Objective To compare the virological responses between Peg IFNαt-2a and Peg IFNα-2b in treatment of chronic hepatitis C.Methods Clinical data of 46 chronic hepatitis C (CHC) patients were retrospectively reviewed.Patients were divided into two groups:Peg IFNα-2a group ( n =24) was given Peg IFNoα-2a 180 μg/week and ribavirin; Peg IFNα-2b group (n =22 ) was given Peg IFNα-2b1.5 μg · kg-1 · week-1 and ribavirin.Serum HCV RNA load at 4th,12th and 24th week of the treatment were detected to evaluate the virological responses.Softwares SPSS 13.0 and PEMS 3.1 were used for statistical analysis.Results There was no significant difference in rapid response rate,early response rate,complete response rate and non-response rate between the two groups (x2 =0.689,0.105,0.105 and 0.105,P ＞ 0.05 ).However for patients with high viral load ( HCV RNA ＞ 6 logl0 copies/mL) at baseline,the rapid response rate in Peg IFNα-2a group ( 86.67％ ) was higher than that in Peg IFNα-2bgroup (42.86％ ) (x2 =4.365,P ＜ 0.05 ).Conclusion Peg IFNα-2a combined with ribavirin may have higher rapid response rate than that of Peg IFNα-2b combined with ribavirin in CHC patients with high viral

Aim To explore the influence of metformin(a first-line drug for type 2 diabetes) on ATP-induced inflammasome activation and the release of interleukin-1β(IL-1β) by LPS-activated peritoneal macrophages, a commonly-used inflammatory cell model.Methods Peritoneal macrophages were elicited by intraperitoneal injection of 30 g·L-1 thioglycollate into C57BL/6 mice.Inflammasome was activated and cell pyroptosis was induced by LPS plus ATP treatment, and the pyroptotic cells were calculated after propidium iodide(PI) staining.The protein levels of IL-1β and caspase-1 expressed in the cells and released from them into the supernatant were evaluated by Western blot.Immunofluorescent microscopy was recruited to detect the subcellular distribution and fluorescent intensity of the purinergic P2X7 receptor(P2X7R).Results Metformin per se did not induce pyroptosis in LPS-activated peritoneal macrophages, but it significantly and dose-dependently increased cell pyroptosis induced by ATP treatment.At protein levels, maturated IL-1β(17 ku) could not be released from the cells upon single LPS or LPS plus metformin stimulation;but after ATP was added, maturated IL-1β was released into the supernatants of the cells.Moreover, metformin dose-dependently increased the protein levels of both maturated IL-1β and active caspase-1 released by the LPS-activated peritoneal macrophages upon ATP stimulation.Conclusion Metformin intensifies the activation of inflammasome and increases the release of active caspase-1 and maturated IL-1β upon ATP stimulation in the LPS-activated peritoneal macrophages, which should promote inflammatory responses.

Objective Previous studies regarding the effects of tamoxifen ( TAM) on the thin endometrium are rare .The aim of this study was to explore the effects of TAM on patients with thin endometrium undergoing frozen thawed embryo transfer ( FET ) . Methods One hundred and thirty three patients with thin endometri-um undergoing FET treatment were recruited from January 2014 to June 2016, who canceled embryo transfer ( ET) or after FET due to thin endometrium in natural cycle or hormone replacement therapy cycle .Patients were randomly divided into letrozole ( LE,n=72) group or tamoxifen (TAM,n=61) group.All of the patients started to have oral pills of Estradiol Valerate 4 mg/d on the third day of menstruating cycles , then 6mg/d on the eighth day ,after 10~12 days then having ultrasonic monitoring of endometrial thickness and blood estradiol (E2), progesterone levels, It′s called endometrial preparation for hormone replacement cycle .To letrozole, tamoxifen group,the way of endometrial preparation were as follows:patients started to have oral pills of LE 2.5mg/d,TAM 40 mg/d on the third day of menstruating cycles for 5 days, then having ultrasonic monitoring and used drug of human chorionic gonadotropic hormone ,It′s called HCG day .After the dominant follicle ovulation then took progesterone intramuscular injection 40 mg/d, oral progesterone 20 mg/d to change endometrium ,then to transplant cleavage embryos or blastocysts after taking 3 or 5 days of progesterone , It′s called embryo transplanting day .The way of TAM endometrium preparation was called TAM cycle .The general data , hormone levels and clinical out-come between two groups were analyzed . Results The serum estradiol level of LE group both on HCG and transfer day [(1193.80± 629.64)ng/L vs (2776.30±157.34)ng/L;(1195.90±820.30)ng/L vs (2129.40±1208.71) ng/L,P=0.000] were statistically lower, serum luteinizing hormone level were statistically higher than TAM group [(20.48±15.50)IU/L vs (10.59±8.34)IU/L,P<0.05];im-plantation rate of LE group were statistically lower than TAM (39.32%vs 45.83%,P=0.001).The endometrial thickness and serum E 2 and P levels in TAM cycles were significantly higher compared with those in hormone replacement therapy cycle [(8.49±1.36)mm vs (6.43±0.96)mm,P=0.018]. Conclusion Tam compared LE with patients of thin endometrium undergoing FET can increased en -dometrial thickness and improve implantation rate ,thus Providing a new solution to thin endometrium .

To know the status of nursing training about physical restraint among nurses in the domestic and overseas. Summarized the forms, content and the appraise tools of the results of physical restraint nursing at home and abroad so as to provide reference of nursing training about the physical restraint among nurses in the domestic.

Objective:To observe the therapeutic effect of quercetin (QUE) on triggering receptor expressed on myeloid cells (TREM-1) activated macrophage inflammation and lipopolysaccharide (LPS) induced acute lung injury (ALI) in mice, and explore its possible mechanism.Methods:In vitro cell experiment: The primary peritoneal macrophages of mice were collected by intraperitoneal injection of 3% calcium mercaptan acetate. The collected cells were divided into blank control group, dimethylsulfoxide (DMSO) vehicle group, TREM-1 agonist group (10 μg/ml), QUE group (10 μmol/L) and TREM-1 agonist + QUE group (cells were pretreated with 10 μmol/L QUE for 30 min before adding agonist). Enzyme linked immunosorbent assay (ELISA) was used to detect the secretion of interleukin (IL)-1β, tumor necrosis factor (TNF)-α and IL-6 in the culture supernatant of primary macrophages; To observe the effect of QUE on LPS-induced TREM-1 protein levels, macrophages were divided into: normal control group, LPS group (100 ng/ml) and LPS+ QUE treatment group [macrophages were pretreated with 10 μmol/L QUE for 2 hours, and then incubated with LPS (100 ng/ml) for 16 hours]. Western blot was used to detect the expression of TREM-1 protein. In animal experiments: 80 male C57BL/6 mice were randomly divided into 4 groups (20 in each group): normal control group, ALI model group, QUE group and QUE treatment group (LPS+ QUE). In the ALI model group, the ALI model was established by intratracheal injection of 5 mg/kg LPS; The mouse ALI model was established by intratracheal injection of LPS 5 mg/kg in the QUE treatment group, and then intraperitoneal injection of 15 mg/kg QUE. The control group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of DMSO, and the QUE group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of 15 mg/kg QUE. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of lung tissue in each group; Inflammatory cells including IL-1β, TNF- α and IL-6 in bronchoalveolar lavage fluid (BLAF) of mice in each group were counted ; The expression of TREM-1 mRNA and protein in lung tissue of mice in each group was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot. Results:In vitro cell experiment: the secretion of IL-1β, TNF-α and IL-6 in the supernatant of primary macrophages in TREM-1 agonist group was higher than those in DMSO vehicle group, while the secretion of IL-1β, TNF-αand IL-6 in the supernatant of primary macrophages in TREM-1 agonist + QUE group were lower than that of TREM-1 agonist group (all P<0.001). The expression of TREM-1 protein in LPS group was higher than that in control group ( P<0.05), while the expression of TREM-1 protein in LPS + QUE group was lower than that in LPS group ( P<0.05). Animal experiments showed that compared with the control group, the ALI model group had higher lung pathological injury score, more total cells, macrophages and neutrophils in BALF and increased TNF-α, IL-6, IL-1β content (all P<0.001). The above indexes in QUE group were lower than those in ALI model group (all P<0.001). The results of qRT-PCR and Western blot showed that compared with the control group, the expression of TREM-1 mRNA and protein in the lung tissue of ALI model group was increased, while the expression of TREM-1 mRNA and protein in the lung tissue of QUE group was lower than that of ALI model group (all P<0.05). Conclusions:Quercetin can inhibit TREM-1 activation, reduce macrophage inflammatory response and LPS induced acute lung injury in mice.

Objective:To carry out the Meta-integration of Intensive Care Unit (ICU) nurses' real experience of palliative care.Methods:The qualitative study that met the criteria in the Cochrane Library, PubMed, EMbase, Web of Science, China Biology Medicine Literature Service System, China National Knowledge Infrastructure (CNKI) , VIP and Wanfang Data were searched by computer from the establishment of the database to June 30, 2020. The quality of the included literature was evaluated using the critical appraisal checklist for qualitative researches of the Australia Joanna Briggs Institute (JBI) Evidence-based Health Center (2017 edition) . The collective integration method was used to integrate the results.Results:A total of 17 articles were included, involving 16 in English and 1 in Chinese. Finally, it was summarized into 11 categories, and 4 integrated results were collected, which were the complex palliative care (multiple roles of ICU nurses in palliative care, patient care, and family care) ; insufficient preparation for palliative care (lack of professional skills, communication skills and psychological preparation) ; insufficient support from palliative care organizations (inadequate psychological support, multidisciplinary team cooperation, and lack of professional palliative care service systems) ; insufficient legal support for palliative care (lack of decision-making power for palliative care, ethics and legal issues in palliative care) .Conclusions:ICU nurses lack the ability to palliative care and lack a reliable support system. Managers should pay attention to the negative experience and needs of ICU nurses for palliative care, and gradually carry out education and training to improve the level of care and the quality of life of dying patients.

Objective To investigate the value of serum lactate dehydrogenase (LDH) in advanced non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI).Methods Pretreatment LDH level,pathological characteristic,tumor staging and treatment situation of 190 advanced NSCLC patients with EGFR sensitive mutation confirmed by pathology were retrospectively collected in Zhuhai People's Hospital of Guangdong Provice from July 2011 to July 2015.All the patients were divided into LDH normal group (LDH ≤252 U/L,n =78) and elevated group (LDH ＞ 252 U/L,n =112) according to pretreatment LDH level.Inaging evaluations of the patients were performed regularly,and the progression-free survival (PFS) and overall survival (OS) were recorded.The survival curves were plotted by Kaplan-Meier method and survival difference between patients with different LDH level was compared by logrank test.Cox regression analysis was used to analyze prognostic factors for mortality.Results The objective response rate of the LDH normal group was 76.9％ (60/78),and the elevated group was 71.4％ (80/112),with no statistically significant difference (x2 =0.716,P =0.398).The disease control rate of the LDH normal group was 89.7％ (70/78),and the elevated group was 85.7％ (96/112),with no statistically significant difference (x2 =0.676,P =0.411).The median PFS of the LDH normal group was 11.5 months,and the elevated group was 9.7 months (x2 =5.92,P =0.015).The median OS was 31.0 months in the LDH normal group,and 26.1 months in the elevated LDH group (x2 =4.79,P =0.029).Both PFS and OS of patients with elevated LDH were shorter than those of patients with normal LDH.Cox multivariate regression analysis showed that tumor staging (HR =1.652,95％ CI:1.386-2.259,P =0.018),PS score (HR =2.248,95％ CI:1.507-3.846,P ＜ 0.001),carcino-embryonic antigen (CEA) level (HR =1.250,95％ CI:1.066-1.703,P =0.037) and LDH level (HR =1.771,95 ％ CI:1.324-1.947,P =0.015) were independent prognostic factors in patients with advanced NSCLC.Conclusion Pretreatment serum LDH can not affect the objective response rate and disease control rate of EGFR-TKI in the treatment of advanced NSCLC,but can affect the PFS and OS of patients.Pretreatment serum LDH is an independent prognostic factor.

Objective To compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)and High Aspheric Lenslet(HAL)defocus lenses in controlling myopia.Methods A total of 214 children and adolescents who were fitted with defocus lenses(DIMS or HAL)in our hospital from January to June 2023 were selected,including 100 cases in DIMS group and 114 cases in the HAL group.Changes in parameters such as spherical lens power,cylindrical lens power,spherical e-quivalent(SE),corneal curvature(K),axial length(AL),binocular accommodative response(BCC),positive/negative relative accommodation(PRA/NRA),distance/near latent phoria(DLP/NLP),and accommodative convergence to accommodation ratio(AC/A)were compared between the two groups before wearing and after wearing the lenses for 6 months,and the effectiveness of myopia control between DIMS and HAL was further compared.Results After wearing the lenses(DIMS or HAL)for 6 months,the average increase in axial length was(0.09±0.14)mm,the average in-crease in spherical lens power was(-0.11±0.23)D,the average increase in astigmatism was(-0.07±0.16)DC,and the average increase in spherical equivalent was(-0.15±0.24)D,with statistically significant differences observed for all these changes(t=9.24,-7.27,-6.60,-9.03,respectively,P＜0.001).Compared with parameters before wearing the lenses,statistically significant differences were noted after wearing for 6 months in spherical lens power,cylindrical lens power,SE,BCC,PRA,DLP,average K,and AL(P≤0.001),except for NRA(t=-0.12,P＞0.05),NLP(t=-0.28,P＞0.05),and AC/A(t=0.33,P＞0.05).The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically signifi-cant difference only in the AL difference(t=4.38,P≤0.001),with no statistically significant differences observed for other parameter differences(P＞0.05).Conclusion Wearing defocus lenses has a positive effect on controlling myopia,delaying axial length elongation,and maintaining binocular visual function balance.

Objective To observe the dynamic changes of cardiac lymphangiogenesis in Doxorubicin(DOX)-induced dilated cardiomyopathy(DCM)model mice,and to study the the protective mechanism of Kuoxin Decoction.Methods The DCM mouse model was established by intraperitoneal injection of DOX,and the dynamic observation was performed every week.On this basis,60 C57BL/6 mice were randomly divided into 6 groups(n=10):control group,Model group,L-KXD,M-KXD and H-KXD groups and Captopril group.After successful modeling,the KXD and the positive control drug Captopril were administered continuously for 28 days.Echocardiography was used to detect cardiac function in mice,HE staining and Masson staining were used to observe pathological and morphological changes of the heart,Whole-mount immunofluorescent staining was used to detect the expression of LYVE-1 and Podoplanin in epicardial lymphatic vessels,Western blot was used to detect the expression of VEGFR-3 protein,and qPCR was used to detect the expression of VEGFR-3 mRNA.Results DCM mice induced by DOX showed significant cardiac function decline from the third week(DOX:15 mg·kg-1,P<0.05),and significant ventricular remodeling at the fifth week(DOX:15 mg·kg-1,P<0.01);The lymphatic vessel area of the mouse heart decreased significantly from the fourth week(DOX:20 mg·kg-1,P<0.0001),and the expression of VEGFR-3 decreased significantly from the third week(DOX:15 mg·kg-1,P<0.01).Conclusion KXD can improve ventricular remodeling and cardiac function in DOX-induced DCM mice,promote cardiac lymphangiogenesis,and upregulate the expression of VEGFR-3 at protein and mRNA levels,with a better effect than captopril.DOX-induced cardiac lymphangiogenesis in DCM mice leads to severe myocardial fibrosis and weakened cardiac function,which gradually worsens with the accumulation of modeling time and dose.KXD can promote cardiac lymphangiogenesis and improve cardiac function in DOX-induced DCM mice.The mechanism may be related to the up-regulation of VEGFR-3 expression.

Objective To compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)and High Aspheric Lenslet(HAL)defocus lenses in controlling myopia.Methods A total of 214 children and adolescents who were fitted with defocus lenses(DIMS or HAL)in our hospital from January to June 2023 were selected,including 100 cases in DIMS group and 114 cases in the HAL group.Changes in parameters such as spherical lens power,cylindrical lens power,spherical e-quivalent(SE),corneal curvature(K),axial length(AL),binocular accommodative response(BCC),positive/negative relative accommodation(PRA/NRA),distance/near latent phoria(DLP/NLP),and accommodative convergence to accommodation ratio(AC/A)were compared between the two groups before wearing and after wearing the lenses for 6 months,and the effectiveness of myopia control between DIMS and HAL was further compared.Results After wearing the lenses(DIMS or HAL)for 6 months,the average increase in axial length was(0.09±0.14)mm,the average in-crease in spherical lens power was(-0.11±0.23)D,the average increase in astigmatism was(-0.07±0.16)DC,and the average increase in spherical equivalent was(-0.15±0.24)D,with statistically significant differences observed for all these changes(t=9.24,-7.27,-6.60,-9.03,respectively,P＜0.001).Compared with parameters before wearing the lenses,statistically significant differences were noted after wearing for 6 months in spherical lens power,cylindrical lens power,SE,BCC,PRA,DLP,average K,and AL(P≤0.001),except for NRA(t=-0.12,P＞0.05),NLP(t=-0.28,P＞0.05),and AC/A(t=0.33,P＞0.05).The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically signifi-cant difference only in the AL difference(t=4.38,P≤0.001),with no statistically significant differences observed for other parameter differences(P＞0.05).Conclusion Wearing defocus lenses has a positive effect on controlling myopia,delaying axial length elongation,and maintaining binocular visual function balance.