Objective To establish a predictive model for spinal canal labor analgesia-related in-trapartum fever and validate its predictive efficacy.Methods A total of 2 276 parturients who received labor analgesia from January to December 2021 were selected as the training set,aged≥18 years,BMI 18.5-40.0 kg/m2,ASA physical status Ⅰ or Ⅱ.The patients were divided into fever group and non-fever group according to the occurrence of intrapartum fever(body temperature≥38.0 ℃).The independent risk factors of intrapartum fever were screened by multivariate logistic regression,and the predictive model was established.A total of 568 parturients who received labor analgesia in the same hospital from January to March 2022 were selected as the verification.The inclusion criteria were the same as the training set,and the model was externally verified by R language.Results There were 197 parturients(8.7％)in the train-ing set and 46 parturients(8.1％)in the validation set experienced intrapartum fever.The multivariate lo-gistic regression analysis showed that primiparity,a high neutrophil count,anemia,and a heavier estimated fetal weight were risk factors of intrapartum fever,while a large body surface area and large cervical dilata-tion degree before labor analgesia were protective factors against intrapartum fever.According to the predic-tors,the predictive model for spinal canal labor analgesia-related maternal fever was established.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.698(95％CI 0.660-0.732),the sensitivity and specificity was 83.2％and 47.9％,respectively.Using R language for the external validation,the AUC of the predictive model was 0.703(95％CI 0.634-0.772),the sensibility and specificity was 65.2％and 71.3％,respectively.The results showed that the prediction model for spinal canal labor analgesia-related intrapartum fever is effective.Conclusion Primiparity,a high neutrophil count,anemia,and a heavier estimated fetal weight were risk factors of intrapartum fever,while a large body surface area and large cervical dilatation degree before labor analgesia were protective factors.The predictive model established based on these indicators can effectively predict the occurrence of intrapartum fever before labor analgesia.

Objective To analyse the effect of hope theory-based pelvic floor exercises on anal function in patients with prophylactic enterostomy reversal.Methods A total of 104 patients with low rectal cancer and underwent prophylactic enterostomy reversal from March 2021 to March 2023 were selected and randomly divided into a routine group and a trial group,with 52 patients per group.Patients in the routine group received a standard postoperative nursing care plus a pelvic floor exercise program,while the patients in the trial group received a hope theory-based pelvic floor exercise program in addition to the standard postoperative nursing care.The anal function of patients was evaluated at 1 and 3 months after surgery,while the self-care ability and hope level were evaluated before the intervention and at 3 months post-surgery.Results In comparison with the routine group,the patients in trial group demonstrated significantly lower scores of anal function at both 1 month and 3 months after surgery(12.1±2.4 vs.13.9±2.2,t=-3.987,P<0.001;5.8±1.4 vs.7.3±1.7,t=-4.912,P<0.001,respectively).The trial group showed significant increases in the total scores in both self-care ability and hope level after the intervention(26.6±3.5 vs.12.3±1.6,t=26.796,P<0.001;7.4±0.3 vs.2.0±0.4,t=77.881,P<0.001,respectively).Conclusion Hope theory-based pelvic floor exercises can enhance postoperative anal function,self-care ability and hope level in patients undergoing prophylactic enterostomy reversal.

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.

Objective:To explore the effects of clinical nursing path model on depression and anxiety among rectal cancer patients with stoma.Methods:From January 2017 to December 2018, this study selected 100 rectal cancer patients with stoma in the First Affiliated Hospital of Nanjing Medical University. All of patients were randomly divided into control group and intervention group with the method of random number table, 50 cases in each group. Patients of two groups all received routine nursing. On the basis of routine nursing, observation group carried out the intervention based on the clinical nursing path model. Depression and anxiety before and after intervention was assessed with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) .Results:Before intervention, there was no statistical difference in the scores of PHQ-9 of patients between two groups ( t=0.116, P=0.908) . After intervention, the score of PHQ-9 of intervention group was lower than that of control group with a statistical difference ( t=6.083, P<0.01) , and lower than that before intervention also with a statistical difference ( t=7.676, P<0.01) . Before intervention, there was no statistical difference in the scores of GAD-7 patients between two groups ( t=0.227, P=0.821) . After intervention, the score of GAD-7 of intervention group was lower than that of control group with a statistical difference ( t=9.249, P<0.01) ; scores of GAD-7 of two groups were lower than that before intervention also with statistical differences ( P<0.01) . Conclusions:Application of clinical nursing path model can effectively improve depression and anxiety of rectal cancer patients with stoma.

Objective To observe the protective effects of Diemailing Injection (DMLI) on myocardial ischemia-reperfusion injury in rats. Methods The myocardial ischemia-reperfusion model was induced by 30 min left anterior descending coronary occulusion and 24 h reperfusion in open-chest anesthetized rats. The changes of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA) contents in serum, and prostacycline (PGI2) and thromboxane A2 (TXA2) levels in plasma were determined. Results In rats treated by DMLI (with dose of 2. 5, 5 and 10 mL ? kg-1 i. v. at 30 min after coronary occulusion), the myocardial ischemia size (MIS) was significantly reduced, the AST, LDH and CK-MB activities in serum and the TXA2 level in plasma were declined, while PGI2 level in plasma and PGI2/TXA2 ratio were increased significantly. In addition, the LPO content in serum declined, SOD and GSH-Px activities in serum were increased markedly. Conclusion DMLI has protective effects on myocardial ischemia-reperfusion injury through improving free radicals metabolism, decreasing TXA2 level in plasma, increasing PGI2 level in plasma and PGI2/TXA2 ratio.

Oral and maxillofacial surgery is one kind of special subjects involving multiple clinical disciplines.The postgraduate training is different from other professional postgraduate training model,which emphasizes the cultivation of students,should be first medical students,then dentist.In new situation,we advance the experiences in exploring how to cultivate high quality postgraduate of oral and maxillofacial surgery.

OBJECTIVE: To study the therapeutic mechanism of salvianolic acid B (SA-B) in treating hepatic fibrosis. METHODS: Twenty-four Wistar rats were randomly divided into 3 groups: normal control group, untreated group and SA-B-treated group. Rats in the untreated and SA-B-treated groups were injected intraperitoneally with 0.5% dimethylnitrosamine (DMN) for 4 weeks, daily for 3 days each week at a dose of 10 microg/kg, to induce hepatic fibrosis. Then, rats in the SA-B-treated group were given SA-B orally for another 4 weeks. Hydroxyproline (Hyp) contents in liver tissue of the rats in 3 groups were determined with HCl hydrolysis, and collagen type I, transforming growth factor-beta 1 (TGF-beta1), transforming growth factor-beta receptor type I (TbetaRI) and transforming growth factor-beta receptor type II (TbetaRII) were detected by Western blotting. RESULTS: The Hyp content and the expressions of collagen type I, TGF-beta1, TbetaRI and TbetaRII in the liver tissue of rats in the untreated group increased significantly as compared with those in the normal control group, while those in SA-B-treated group decreased significantly as compared with those in the untreated group. CONCLUSION: The therapeutic mechanism of SA-B in treating hepatic fibrosis may be related to inhibiting the expressions of TGF-beta1 and its receptors.

Antiviral Agents ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy

OBJECTIVE:To explore ways of promoting the rational use of antibacterials.METHODS:To analyze and e-valuate the effect of whole-ranged pharmaceutical care on promoting rational use of antibacterials.RESULTS:The whole-ranged pharmaceutical care was the efficient way to ensure the rational drug use of antibacterials.CONCLUSION:The whole-ranged pharmaceutical care should be carried out in hospital pharmacy so as to promote the rational use of antibacterials and to make the utmost use of the limited resource of Antibacterials.

OBJECTIVE　To study the effects of Panax quinquef olium 20S-protopanaxdiol saponins extracted from the leaves of panax qu inque-folium (PQDS) on the hemodynamics and cardial oxygen metabolism in dogs with acute myocardial infarction (AMI).METHODS　The paramete rs of hemodynamics and cardial oxygen metabolism were determined by using the mo del of ligation of LAD in the anaesthetized open-chest dogs.RESULTS 　In dogs treated with PQDS (in a dosage of 10 and 20 mg*kg-1 iv infusion),the myocardial blood flow (MBF) was increased and coronary vascular re sistance (CVR) was decreased significantly.The heart rate (HR) was slowed.The ar terial blood pressure (ABP),left ventricular pressure (LVP),the maximum rise rat e of left ventricular pressure(+dp/dtmax),left ventricular work index (LVW I) and total periphery resistance(TPR) were reduced,whereas the stroke index(SI) and cardiac index (CI) were increased.In addition,the decreasing range of the m aximum decline rate of left ventricular pressure(-dp/dtmax) and the rising range of left ventricular end diastolic pressure (LVEDP) were reduced.Meanwhile the cardiac oxygen consumption,myocardial oxygen utilization rate and cardiac o xygen consumption index were also decreased.CONCLUSION　PQDS had protective effects on acute myocardial ischemia including improving heart fu nction,decreasing cardiac oxygen consumption and increasing myocardial blood flo w,etc.