Objective:To observe the effects of Periploca forrestil Schltr Compound extract in serum interleukin-4(IL-4),interferon-γ(IFN-γ),tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in joint synovial tissue of rats,and further to investigate it′s therapeutic effects and related mechanism.Methods: To built the complete adjuvant arthritis (AA) model in rats,and then to detect the contents of IL-4,IFN-γ,TNF-α in serum by ELISA,TGF-β1 in synovial tissues of rats knee was detected by immunohistochemistry.Results: The contents of IFN-γ,TNF-α were higher and IL-4 and TGF-β1 were lower in adjuvant arthritis rats (model group) than those in blank control (P<0.01).By comparing with the model group the contents of IFN-γ and TNF-α were significantly lower in Periploca forrestil Schltr Compound treated rat group,whereas the expressions of IL-4 and TGF-β1 were increased(P<0.05).Conclusion: The Periploca forrestil Schltr Compound can significantly inhibit the expression of IFN-γ and TNF-α,and enhance the expression of IL-4 and TGF-β1,adjusted the Th1/Th2 cell and cytokines imbalance,to alleviate arthritis and cartilage destruction,therefore the Periploca forrestil Schltr Compound can significantly inhibit the proliferation of T lymphocyte and infiltration in synovial tissues of experimental rheumatoid arthritis.

Objective To study the direct immunofluorescence method for rapidly detecting influenza A virus antigen and its clinical application .Methods The inpatients with clinically diagnosed acute respiratory tract infection were selected .Two hundred samples were collected and divided into two groups :the winter and spring epidemic seasons children group and the summer and au‐tumn non‐epidemic seasons children group ,100 cases in each group .The US D3 Ultra influenza A virus antigen detection reagent was used .The fluorescence labeled monoclonal antibody was adopted to detect influenza A virus antigen in the patients with cold . Results During the winter and spring seasons of influenza prevalence ,8 cases of 100 detected cases were positive with the positive rate of 8% ;during the summer and autumn seasons of non‐influenza prevalence ,2 cases of 100 cases were positive with positive rate of 2% ,the difference in the positive rate between the two groups had statistical significance(P<0 .05) .Conclusion Applying the direct immunofluorescence method for rapidly detecting influenza A virus antigen is an economical ,efficient ,rapid and specific detec‐tion method ,and can guide clinical rapid diagnosis and rational medication .

Insulin resistance in insulin sensitive organ results in metabolic disorder such as hyperglycemia, hyperinsulinemia and hyper triglyceridemia which are common features of type 2 diabetes.Insulin resistance in liver cells mainly causes impaired glycogen synthesis, failed to suppress glucose production which is the major contribution to hyperglycemia.FGF-21 as a new metabolic regulator can control fasting blood glucose.The mechanism of FGF-21 effects on regulating plasma glucose has little to known.In order to establish an in vitro insulin resistant model of liver cells and evaluate the effects and mechanism of FGF-21 on glucose metabolism in the cell model, HepG2 cells were incubated with 10-7 mol/L insulin for 24 h to build insulin-resistant cell model.To evaluate the cells for insulin resistance, the cells were stimulated with fresh insulin for 24 h and the glucose uptake by these cells was carried out.The insulin-resistant cells were treated with different concentrations of FGF-21 for 24 h and insulin-treated cells were used as a control.The glucose uptake by the cells was detected by the method of glucose oxidizes/peroxides(GOD-POD);the synergy between insulin and FGF-21 was evaluated.The mRNA expression of GLUT1 in the insulin-resistant cells was detected by the real-time PCR.Glycogen synthesis of the cells was examined by the anthrone method.The results showed that HepG2 cells treated with 10-7 mol/L insulin for 24 h became resistant to insulin and the insulin resistance status was maintained for 48 h without change of cell morphology.FGF-21 could stimulate glucose consumption of the insulin-resistant model in a dose-dependent manner.The glucose consumption and glycogen synthesis of the insulin-resistant model were significantly improved by FGF-21 treatment.FGF-21 showed strong synergy with insulin in glucose uptake and glycogen synthesis of the model cells.While the cells became resistant to insulin, FGF-21 could increase the mRNA expression of GLUT1.Thus, It is concluded that FGF-21 stimulates glucose uptake in insulin resistant HepG2 cells through GLUT1 expression, stimulates glycogen synthesis and improves the glucose metabolism in the insulin resistant liver cell model.

Objective To establish a method for the determination of protocatechuic acid, salidroside, and chlorogenic acid in Sargentodoxa cuneata. Methods The separation was performed on a Waters XSELECT CSH C18 (150 mm × 4.6 mm, 5 μm) with methanol-acetonitrile-0.2 % phosphoric acid as the mobile phase in a gradient elution at a flow rate of 0.8 ml/min. The detection wavelength was 260 nm and the column temperature was 35 ℃. Results The linear ranges of protocatechuic acid, salidroside, and chlorogenic acid were 0.0020-0.0120, 0.0600-0.3602, 0.0750-4.5006 mg/ml, respectively. The average recoveries were 98.01% (RSD=0.07%), 98.53 % (RSD=0.12%), and 101.10 % (RSD=1.92%), respectively. Conclusions The method is simple, accurate, and highly reproducible, which could provide the scientific evidence for the quality control of Sargentodoxa cuneata.

Objective:To investigate the relationship between peripheral blood sST2 level and prognosis in patients with heart failure (HFpEF) complicated with hypertension with ejection fraction preservation.Methods:A total of 122 patients with HFpEF hospitalized in Teda International Cardiovascular Hospital and Baoding First Central Hospital from May 5, 2021 to March 9, 2023 were selected. According to whether they were combined with hypertension, they were divided into HFpEF combined with hypertension group (73 cases, 32 males, (67.56±12.06) years old). There were 41 females (70.61±9.95 years old) and 49 males (67.00±11.64 years old) in the HFpEF group alone. There were 24 female patients (70.12±7.49 years old). sST2 levels in peripheral blood were compared between the two groups.HFpEF patients with hypertension were grouped by hypertension grade and prognosis, and the difference of sST2 in different groups was compared. Logistic regression was used for multivariate analysis. ROC curve to evaluate the diagnostic value of sST2 in the poor prognosis of HFpEF patients with hypertension. Patients were followed up regularly and major adverse cardiac events were recorded within 6 months after discharge, including cardiogenic death and heart failure re-hospitalization. The critical value of poor prognosis diagnosed by sST2 was divided into two groups, survival analysis was performed by Kaplan-Meier,and the Log Rank test was performed. Cox regression analysis was performed to determine whether high levels of sST2 were a risk factor for poor prognosis after 6 months of follow-up.Results:There was no significant difference in sST2 in HFpEF combined with hypertension and HFpEF alone ( P>0.05). sST2 was higher in grade 2 and 3 than in grade 1 hypertension (23.83 ng/ml vs. 12.68 ng/ml, Z=-2.778, P=0.005; 22.54 ng/ml vs. 12.68 ng/ml, Z=-2.865, P=0.004); BNP was higher in grade 3 hypertension than in grade 1 hypertension (582.95 pg/ml vs. 154.50 pg/ml, Z=-2.101, P<0.05). sST2 and BNP were higher in the poor prognosis group than in the good prognosis group (30.10 ng/ml vs. 18.95 ng/ml, Z=-2.803; 685.00 pg/ml vs. 347.50 pg/ml, Z=-2.385), all P<0.05. Logistic regression analysis showed that sST2 was a risk factor for poor prognosis ( OR=1.045, P=0.013). The auxiliary diagnostic value of sST2 level in HFpEF patients with hypertension was analyzed by ROC curve (AUC was 0.721, P<0.05). The incidence of cardiac adverse events in sST2>29.12 group was higher than that in sST2≤29.12 group (44.00% vs. 14.58%), and the difference was statistically significant (χ 2=7.657, P=0.006). Kaplan-Meier survival analysis showed that the percentage of patients with no endpoint event in the sST2≤29.12 group was higher than that in the sST2>29.12 group ( P=0.003).Cox regression analysis showed that the risk of endpoint event in sST2>29.12 group was 3.879 times that in sST2≤29.12 group ( OR=3.879, P=0.011). Conclusions:sST2 level can be used as an indicator of poor prognosis in HFpEF patients with hypertension, and can be used to stratify the risk of HFpEF patients. High levels of sST2 are associated with major adverse cardiac events.

Objective:To explore the indications and effect of surgical treatment of autoimmune pancreatitis.Methods:Clinical data of these 15 patients with autoimmune pancreatitis diagnosed and treated at the Department of General Surgery, the First Hospital of Peking University from 2010 to 2021 were retrospectively analyzed.Results:The main clinical symptoms were obstructive jaundice, abdominal pain, distension and weight loss. The diagnosis of AIP was confirmed by EUS-FNA in 6 patients,among them, 4 did not relapse after oral hormone treatment, 2 did not receive relevant treatment, and 1 developed gastric cancer one year later. Under a suspicion of malignancy, 9 patients underwent surgical laparotomy ,and the diagnosis was established by pathology. There was no recurrence after oral hormone therapy in 1 patient who underwent laparotomy and pancreatic biopsy. One out of the 3 patients with choledochojejunostomy relapsed after 3 years. Of the 5 patients who underwent pancreatectomy, 4 had no obvious recurrence, and 1 had recurrence after 3 years.Conclusions:Untypical autoimmune pancreatitis is likely to be misdiagnosed as pancreatic cancer. For patients with suspicious malignancy, operational management and biopsy may benefit.

Objective:To summarize the best evidence for the prevention and management of central venous catheter-related thrombosis in adults.Methods:Based on evidence-based methods, computer searches were conducted on UpToDate, BMJ Best Practice, Joanna Briggs Institute Evidence-based Healthcare Center Database in Australia, Guidelines International Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Medlive, Cochrane Library, website of Infusion Nursing Society, website of Chinese Medical Association, PubMed, China Biology Medicine disc, CNKI, Wanfang database, etc. The search period was from the establishment of the database to May 31, 2022. Two researchers independently conducted literature quality evaluation and evidence level assessment.Results:A total of 12 articles were included, including 3 clinical decisions, 4 guidelines, 3 evidence summaries, 1 randomized controlled trial and 1 expert consensus. 10 topics including team and training, risk factors assessment, catheterization, functional exercise, physical prevention, drug prevention, tube flushing and sealing, observation and identification, extubation and anticoagulation, health education and 25 best evidence were summarized and formed.Conclusions:This study summarizes the best evidence currently available for the prevention and management of central venous catheter-related thrombosis in adults, so as to provide evidence-based evidence for nurses and nursing managers to scientifically manage and prevent central venous catheter-related thrombosis.

Epileptic seizures after stroke and post stroke epilepsy (PSE) are the main causes of elderly patients with epilepsy. More and more doctors and researchers have devoted to clinical and basic trails relevant to them, hoping obtain a scientific and unitive guideline for timely and effectively treatment. This review will focus on definition, pathogenesis, risk factors, attack types, clinical diagnosis and treatment as follows to improve the understanding of the clinical peers.

Objective:To investigate the changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its role in predicting major adverse cardiac events (MACEs) in patients with end-stage heart failure (ESHF) before and after implanted a HeartCon left ventricular assist device (LVAD).Methods:The retrospective study included 30 ESHF patients [23 males and 7 females, aged 54.5 (40.8, 60.0) years], who were admitted to TEDA International Cardiovascular Disease Hospital from September 15, 2020 to June 20, 2023 to receive treatment with HeartCon LVAD implantation. Their clinical data were analyzed and NT-proBNP concentrations in their blood samples were measured preoperatively and during the follow-up period. Patients were followed regularly and MACEs, including cardiac death and rehospitalization for right heart failure, were recorded within 6 months of discharge; Logistic regression was used for prognostic analysis, and Receiver Operator Characteristic (ROC) curves were used to assess the adjunctive diagnostic value of NT-proBNP for poor prognosis in LVAD patients. The cut-off values for diagnosing poor prognosis by NT-proBNP were divided into two groups, and survival analysis was performed by Kaplan-Meier and tested by log rank; Cox regression was performed to analyze whether high levels of NT-proBNP at 6 months of follow-up wsa a risk factor for poor prognosis in patients with LVAD.Results:The median preoperative NT-proBNP level in 30 ESHF patients successfully implanted with HeartCon LVADs was 3 251.0 (1 544.5, 6 401.5) pg/ml. It decreased significantly 7 days postoperatively (3 251.0 vs. 1 815.0 pg/ml, P<0.05), and then the decreasing trend slowed. It decreased to 1 182.0 (620.0, 3 385.3) pg/ml on the 90th post-operative day. The preoperative NT-proBNP>3 251.0 pg/ml group had a longer postoperative hospital stay (47 d vs 33 d, Z=-2.138, P=0.032). Multivariate logistic regression analysis, only NT-proBNP at 7 days postoperatively was found to predict poor prognosis in LVAD patients, with an OR of 1.001 ( P=0.01); ROC curves were analyzed for the adjunctive diagnostic value of 7-day postoperative NT-proBNP levels for poor prognosis (cut-off value of 2 083.0 pg/ml), with an AUC of 0.833 ( P=0.002); The Kaplan-Meier survival analysis showed that the time to MACEs within 6 months was significantly shorter in the group with NT-proBNP>2 083.0 pg/mL on postoperative day 7 than in the group with NT-proBNP≤2 083.0 pg/ml (3.538±0.689 vs. 5.471±0.323 months, P=0.004); Cox regression analysis showed that the risk of MACEs was 4.25 times higher in the 7-day postoperative NT-proBNP>2 083.0 pg/ml group than in the NT-proBNP≤2 083.0 pg/ml group ( HR=4.25, P=0.035). Conclusions:The higher the preoperative NT-proBNP level, the longer the postoperative hospital stay in HeartCon LVAD patients. NT-proBNP levels decrease most significantly on postoperative day 7 and is a risk factor for MACEs. It may be used as a prognostic predictor in ESHF patients with implanted LVADs.

Objective To investigate the effects of dexmedetomidine(DEX)combined with sufentanil for patient-controlled intravenous analgesia(PCIA)on postoperative immune function and respiratory function recovery in patients undergoing thoracoscopic radical resection of lung cancer.Method From October 2020 to June 2022,92 ASA Ⅰ or Ⅱ patients scheduled for thoracoscopic radical resection of lung cancer were selected in our hospital,and they were randomly divided into sufentanil group(Group S)and DEX group(Group D)with 46 cases in each group.There was one case of postoperative bleeding in group S and one case of intraoperative bleeding in group D withdrew from the experiment.the group S postoperative PCIA with sufentanil injection 1.0 μg/kg pre day and tropisetron hydrochloride 20 mg/150 ml,Group D was treated with dexmedetomidine 1.0 μg/kg pre day and sufentanil injection 1.0 μg/kg pre day and tropisetron hydrochloride 20 mg/150 ml.At the four time points in preoperative day(T0),24 h(T1),48h(T2)and 72 h(T3)after operation.Rest and cough NRS scores and SAS scores were recorded and venous blood samples were taken to detected CD3+,CD4+,CD8+,CRP and PCT,Arterial blood gas analysis was detected to calculate OI;clinical pulmonary infection score(CPIS),the incidence of hypoxemia and pulmonary edema and adverse reactions including nausea and vomiting,drowsiness,bradycardia,respiratory depression and shivers were recorded at T2.Results Compared with S group,NRS score of resting or cough,SAS score,CRP and PCT of group D were significantly decreased at T,to T3(P＜0.05),while CD3+,CD4+,CD4+/CD8+and OI value was increased,CD8+was only lower in T1(P＜0.05).There were no significant differences in rest and cough NRS scores、SAS scores、CD3+、CD4+、CD8+、CD4+/CD8+、CRP,PCT and OI between the two groups at T0(P＞0.05).Compared with T0,Rest and cough NRS scores、CRP and PCT were significantly increased,CD3+、CD4+、CD4+/CD8+、OI and SAS scores were decreased in the two groups at T1-T3,CD8+increased only at T1 and T2(P＜0.05).Compared with group S[8(17.8％),(3.5±1.3)],the proportion of nausea and vomiting and CPIS score in group D[1(2.2％),(1.2±1.1)]was decreased(P＜0.05).There was no significant difference in the proportion of hypoxemia,pulmonary edema,drowsiness,bradycardia,respiratory depression and shivers(P＞0.05).Conclusion Dexmedetomidine combined with sufentanil patient-controlled analgesia has better analgesic and sedative effects,which can not only reduce the degree of immunosuppression caused by surgical trauma,but also reduce the adverse reactions of opioids,and is conducive to the recovery of postoperative respiratory function.It is a safer PCIA method after thoracoscopic radical resection of lung cancer.