Objective To explore the relationship between homocysteine(HCY),glycosylated hemoglobin(HbA1c),lipids and posterior circulation ischemia and the clinical significance of their levels in the posterior circulation ischemic (PCI)diseases. Methods Difference between PCI were diagnosed in 140 examinees and a healthy control group,with fasting serum,HCY, HbA1c,total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C)and low-density lipoprotein cholesterol (LDL-C)were detected.Results HCY and HbA1c were significantly higher,HDL-C was significantly lower in the patients with PCI,two independent sample t-test showed a significant difference between the test group and control group (P <0.001 and P =0.001),the remaining lipid indicators was not statistically significant.Spearman rank correlation analysis showed that HCY levels had significant positive correlation (P <0.001)and TG levels had significant negative cor-relation (P =0.013)with the subjects age,HCY levels had significant negative correlation with TG levels(P = 0.028), HbA1c levels had significant positive correlation with TG levels and LDL-C levels(P =0.001 and P =0.027).Conclusion High levels of HCY and HbA1c were closely associated with PCI,which HCY and HbA1c should be attached great impor-tance to the effective prevention and treatment and improve of PCI.

Objective:To explore the impact of celastrol(CEL)on angiogenesis in rats with endometriosis(EM)and its regu-latory mechanism on Hippo-YAP signal pathway.Methods:SD female rats were grouped into six groups:sham operation group,model group,positive drug group(gestrinone),Verteporfin group(YAP inhibitor),low and high doses CEL groups,with 12 rats in each group.The weight and volume of rat endometrium were measured;HE staining was applied to observe the histological changes of rat endometrium;the microvessel density(MVD)in rat endometrium was detected by immunohistochemistry;the expressions of vascular endothelial growth factor(VEGF),TNF-α,IL-1β and IL-6 in rat serum were detected by ELISA;Western blot was applied to detect the expressions of VEGF and YAP proteins in rat endometrium.Results:Compared with sham operation group,the EM rats in model group showed obvious ectopic endometrial tissue lesions,increased number of interstitial cells,and obvious vascular proliferation,the weight,volume,MVD,the contents of VEGF,TNF-α,IL-1β,IL-6,and the expression levels of YAP,TAZ,and VEGF receptor 2(VEGFR2)proteins in endometrial tissue increased(P<0.05);compared with model group,the ectopic endometrium tissue of EM rats in positive drug group,Verteporfin group and low and high dose CEL groups gradually fell off,the number of interstitial cells were decreased,the structure was loose,and the blood vessels were significantly reduced,the weight,volume,MVD,the contents of VEGF,TNF-α,IL-1β,IL-6,and the expression levels of YAP,TAZ,and VEGFR2 proteins in endometrial tissue were decreased(P<0.05).Conclusion:CEL can inhibit angiogenesis in EM rats by inhibiting Hippo-YAP signal pathway.

Objective To explore the nursing essentials of complicated incision infection and embedding syndrome after percutaneous endoscopy gastrojejunostomy(PEGJ). Methods Comprehensive treatment and care including improved nursing methods, negative pressure suction, the dressing strengthening, and enteral nutrition. Results The swelling of the incision gradually subsided. On the 18th day, there was slight redness around the tube, no exudate, no fever, and the incision healed well. On the 20th day, family members were taught with routine maintenance method of the PEG/J tube, and the patient was discharged from hospital with the tube home for continue treatment. Conclusion Comprehensive nursing methods according to cause analysis can improve the curative effect of complications after PEGJ implantation.

The lung is one of the most common sites for cancer metastasis. Collagens in the lung provide a permissive microenvironment that supports the colonization and outgrowth of disseminated tumor cells. Therefore, down-regulating the production of collagens may contribute to the inhibition of lung metastasis. It has been suggested that miR-29 exhibits effective anti-fibrotic activity by negatively regulating the expression of collagens. Indeed, our clinical lung tumor data shows that miR-29a-3p expression negatively correlates with collagen I expression in lung tumors and positively correlates with patients' outcomes. However, suitable carriers need to be selected to deliver this therapeutic miRNA to the lungs. In this study, we found that the chemotherapy drug cisplatin facilitated miR-29a-3p accumulation in the exosomes of lung tumor cells, and this type of exosomes exhibited a specific lung-targeting effect and promising collagen down-regulation. To scale up the preparation and simplify the delivery system, we designed a lung-targeting liposomal nanovesicle (by adjusting the molar ratio of DOTAP/cholesterol-miRNAs to 4:1) to carry miR-29a-3p and mimic the exosomes. This liposomal nanovesicle delivery system significantly down-regulated collagen I secretion by lung fibroblasts in vivo, thus alleviating the establishment of a pro-metastatic environment for circulating lung tumor cells.