with medium-risk were affected by additive genetics, common and unique environmental factors, seen among the twins. The overall heritability appeared as 24.3 % (95 %CI: 0 to 56.8 %). Furthermore, 50.7 % of the variation (95 %CI: 20.4 %-79.0 %) could be explained by the common environmental factors and 24.9 % (95 %CI: 18.3 %-36.5 %) by unique environmental factors. High-risk related drinking behavior was affected by both common and unique environmental factors. The common environmental component appeared as 75.6 % (95 %CI: 69.6 %-80.8 %) and unique environmental component as 24.4 % (95 %CI: 19.2 %-30.4 %), respectively. Gender difference was seen in the heritability of those with medium or high-risk drinking behaviors. The heritability of men was 30.8 % (95 %CI: 9.8 %-53.5 %), while in women it was mainly affected by the environment. Conclusion:Both alcohol drinkers with medium and high-risk drinking behaviors were mainly affected by the environment factors and gender. With the increase of drinking volume, the effect of environment on drinking behaviors became more obvious.

Objective:To investigate the expressions and correlation of bcl-2, programmed death-1 (PD-1) and programmed death ligand-1(PD-L1) in diffuse large B-cell lymphoma (DLBCL) tissue specimens, and the relationship between chemotherapy efficacy and prognosis of DLBCL patients.Methods:The expressions of bcl-2, PD-1 and PD-L1 in 82 patients with DLBCL who were admitted to Chenzhou First People's Hospital of Hunan Province from May 2011 to April 2014 were detected by using immunohistochemistry, and the correlation of the expressions of bcl-2, PD-1 and PD-L1 with clinicopathological characteristics and prognosis was analyzed.Results:The positive rate of bcl-2, PD-L1 and PD-1 in cancer tissues of DLBCL patients was 53.7% (44/82), 56.1% (46/82) and 32.9% (27/82), respectively. There was a correlation between bcl-2 and PD-L1 expression ( r = 0.306, P = 0.005). Bcl-2 was highly expressed in patients with international prognosis index (IPI) score 3-4 points, non-germinal center B-cell-like (non-GCB) subtype and B symptoms (all P < 0.05); PD-1 was highly expressed in patients with IPI score 3-4 points ( P < 0.05); PD-L1 was highly expressed in patients with IPI score 3-4 points, tumor stage Ⅲ-Ⅳ, B symptoms, ≥60 years old, and non-GCB (all P < 0.05). The overall survival (OS) and progression-free survival (PFS) in bcl-2-negative group were better than those in the bcl-2-positive group, and the differences were statistically significant (both P < 0.05); OS and PFS in PD-L1-negative group were better than those in PD-L1-positive group, and the differences were statistically significant(both P < 0.01). There were no statistical differences in OS and PFS between PD-1-positive group and PD-1-negative group (both P > 0.05). OS and PFS in bcl-2 and PD-L1 co-expression group were worse than those in both negative or any negative group (all P < 0.01), and PFS in bcl-2 and PD-1 co-expression group was worse than those in both negative or any negative group ( P = 0.044). Cox multivariate analysis showed IPI score 3-4 points and B symptoms were the independent influencing factors of OS in DLBCL patients (both P < 0.01); IPI score 3-4 points, B symptoms and PD-L1-positive were the independent influencing factors of poor PFS in DLBCL patients (all P < 0.05). Conclusion:The positive expressions of bcl-2 and PD-L1 are the independent factors for the poor prognosis of DLBCL patients, which may become new targets for the treatment of DLBCL.