Objective:To explore the effect of extracorporeal shock wave combined with meloxicam tablets on joint function and serum matrix metalloproteinase-9 (MMP-9) and resistin levels in elderly patients with osteoarthritis.Methods:80 cases of elderly patients with osteoarthritis in Nanchong Central Hospital from May 2016 to March 2019 were selected as the research objects, and they were randomly divided into two groups, 40 cases in each group. The control group was given conventional oral medicine (meloxicam + potassium glucosamine sulfate tablets), and the observation group was given meloxicam tablets combined with extracorporeal shock wave therapy. The total effective rate, incidence of adverse reactions, and the scores of osteoarthritis symptoms (WOMCA), joint function (Lysholm), serum MMP-9 and resistin before and after 8 weeks' treatment were compared between the two groups.Results:After treatment, the WOMCA score of the observation group was lower than that of the control group, and Lysholm score was higher than that of the control group ( P<0.05); the total effective rate of the observation group (95.00%) was higher than of the control group (77.50%) ( P<0.05); the serum resistin and MMP-9 levels of the observation group were lower than those of the control group after treatment ( P<0.05); there was no significant difference in the incidence of adverse reactions between the observation group (15.00%) and the control group (17.50%) ( P>0.05). Conclusions:Extracorporeal shock wave combined with meloxicam tablets in the treatment of elderly patients with osteoarthritis can significantly improve the clinical symptoms, promote the recovery of joint function, reduce the levels of serum resistin and MMP-9, and further improve the treatment effect with high safety.

Objective To study the amount of rhizospheric microorganisms and soil enzyme activity influenced by Paridis Rhizoma in different locations and of different strains. Methods The amount of rhizospheric microorganisms, soil enzyme activity and their correlation were researched through field survey and collection of rhizospheric soil in Paridis Rhizoma cultivated in Three Gorges Reservoir Region and by microbial dilution plate culture method. Results The amount of rhizospheric microorganisms in Paridis Rhizoma from different habitats showed significant differences. The dominant species in soil microflora was bacteria; the second one was actinomycetes; the fewest one was fungus. The variation trend of the amount of rhizospheric microorganisms was not consistent with the variation trend of rhizospheric microorganisms diversity index. The activity of soil phosphatase, invertase and pepsin in Paridis Rhizoma from different habitats varied. The correlation analysis showed that the correlation between the soil enzyme activity and the amount of rhizospheric microorganisms existed. Conclusion Choosing the suitable strains and habitats of Paridis Rhizoma is beneficial to enhancing the amount of rhizospheric microorganisms and soil enzyme activity, which can create good micro-ecological environment for growth and cultivation of Paridis Rhizoma.

Objective:To explore the role of one-to-one tutorial system combined with reflective teaching method in the teaching of clinical nurses in intensive care unit (ICU).Methods:A total of 21 nurses who practiced in ICU from March 2019 to October 2019 were set as the control group, and 21 nurses who practiced in ICU from December 2019 to July 2020 were set as a research group. The control group adopted traditional teaching, and the research group adopted the tutorial system combined with reflective teaching. The theoretical and technical performance assessment results, professional self-efficacy before and after teaching, and clinical comprehensive ability before and after teaching were compared between the two groups. SPSS 26.0 was used for t test χ2 test, and rank-sum test was used for rank distribution. Results:After teaching, there were significant differences between the two groups in the grades distribution of theoretical and technical operation examination results ( P<0.05). The excellent and good rate of theoretical and technical operation examination in the study group were higher than those in the control group ( P<0.05). Before teaching, there was no significant difference in the scores of job responsibility and education requirements in professional self-efficacy scale and clinical comprehensive ability (observation ability, communication ability, health education ability, humanistic care ability, emergency response ability, professional knowledge, accurate execution of doctor's advice and coordination ability with doctors) between the two groups ( P > 0.05). After teaching, the scores of professional self-efficacy scale and clinical comprehensive ability of nursing students in the two groups were significantly increased ( P<0.05). The scores of professional self-efficacy scale and comprehensive ability of nursing students in the study group after teaching were higher than those in the control group ( P<0.05). Conclusion:The application of one-to-one tutorial system combined with reflective teaching method can significantly improve the professional self-efficacy of nursing students, improve the teaching effect, and improve the clinical comprehensive quality of nursing students.

BACKGROUND:As a member of bone morphogenetic proteins,growth differentiation factor-5 shows promising potential in the application of cartilage and bone repair.The affinity of growth differentiation factor-5 onto bone tissue determines protein use efficiency,so it is of great significance to prepare growth differentiation factor-5 with bone targeting capability. OBJECTIVE:To modify growth differentiation factor-5 using bisphosphonates and investigate the effects of modified protein on the growth of preosteoblasts in mice. METHODS:Pamidronate disodium/growth differentiation factor-5 complex was prepared using chemical crosslinking to couple growth differentiation factor-5 with pamidronate disodium.The functional groups and structures of the complex were characterized using Fourier transform infrared spectroscopy and circular dichromatography.To determine the bone targeting in vitro,the binding of the modified growth differentiation factor-5 with calcium phosphate and in vitro release amount of growth differentiation factor-5 were measured with an ELISA kit.Growth differentiation factor-5(control group)and the pamidronate disodium/growth differentiation factor-5 complex(experimental group)were co-cultured with preosteoblasts MC3T3-E1.Individually cultured cells were blank controls.The effect of the complex on cell proliferation and differentiation was evaluated. RESULTS AND CONCLUSION:(1)The infrared spectroscopy and circular dichromatography results indicated that the bisphosphonate/growth differentiation factor-5 complex was successfully prepared without significant changes in the protein secondary structure.In vitro protein adsorption results showed that growth differentiation factor-5 adsorption on calcium phosphate was increased by about one time after coupling with a bisphosphonate.In the presence of cysteine,growth differentiation factor-5 could be released from the bisphosphonate/growth differentiation factor-5 complex.(2)CCK-8 assay results showed that the absorbance value of the experimental group cultured for 4 and 7 days was higher than that of the control group and blank control group(P<0.000 1).After 7 days of culture,the expression of alkaline phosphatase in the experimental group was significantly higher than that in the control group and blank control group(P<0.000 1).After 13 days of culture,the content of calcium nodules in the experimental group was significantly higher than that in the control group and the blank control group(P<0.000 1).The results of qRT-PCR showed that the mRNA expression of alkaline phosphatase,osteocalcin and Runx2 in the experimental group was higher than that in the control group and the blank control group after 7 days of culture(P<0.01,P<0.001,P<0.000 1).(3)These findings exhibit that bisphosphonate modification can enhance the binding capacity of growth differentiation factor-5 to calcium phosphate as well as improve its biological activity.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and macrophage polarization plays an important role in its pathogenesis. However, which molecule regulates macrophage polarization in NAFLD remains unclear. Herein, we showed NAFLD mice exhibited increased 17β-hydroxysteroid dehydrogenase type 7 (17β-HSD7) expression in hepatic macrophages concomitantly with elevated M1 polarization. Single-cell RNA sequencing on hepatic non-parenchymal cells isolated from wild-type littermates and macrophage-17β-HSD7 knockout mice fed with high fat diet (HFD) for 6 weeks revealed that lipid metabolism pathways were notably changed. Furthermore, 17β-HSD7 deficiency in macrophages attenuated HFD-induced hepatic steatosis, insulin resistance and liver injury. Mechanistically, 17β-HSD7 triggered NLRP3 inflammasome activation by increasing free cholesterol content, thereby promoting M1 polarization of macrophages and the secretion of pro-inflammatory cytokines. In addition, to help demonstrate that 17β-HSD7 is a potential drug target for NAFLD, fenretinide was screened out from an FDA-approved drug library based on its 17β-HSD7 dehydrogenase inhibitory activity. Fenretinide dose-dependently abrogated macrophage polarization and pro-inflammatory cytokines production, and subsequently inhibited fat deposition in hepatocytes co-cultured with macrophages. In conclusion, our findings suggest that blockade of 17β-HSD7 signaling by fenretinide would be a drug repurposing strategy for NAFLD treatment.