Objective: To investigate the effects of Wuling Capsule, a compound traditional Chinese herbal medicine, on hippocampal neurogenesis by examining the expressions of brain-derived neurotrophic factor (BDNF) and connexin 43 (Cx43) in rats with depression induced by chronic unpredictable mild stress (CMS), and thereby to explore its antidepressant mechanism. Methods: Forty-five adult male Sprague-Dawley rats were randomly divided into three groups: control group (n=15), untreated group (n=15) and Wuling group (n=15). All rats except those in the control group were subjected to 3-week CMS to induce depression. At the same time Wuling Capsule was daily added to the diet of the rats in the Wuling group at a dose of 100 mg/kg body weight for 21 days. The degree of depression was determined by sucrose preference test. BDNF expression and neurogenesis were tested by using immunohistochemical staining with BDNF and 5-bromodeoxyuridine (BrdU) antibodies; and the mRNA and protein expression levels of Cx43 in hippocampus were examined by semi-quantitative reverse transcription-polymerase chain reaction and Western blotting. Results: The numbers of BDNF-positive neurons and BrdU-positive particles in dentate gyrus (DG) were significantly decreased in CMS rats as compared with the normal rats, and the same changes were found in Cx43 mRNA and protein expressions. After Wuling Capsule treatment, the depressed behaviors were improved. Moreover, the reduced expression levels of Cx43 mRNA and protein and fewer newborn neurons induced by CMS were recovered to the normal levels. However, BDNF-positive cells remained low in DG. Conclusion: Wuling Capsule can improve the low hippocampal neurogenesis in rats subjected to CMS and the antidepressant effects are related to enhancing the Cx43 expression but not through BDNF mediation.

Objective To investigate the relationship between the activity of superoxide dismutase (T-SOD)as well as its manganese superoxide dismutase isozyme (Mn-SOD),concentration levels of hypersensitive c-reactive protein(hs-CRP)and coronary heart disease.Methods The levels of serum T-SOD,Mn-SOD and hs-CRP were measured in 81 patients with coro-nary heart disease and 60 healthy controls,respectively.T-SOD was measured by colorimetricmethod and hs-CRP was meas-ured by latex enhanced immune turbidimetric assay.Results Compered with the control group,activity of T-SOD,Mn-SOD in CHD group were significantly decreased (t=9.41,6.34,all P<0.01).However,hs-CRP in CHD group were significantly increased to those in controls (t=3.09,P<0.05).The activity of T-SOD,Mn-SOD were negatively correlated with hs-CRP (P<0.01).Conclusion The variation of T-SOD,Mn-SOD activity and hs-CRP content were closely related to the occur-rence and development of CHD,they could be the impor tant indicators for riskfactors assessment of CHD.Moreover,con-joint analysis the correlation of T-SOD,Mn-SOD and hs-CRP has certain guiding significance for the clinical treatment and prognosis of coronary heart disease.

Aim To establish a novel acute hyperuricemia mouse model and apply it to evaluate the hyporucicemia effects of Ulodesine, a purine nucleoside phosphorylase(PNP) inhibitor.Methods The mice were intraperitoneal injected inosine and subcutaneous injected Oteracil potassium to induce accumulation of uric acid, and the animal blood was collected from eyeball or vena angularis in different time points.The levels of serum uric acid were measured and determined to test whether the acute hyperuricemia mouse model were successful or not.In order to verify the hyperuricemia seen in the model was associated with the accumulation of inosine, which was converted to uric acid by action of PNP,hyporucicemia effects of Ulodesine, a PNP inhibitor, was assessed in an enzyme assay and confirmed by using the newly established model.Result Accumulation of uric acid in the blood of mouse models was observed by combined injections of intraperitoneal 200 mg·kg-1 inosine and subcutaneous 200 mg·kg-1 Oteracil potassium respectively after 1.5 h.The enzyme assay indicated that Ulodesine was a potently PNP inhibitor with IC50 of 2.293 nmol·L-1.IV injection of Ulodesine eliminated uric acid accumulations in blood of the mouse model, which was expected as the in vivo action of Ulodesine.Conclusions A novel acute hyperuricemia mouse model is established.This is a relatively easy and more effective protocol to generate the hyperuricemia in mice, which will be a useful platform to assess the anti-hyperuricemia activity of PNP-target drugs in vivo.

Objective To understand the nutrition status in elderly patients with hip fracture, and clarify its effects on postoperative functional recovery,complications and mortality based on literature analysis of the past 10 years. Methods PubMed,Medline,Embase Database,Wanfang Database,Chinese National Knowledge Infrastructure(CNKI)and China Biology Medicine disc(CBMdisc)were searched,and relevant researches published from 1st January,2010 to 31th May,2019 were collected. Single rate Meta-analysis was used to integrate the prevalence and mortality of malnutrition. A qualitative systematic review was used to analyze the relationship between nutritional status and prognosis after surgery. Results A total of 11 articles was included,including 21791 patients. Meta-analysis showed that the mean prevalence of malnutrition during hospitalization in elderly patients with hip fracture was 46％(95％CI:45％-47％)using serum albumin(ALB),and was 17％(95％CI:12％-22％)assessing by the Mini Nutritional Assessment (MNA),and the risk of malnutrition prevalence was 42％(95％CI:45％-47％). The results of qualitative evaluation showed that compared with the well-nutrition group(Short-form MNA 12-14 points),the malnutrition risk group(Short-form MNA 8-11 points)had lower activity ability 4 months after the operation (OR=2.03,95％CI:1.24-3.31),and the MNA score decreased by 1 point,the risk of death increased by 15％(HR=0.869,95％CI:0.757-0.998). The malnutrition group(ALB<3.5 g/dl)had a higher incidence of sepsis (P< 0.001)and pulmonary infection(P=0.019),with every 1 g/dl reduction in ALB and 0.59-fold increased risk of death(RR=0.59,95％CI:0.53-0.65). Conclusions The incidence of hip fracture malnutrition or malnutrition risk is very high in the elderly patients with hip fracture. Both malnutrition and malnutrition risk have negative effects on postoperative functional recovery,complications and death rates,and the worse the nutritional status,the worse the prognosis. So,both ALB and MNA are recommended to be included in the care plan of elderly patients with hip fracture. When ALB is failed to diagnose malnutrition,the MNA evaluation method should be adopted to find the problems of nutrition and offer nutritional intervention in advance.

Training and improving the clinical skills of specialist nurses is an important part of nursing education in Operating Room. The objective structured clinical examination is currently recognized as an objective assessment method to evaluate the clinical practice skills of medical students. Its assessment model is still in its infancy in the field of clinical nursing education in China. This article reviews the connotation of clinical skills,the design of objective structured clinical examination and the application status of clinical skills training of specialist nurses in Operating Room.

Objective To observe the role of abatacept in the treatment of diabetic nephropathy in rats. Methods Type 2 diabetic nephropathy rat model was established, and was randomly divided into abatacept group and non-intervention group, 15 each. 15 normal rats were served as control group ( NC) . The abatacept group was given abatacept for 8 weeks. The control group was set at the same time period. Then the blood biochemical indexes, blood flow parameters of renal main artery, elasticity of renal parenchymal, HE staining of renal parenchymal and ultrastructure of podocytes were all evaluated. The expression of CD31, CD34, podocin, nephrin, and B7-1 in renal parenchyma were detected. Results Compared to the NC group, the fasting blood glucose, creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the non-intervention and abatacept groups were significantly increased (P<0. 05);creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the abatacept group were significantly lower compared to the non-intervention group (P<0. 05). There were significant differences in peak systolic velocity, end diastolic velocity, and mean velocity among these 3 groups, and these differences were ranked as non-intervention groupabatacept>control groups (P<0. 05). There were significant differences in the stiffness of kidneys among these three groups, with the differences ranked as non-intervention>abatacept>control groups (P<0. 05). HE staining and transmission electron microscope observation showed that there were obvious changes in the renal parenchyma of rats in the non-intervention group and the abatacept group, and the changes of kidney in the non-intervention group were worse than those in the abatacept group. CD31 and CD34 expression in kidney parenchyma of rats in the abatacept group and non-intervention group were higher than those in the control group, the abatacept group and non-intervention group>the control group (P<0. 05), while no significant differences between the abatacept group and non-intervention group in CD31 and CD34 expression (P>0. 05). There were significant differences in podocin and nephrin expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control>abatacept>non-intervention groups (P<0. 05). There were significant differences in B7-1 expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control

Objective:To construct nursing quality evaluation indicator system for comprehensive stroke center, so as to provide reference for standardized nursing quality evaluation of comprehensive stroke center.Methods:From September 2018 to December 2019, based on the theory of Donabedian′s structure-process-outcome quality model, literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to determine nursing quality evaluation index system and index weight for comprehensive stroke center.Results:A total of 16 experts from comprehensive stroke center were consulted for two rounds. The clinical working time was 24.63±10.08 years, and the effective recovery rates of two rounds were 100%. The authority coefficient of experts was 0.888, and the coordination coefficients W of two rounds were 0.229 and 0.283 respectively.Finally, a nursing quality evaluation indicator system for comprehensive stroke center was constructed, including 3 first-level indicators, 13 second-level indicators and 46 third-level indicators. Conclusions:The established nursing quality evaluation indicator system for comprehensive stroke center covers the whole process of stroke emergency, stroke unit, and follow-up, which is scientific and reliable, and provides an evaluation tool for daily nursing quality monitoring and continuous quality improvement in comprehensive stroke centers.

Objective? To explore the medical staff's recognition of the nursing quality evaluation of a comprehensive stroke center,so as to provide reference for constructing the nursing quality evaluation index system in the comprehensive stroke center. Methods? By descriptive qualitative method, 11 doctors and nurses from comprehensive stroke center were enrolled to have semi-structured in-depth interviews from February to April of 2019. The data were analyzed using a directed content analysis method. Results? A total of 2 subjects related to structured nursing quality evaluation were extracted: nursing staff allocation,organizational structure configuration; 6 subjects related to process nursing quality evaluation:disease condition observation and assessment,specialist nursing practice,complications management,rehabilitation nursing,health education, effective communicationand coordination; 3 subjects related to outcome nursing quality evaluation: incidence of complications,physical and mental status,patient benefits. Conclusions? The relevant topics of comprehensive stroke center nursing quality evaluation extracted based on the perspective of medical staff, can provide a reference for constructing a comprehensive, scientific and applicable index system to improve the quality of care in the comprehensive stroke center.

Objective:To explore the influencing factors of fear of falling in patients with first cerebral infarction in recovery period.Methods:Using the convenient sampling method, a total of 221 patients with first cerebral infarction who were hospitalized and treated in Department of Neurology and Department of Cardiology in Qingdao Hospital of Shandong First Medical University from May 2017 to October 2019 were selected as research objects. Short Falls Efficacy Scale International (SFES-I) was used to evaluate the patients, and the influencing factors of the fear of falling in patients with first cerebral infarction in recovery period were analyzed.Results:The results of univariate analysis showed that SFES-I scores of patients with different ages, marital status, family monthly income, history of falls, number of chronic diseases, anxiety, depression, activity of daily living (ADL) limitation and walking ability had statistically significant differences ( P<0.05) . The results of multivariate logistic regression analysis showed that five variables including age (65-80) , marital status, history of falls, anxiety, and depression were retained in the regression model, and the differences were statistically significant ( P<0.05) . Among them, the marital status of the spouse was the protective factors of fear of falling of patients ( OR<1) , while the other 4 factors were risk factors of fear of falling of patients ( OR>1) . Conclusions:Age, marital status, history of falling, anxiety, and depression are the influencing factors of falling fear in patients with first cerebral infarction in recovery period, so targeted nursing measures should be taken according to different characteristics of patients.

Objective:To construct the nutritional intervention regimen for elderly patients with hip fractures during the perioperative period and rehabilitation period.Methods:Based on Stetler evidence-based practice model, 151 elderly patients with hip fractures surgery who were admitted to Jiading District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January to May 2019 were investigated, and nutritional problems were found in the perioperative period and 3 months after surgery. Through systematic literature search, the best evidence was extracted to construct a nutritional intervention regimen for elderly hip fractures patients with oral nutrition supplements (ONS) . The expert meeting method was adopted to demonstrate the scheme and determine the final intervention scheme and process.Results:A total of 7 guidelines were included, and 25 recommendations were formed based on evidence, including 24 strong recommendations and 1 weak recommendation. Nutritional intervention scheme and process for elderly patients with hip fractures, mainly ONS, were determined. The expert authority coefficient was 0.89.Conclusions:In this study, the nutritional intervention regimen for elderly patients with hip fractures, mainly ONS, was constructed with a high degree of expert authority and reliable results, providing a theoretical basis for clinical nutrition intervention for elderly patients with hip fractures in the perioperative period.