Objective To investigate the protective effect of ǎn soup of Miao nationality on the intestinal barrier function in rats with acute liver failure ,in order to provide effective diet measures for hepatic failure patients .Methods A total of 50 male SD rats were randomly assigned to five groups :control group(group A) ,acute liver failure model group(group B) ,Bifidobacterium tri‐ple probiotics group(group C) ,high‐doseǎn soup group(group D) and low‐doseǎn soup group(E) ,10 cases in each group .The last four groups were subjected to the acute liver failure model by hypodermic injection with thioacetamide twice .In addition ,the last three groups were respectively intragastrically perfused with Bifidobacterium triple probiotics ,6 mL of ǎn soup and 1 .5 mL of ǎn soup before and during building the acute liver failure model .28 hours after the second injection ,femoral arterial blood to was drew to test serum endotoxin(ETX) ,diamine oxidase(DAO) ,D(‐)‐lactate(D‐lac) ,alanine aminotransferase (ALT) and aspartate amin‐otransferase(AST) .At the same time ,hepatic tissue and ileal tissue within 3 cm away from the ileocecal region were collected to do pathological examination .Results Pathological examination results showed that hepatic cord in hepar arranged mussily ,hepatic lob‐ules structure disordered ,hepatocyte focal necrosis or with large necrotic areas in which a large number of inflammatory cell infiltra‐tion in the acute liver failure model group .The pathology damage of liver in the other groups was almost in the same extent .The ile‐um mucosa in the group A was morphologically intact with clear structure of villi and lined up ,while that of group B was disorder with sparse villi ,epithelial cells in different degree of loss ,missing and necrosis ,lamina propria obviously hyperemia and there were large amount of inflammatory cellular infiltration .Intestinal mucosa injury in the other intervention groups was lighter than that in the group B .In particular ,levels of serum ETX ,D‐Lac ,DAO ,ALT and AST in the group B and other intervention groups were sig‐nificantly higher than that in the group A(P<0 .01) .Compared to the group B ,levels of serum ETX ,D‐lac ,DAO ,ALT and AST in other intervention groups were decreased to various degrees ,and there was significant difference between group B ,group C and group D(P<0 .01) ,and there was no significant difference between group B and group E (P>0 .05) .However ,there was no signif‐icant difference between group C and group D (P>0 .05) ,when obvious difference was observed between group C and group E(P<0 .05) .There was significant difference between group E and roup D (P<0 .05) .Conclusion Results demonstrated that ǎn soup protected intestinal barrier function of acute liver failure rats by reducing the production and release of serum endotoxin content in liver failure rats ,lowering intestinal endotoxemia (IETM ) ,which seems to prevent subsequent liver injury caused by IETM and have certain dietotherapy effect on liver failure .

Nursing management is an important part of hospital management,the head nurses,as leaders and organizers of first-line clinical nursing work of the hospital,play a decisive role in hospital nursing management.As the first-line managers and organizers,the head nurse management level and ability is directly related to the hospital nursing quality and the overall quality of nurses.The implementation of the performance appraisal and management by objectives in current nursing management has been more and more used in the hospital.This article aimed to review the management by objective and quantitative assessment home for head nurse at home and abroad,in order to help nursing managers to learn and master performance appraisal of head nurses,comprehensively improve quality of head nurses,promote the improvement of nursing quality,and push the development of nursing course.

Objective To explore the level of interleukin 35-producing B cells (i35-Breg) as well as its effect factors,interleukin-35 (IL-35),in peripheral blood of patients with chronic hepatitis B (CHB),and their relationship with hepatitis B virus (HBV) DNA and liver inflammatory degree.Methods A total of 35 treatment-naive CHB patients,17 interferon (IFN)-treated HBeAg-positive CHB patients and 15 healthy controls (HC) were enrolled.The levels of i35-Breg and IL-35 in peripheral blood were tested by flow cytometry and enzyme-linked immunosorption assay (ELISA).Kruskal-Wallis test,Wilcox rank sum test and two variables correlation analysis were used for statistical analysis.Results The percentage of i35-Breg cells as well as IL-35 level in peripheral blood of naive CHB patients were 3.05％ (0.89％,4.97％) and 2.81 μg/L (0.30 μg/L,12.33 μg/L),respectively,which were both significantly higher than those in HC group,which were 0.17％ (0.13％,0.45％) and 0.17 μg/L(0,1.93 μg/L),respectively.The difference were statistical significant (Z=-3.309 and-2.419,respectively,P=0.001 and 0.016,respectively).The peripheral level of i35-Breg was negatively correlated with the viral load in treatment-naive CHB patients (r=-0.529,P=0.008),while there was no correlation between the peripheral level of IL-35 and the viral load in treatment-naive CHB patients (r=0.11,P=0.54).The levels of i35-Breg and IL-35 in HBeAg positive CHB patients were 3.16％ (1.34％,5.62％) and 4.58μg/L (0.79μg/L,22.37 μg/L),respectively,which were both higher than those in HC group.The difference was statistically significant (F=3.39 and 3.37,respectively,both P＜0.01).Compared to HC group,the IL-35 levels in peripheral blood of CHB patients with ALT and AST levels less than 300 U/L were 3.03 μg/L (0.74 μg/L,22.37 μg/L) and 3.25 μg/L (0.83 μg/L,22.35 μg/L),respectively,with statistically significant difference (F=2.868 and 3.114,respectively,both P＜0.01).Compared to HC group,the peripheral level of i35-Breg in treatment-naive CHB patients with ALT levels less than 300 U/L was 3.14％ (1.03％,4.65％),with statistically significant difference (F=3.219,P=0.004).The IL-35 level showed a decreased trend in CHB who received IFN therapy,but there was no statistically significant difference (x2 =1.45,P =0.48).Furthermore,the baseline IL-35 level in patients who developed sustained viral response (SVR) was 0 (0,13.33 g/L),which was lower than that in patients who developed partial or primary no response 0.61 μg/L (0,24.72 μg/L).However,there was no statistical difference (F=0.75,P =0.68).Conclusions i35-Breg as well as its effect factor,IL-35,are involved in the progression of chronic HBV infection.The percentage of i35-Breg cells as well as IL-35 level in peripheral blood of treatment-naive CHB patients are increased.The peripheral level of i35-Breg is negatively correlated with the viral load,while there is no correlation between the peripheral level of IL-35 and the viral load.The percentage of i35-Breg cells as well as IL-35 level in CHB patients with low inflammatory degree are increased.

This study was aimed to investigate the effect of Nan-She-Teng (Celastrus orbiculatus) extract on epithe-lial-mesenchymal transition(EMT) in HepG2 cells. Except the control group, human hepatocellular carcinoma HepG2 cells in other groups were treated with Celastrus Orbiculatus extract in different concentrations (10, 20, 40, 80, and 160 μg·mL-1). The protein expression levels related to EMT were detected by western blotting. At 48 h after fertiliza-tion, the zebrafish embryos were randomly assigned to 7 groups as follows: untreated control group (E3 buffer), DMSO group (E3 buffer with 1% DMSO), and different dosages treatment of C.orbiculatus extract (10, 20, 40, 80, and 160μg·mL-1) for 24 h. The protein expressions of mTOR signaling pathways were detected by western blotting. The re-sults showed that compared with the control group, C.orbiculatus extract significantly increased E-cadherin protein expression. Simultaneously, C.orbiculatus extract inhibited vimentin and mTOR signaling pathways at protein levels. It was concluded that to a certain extent, C.orbiculatus extract prevented EMT in HepG2 cells by modulating the mTOR signaling pathway. Therefore, it suggested that mTOR can be chosen as a new therapeutic target for clinical treatment of hepatic carcinoma.

This study was aimed to investigate whether the extracts of Celastrus orbiculatus enhanced the invasion function of maspin tumor inhibitor gene through the construction of maspin overexpression human gastric carcinoma MGC803 cell line. Maspin was cloned into plasmid GV208-EGFP eukaryotic expression vector. And then, the recombinant plasmid GV208-maspin-EGFP was transfected into human gastric carcinoma MGC803 cells. After the maspin overexpression MGC803 cell were treated with Celastrus orbiculatus extracts in different concentrations (10, 20, 40 μg·mL-1), the invasion effects were detected by Transwell chamber assay. The results showed that after the successful construction of maspin overexpression cell line, the number of cells invading through Matrigel was obviously decreased in the Transwell chamber assay. It also showed drug concentration dependency. It was concluded that maspin gene can inhibit invasion of gastric carcinoma MGC803 cells. Simultaneously, the extracts of Celastrus orbiculatus can enhance the function of maspin gene.

Objective To investigate if improving or slowing the progression of glucose intolerance might be linked with the reduction of cardiovascular disease(CVD)events and mortality in a Da Qing population with prediabetes.Methods In 1986,577 subjects with impaired glucose tolerance in 33 clinics in Daqing city were randomly assigned to either the control group or one of three lifestyle intervention groups(diet,exercise,or diet plus exercise)to receive a 6 year lifestyle intervention.All the participants were followed for 14 years(1993-2006)after completion of the 6 year active interventions to assess the long-term effect of the interventions.In this post-hoc analysis,the participants were stratified into four subgroups(quartiles)based on their 2 h plasma glucose(2hPG)level after glucose loading at the end of the active intervention,in order to analyze the impact of plasma glucose level on CVD events and mortality.Results During the 20-year follow-up,there were a total of 142 deaths(68 of which were attributed to CVD)and 211 first CVD events(145 strokes and 66 myocardial infarctions).From the highest to the lowest levels of 2hPG in the 4 quartiles,the all-cause mortality(17.8,12.7,10.9,and 9.7/1 000 personyears),CVD mortality(9.1,5.9,6.1,and 4.9/1 1300 person-years)and the incidence of first CVD events(30.4.24.0,18.8,and 19.7/1 000 person-years)showed a clear trend of decline.In multivariate analyses,controlled for age,sex,body mass index,smoking habit,blood pressure,and intervention methods at baseline,the results showed that the 5 mmol/L elevation of 2hPG level after glucose loading in 1992 significantly increased the all-cause mortality(HR 1.335.P=0.005),the incidences offirst CVD events(HR 1.227,P=0.012)and stroke(HR 1.213,P=0.026).Conclusion In pre-diabetes population.if the lifestyle intenrentions are substantially efficacious in improving glucose intolerance,the CVD risk and mortality will be reduced.

Objective To explore the effect of hospital community integration management program on monocyte(MONO),blood uric acid(BUA),body mass index(BMI)and MONO/high density lipoprotein cholesterol ratio(MHR)in patients with hyperuricemia(HUA).Methods A total of 103 HUA patients admitted to the department of nephrology of the First Hospital of Ninghai County from January 2020 to January 2022 were chosen as the study object.The patients were divided into experimental group(51 cases,management method:hospital community integration management mode)and the control group(52 cases,management method:conventional management mode)based on the admission order(odd and even).The differences of MONO,BUA,BMI,MHR between the two groups at admission and discharge and 6,12 and 24 months after discharge were compared,and the occurrence of adverse reactions was observed.Results There were no significant differences in MONO,BUA,BMI and MHR levels at admission between the two groups,MONO,BUA,BMI and MHR levels were significantly lower at discharge and at 6,12,and 24 months after discharge compared with admission.The lowest level was reached 24 months after discharge,and the experimental group was significantly lower than the control group[MONO(×109/L):0.34(0.16)vs.0.37(0.18),BUA(μmol/L):329.7±70.5 vs.381.2±71.7,BMI(kg/m2):21.3±1.1 vs.24.2±0.9,MHR:0.24(0.16)vs.0.27(0.15),all P<0.05].The overall incidence of adverse reactions in the experimental group was significantly lower than that of control group[3.92%(2/51)vs.15.38%(8/52),P<0.05].Conclusion The scientific and reasonable implementation of integrated hospital and community management is beneficial to reduce the levels of MONO,BUA,BMI,MHR and reduce the occurrence of adverse reactions in patients.

Objective:To study the genetic variation and distribution characteristics of thalassemia in people of childbearing age in Hubei Province, and to provide clinical basis for the local government decision-making departments to formulate and promote appropriate policies for prevention and control of thalassemia.Methods:Venous blood samples were collected from 44 849 people of childbearing age in hospitals in Hubei Province from May 13, 2019 to August 17, 2021. PCR-flow fluorescence hybridization and PCR+diversion hybridization were used to screen thalassemia genes. Spouses of those who tested positive were also tested for thalassemia genes. When both spouses carried the same type of thalassemia gene, the amniotic fluid of pregnant women was extracted for prenatal diagnosis and followed up.Results:Among the 44 849 people of childbearing age, 2 286 cases were diagnosed as thalassemia gene carriers through genetic testing, and the total detection rate was 5.10% (2 286/44 849). Among them, 1 488 cases were diagnosed as α-thalassemia, and the detection rate was 3.32% (1 488/44 849); 767 cases were diagnosed as β-thalassemia, and the detection rate was 1.71% (767/44 849); 31 cases were diagnosed as α-thalassemia combined with β-thalassemia, and the detection rate was 0.07% (31/44 849). The top three genotypes of α-thalassemia were -α 3.7/αα, -- SEA/αα, and -α 4.2/αα, accounting for 58.06% (864/1 488), 26.14% (389/1 488), and8.74% (130/1 488), respectively. The top three genotypes of β-thalassemia were β IVS-Ⅱ-654/β N, β CD41-42/β N, and β CD17/β N, accounting for 41.72% (320/767), 21.25% (163/767), and 16.04% (123/767), respectively. The main genotypes of α-thalassemia combined with β-thalassemia were -α 3.7/αα complex β IVS-Ⅱ-654/β N and -α 3.7/αα complex β CD41-42/β N, accounting for 29.03% (9/31) and 16.13% (5/31), respectively. A total of 59 people of childbearing age were conducted prenatal diagnosis, among fetus, there were 4 cases of severe thalassemia (2 cases of severe α-thalassemia, 2 cases of severe β-thalassemia), 5 cases of intermediate α-thalassemia, 5 cases of intermediate or severe β-thalassemia, 19 cases of mild thalassemia (8 cases of mild α-thalassemia, 11 cases of mild β-thalassemia), 13 cases of stationary α-thalassemia, and 1 case of stationary α-thalassemia combined with mild β-thalassemia, there were 12 cases without α-thalassemia or β-thalassemia genes. After follow-up, 4 cases of severe thalassemia, 2 cases of intermediate α-thalassemia, and 5 cases of intermediate or severe β-thalassemia were terminated pregnancy by the joint decision of both parents. Conclusions:In Hubei Province, the detection rate of thalassemia is high, and α-thalassemia is the main mutation type. The combination of thalassemia gene screening and prenatal diagnosis is of great significance in reducing the birth rate of children with thalassemia.

Objective:To explore the effect of 5E rehabilitation model in patients with stable chronic obstructive pulmonary disease (COPD) .Methods:From January 2018 to April 2020, convenience sampling was used to select 154 COPD outpatients and inpatients in the West China Hospital of Sichuan University as the research object. The patients were divided into the observation group (78 cases) and the control group (76 cases) by random number table method. The control group was given routine nursing, and the observation group received the 5E rehabilitation model on the basis of the control group. The scores of the Chronic Obstructive Pulmonary Disease Knowledge Questionnaire (COPD-Q) , Self-Management Scale for Chinese Patients with Chronic Obstructive Pulmonary Disease and the St George's Respiratory Questionnaire (SGRQ) were compared between the two groups before intervention and after six months of follow-up.Results:After six months of follow-up, the COPD-Q score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The total score and the scores of each dimension of the Self-Management Scale for Chinese Patients with Chronic Obstructive Pulmonary Disease in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total score and each dimension score of SGRQ in the observation group were lower than those in the control group with statistical differences ( P<0.05) . Conclusions:The 5E rehabilitation model is conducive to improving the health literacy, self-management ability and the quality of life of patients with stable COPD.

Objective:To explore the effects of hospital-to-community model-based case management on outcomes and life quality of patients with atrial fibrillation.Methods:By convience sampling method, a total of 90 cases of atrial fibrillation patients admitted to Changzhou Second People′s Hospital from January 2019 to May 2020 were randomly divided into control group and experimental group, with 45 cases in each group. The patients in the control group received routine nursing care, the experimental group implemented hospital-to-community model-based case management. The beliefs about medicine, medication compliance, quality of life and readmissions of cardiovascular events were compared between 2 groups before and 6 months after intervention.Results:Finally, 41 cases were included in the experimental group and 38 cases in the control group. Before intervention, there were no significant differences in various indexes between the two groups ( P>0.05). After 6 months of intervention, the scores of specific-necessity in Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Morisky Medication Adherence Scale-8 (MMAS-8) were (16.98 ± 4.22) and (7.15 ± 0.69) points in the experimental group, higher than in the control group (14.95 ± 4.33) and (6.32 ± 1.07) points; the scores of specific-concerns in BMQ-Specific were (6.83 ± 1.91)points in the experimental group, lower than in the control group (8.42 ± 2.73) points. The differences were statistically significant ( t = 2.11, 4.07, 2.98, all P<0.05); the scores of physical function, role-physical, pain, general health, mental health dimensions and total scores in SF-36 were (80.37 ± 3.46), (46.63 ± 14.54), (90.37 ± 5.78), (70.07 ± 9.98), (84.20 ± 8.73) and (584.88 ± 25.71) points in the experimental group, higher than in the control group (70.13 ± 11.20), (37.34 ± 10.25), (83.37 ± 6.89), (59.55 ± 7.98), (77.58 ± 9.09) and (533.87 ± 31.62) points, the differences were statistically significant ( t values were 3.30-7.89, all P<0.05). At 6 months after discharge, the re-admission of cardiovascular events were 5 cases (12.2%) in the experimental group and 12 cases (31.6%) in the control group, the difference was statistically significant ( χ2=4.74, P<0.05). Conclusions:Hospital-to-community model-based case management can effectively promote beliefs about medicine and medication compliance, improve quality of life and decrease re-admission of cardiovascular events of patients with atrial fibrillation.