Chronic heart failure （CHF） is the terminal stage of various heart diseases， with high morbidity， mortality， and hospitalization rate. According to the theory of collateral diseases， the core pathogenesis of CHF is blood stasis of collaterals， water retention and stagnation， and pathogen accumulation in collaterals. Accordingly， the treatment should focus on reinforcing healthy Qi to warm Yang， activating blood to dredge collaterals， and excreting water to alleviate edema. On this basis， Qili Qiangxin capsules （QLQX） are created. This prescription can effectively treat chronic heart failure. Modern studies have shown that QLQX contains a variety of pharmacological components such as flavonoids， alkaloids， terpenoids， phenylpropanoids， phenolic acids， and cardiac glycosides. QLQX can improve the cardiac function， inhibit myocardial fibrosis， improve hemodynamics， mitigate inflammation， reduce cardiomyocyte apoptosis， and regulate the nervous system， with mild adverse reactions. This study analyzed the etiology and pathogenesis of CHF based on the theory of collateral diseases， explored the relationship between the prescription and syndrome， and delved into the material basis and mechanism of QLQX in the treatment of CHF， aiming to provide reference for the clinical application and scientific research of QLQX.

The liver regenerative capacity is crucial for patients with end-stage liver disease following partial hepatectomy (PHx). The specific bacteria and mechanisms regulating liver regeneration post-PHx remain unclear. This study demonstrated dynamic changes in the abundance of Parabacteroides distasonis (P. distasonis) post-PHx, correlating with hepatocyte proliferation. Treatment with live P. distasonis significantly promoted hepatocyte proliferation and liver regeneration after PHx. Targeted metabolomics revealed a significant positive correlation between P. distasonis and β-hydroxybutyric acid (BHB), as well as hyodeoxycholic acid and 3-hydroxyphenylacetic acid in the gut after PHx. Notably, treatment with BHB, but not hyodeoxycholic acid or 3-hydroxyphenylacetic acid, significantly promoted hepatocyte proliferation and liver regeneration in mice after PHx. Moreover, STAT3 inhibitor Stattic attenuated the promotive effects of BHB on cell proliferation and liver regeneration both in vitro and in vivo. Mechanistically, P. distasonis upregulated the expression of fatty acid oxidation-related proteins, and increased BHB levels in the liver, and then BHB activated the STAT3 signaling pathway to promote liver regeneration. This study, for the first time, identifies the involvement of P. distasonis and its associated metabolite BHB in promoting liver regeneration after PHx, providing new insights for considering P. distasonis and BHB as potential strategies for promoting hepatic regeneration.

BACKGROUND:Among the surface modification technologies of metal implants,micro-arc oxidation has been widely concerned for its convenience,low cost and ability to effectively adjust the microstructure and elements of surface coatings. OBJECTIVE:To summarize research advances in physical and chemical properties and biological activities of oxidation coatings prepared by micro-arc oxidation on different materials. METHODS:The articles about the effects of micro-arc oxidation on the biological activity of medical metals were searched in PubMed and Web of Science based on the English search terms"MAO,micro-arc oxidation,osseointegration,mechanical property,biological activity,angiogenesis,fibrogenesis".The search time was from January 2016 to December 2022.According to the inclusion and exclusion criteria,82 articles were finally retained for review. RESULTS AND CONCLUSION:Micro-arc oxidation is a potential surface modification technology,which can greatly improve the success rate of implantation,and can be widely used in other fields.The specific reasons are as follows:(1)Micro-arc oxidation technology forms special porous morphology on the surface of materials,which can optimize the mechanical properties such as wear resistance and corrosion resistance,contributing to the reduction of the degradation rate of magnesium alloys.(2)Micro-arc oxidation technology can significantly enhance the bioactivity and improve the bioinertness of titanium and titanium alloys through the addition of strontium,hydroxyapatite and other metallic or nonmetallic substances to its porous morphology for helping elevate its osteogenic differentiation,angiogenesis,fibrogenesis and other biological activities.

BACKGROUND:Micro-arc oxidation can effectively add bioactive elements to the metal surface and improve the anti-bacterial and anti-inflammatory properties of biomedical metal materials,so this technology has become one of the hotspots of biomedical materials. OBJECTIVE:To summarize the anti-bacterial and anti-inflammatory properties of surface coatings prepared by the combination of micro-arc oxidation and other surface modification technologies. METHODS:Articles from January 1996 to December 2022 were searched on CNKI,WanFang and PubMed databases using Chinese and English search terms"micro-arc oxidation,antibacterial properties,anti-inflammatory properties,metal implants".After preliminary screening according to inclusion and exclusion criteria,89 articles were retained and summarized. RESULTS AND CONCLUSION:The ceramic layer prepared by micro-arc oxidation can improve the anti-bacterial and anti-inflammatory properties of titanium,magnesium and other alloys.Combination with other surface modification technologies can effectively solve the effect of pores on the surface properties of the alloy,and further improve the biological properties of the oxide film.It has a wide application prospect in orthopedics and dentistry.At present,most studies are limited to metal coatings,and most of them focus on metal elements with good antibacterial properties such as silver and copper,while only a few studies mention non-metallic coatings such as graphene oxide,hydroxyapatite and chitosan.In the future,extensive studies can be conducted on inorganic coatings and polymer coatings,and more combinations of different bioactive elements can also be adopted to improve antibacterial properties.Currently,studies on the inflammation of implant coatings prepared by micro-arc oxidation are mostly limited to the immune system and focused on macrophages,while studies on neutrophils and platelets are scarce.In the future,a variety of advanced technologies should be combined to explore the specific effects of micro-arc oxidation coating on other immune cells and inflammatory cells.

Summarize the nursing experience of 9 children with X-linked agammaglobulinemia who were first treated with subcutaneous infusion of human immunoglobulin in mainland China. Nursing points: there is no precedent in mainland China for high-dose subcutaneous infusion of human immunoglobulin, therefore, it is necessary to make sufficient preparation and care before infusion, pay attention to the observation and care of drug infusion, provide guidance on home medication, pay attention to psychological care, and ensure that patients smoothly transition from hospital medication to home medication. All 9 patients successfully completed subcutaneous injection of human immunoglobulin treatment, ensure smooth transition of patients from hospital medication to home medication. and no serious adverse reactions occurred, resulting in good results.

Objective:To evaluate the feasibility of Full-stack Smart Pelvic Floor Ultrasound (FSPFU) software in the acquisition and measurement of the minimal levator hiatus (LH).Methods:Transperineal pelvic floor ultrasonography was performed in 119 women of 6-month postpartum from Nov.2020 to Jan.2021 of Shenzhen Second People′s Hospital. Mid-sagittal plane of pelvic floor was set as the initial plane, and the three-dimensional volume data was acquired. The dataset was stored in the machine. The offline volume data was manually adjusted to obtain the minimal LH images and measured by four physicians (two junior physicians as the D1 group and two senior physicians as the D2 group). For comparison, the results were also obtained using the fully automated method—the FSPFU software by a junior physician (the D3 group). The obtained parameters of minimal LH included area, circumference, anterioposterior diameter, transverse diameter, left and right levator-urethral gap distance. Analysis time was recorded for each group. The contours of minimal LH were outlined by three groups and the overlapping rate was calculated. The quality of the resulted images was evaluated and scored by another two senior physicians(A and B) independently.Results:The D3 group had a significant shorter analysis time compared with the other two groups, and the D1 group took a longer time than the D2 group, regardless of the cystocele severity (D1: 82.97 s, D2: 62.51 s, D3: 2.71 s, all P<0.05). The intergroup agreements and correlations of the minimum LH area were good (all ICC>0.85, rs>0.70, P<0.001) and the outlined contours were largely overlapped (>92%). There was no significant difference in image quality among the three groups(all P>0.05). Conclusions:FSPFU software can automatically obtain and measure the minimum LH in an efficient and accurate way, which can improve the effectiveness of the present pelvic floor examination. FSPFU software can be an useful tool in the diagnosis of pelvic floor dysfunctional diseases.

【Objective】 To evaluate the safety and effectiveness of Perioperative Transfusion Trigger Score (POTTS) in guiding surgical patients blood transfusion intraoperatively and postoperatively. 【Methods】 A total of 900 patients(perioperative Hb 60~100 g/L) from December 2017 to March 2021 were collected, including 251 males and 649 females, with ASA grading Ⅰ~Ⅳ, and randomly divided into experimental group and controls. In the experimental group, the allogeneic RBC transfusion trigger(Hb threshold) and transfusion units in anemia patients was determined by POTTS. While those in the controls were decided by physicians according to current guidelines concerning transfusion. The proportion and units of allogeneic RBC transfusion, the incidence of postoperative complications, the mortality of hospitalization and discharge for 4 weeks, Hb value, healing of surgical incision, ICU admission rate and ICU length of stay, length of hospitalization, etc were recorded. 【Results】 The proportion of allogeneic RBC transfusion in the experimental group(35.3%)were less than the controls(42.2%)(P<0.05). The units of allogeneic RBC transfused, incidence of postoperative complications and mortality in hospital and 4 weeks after surgery, healing of surgical incision (grade A/ grade B/ grade C), the Hb level 24 h after surgery and at discharge, the ICU admission rate and ICU length of stay, length of hospitalization were not significantly different between the groups. 【Conclusion】 The peri-operative allogeneic red blood cells transfusion guided by POTTS can reduce the proportion of allogeneic RBC transfusion, and is safe and effective.

Objective:To investigate the prognostic significance of D-dimer level in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 70 newly diagnosed DLBCL patients who were admitted to Tianjin People's Hospital from January 2015 to June 2019 were retrospectively analyzed. The optimal cut-off value of D-dimer for survival was determined according to the receiver operating characteristic (ROC) curve, and the patients were grouped. The differences of coagulation related indexes and clinicopathological features between patients with different D-dimer levels were compared. Kaplan-Meier method was used for univariate analysis of overall survival (OS), and Cox regression model was used for multivariate analysis of OS.Results:According to ROC curve, the best cut-off value of D-dimer for survival was 0.75 mg/L. The proportion of patients with different clinical staging, international prognostic index score, lactate dehydrogenase level had statistically significant differences between the D-dimer ≥0.75 mg/L group (36 cases) and <0.75 mg/L group (34 cases) (all P < 0.05). The prothrombin time of D-dimer ≥ 0.75 mg/L group and < 0.75 mg/L group were (13.5±0.9) s and (13.0±0.8) s, respectively, and the activated partial thromboplastin time were (37±5) s and (34±6) s, respectively,and the differences were statistically significant (all P < 0.05). Univariate analysis showed that the 5-year OS rates of DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ, international prognostic index score > 2, lactate dehydrogenase level > 240 U/L, B symptoms, D-dimer level ≥0.75 mg/L were decreased (all P < 0.05). Multivariate Cox regression analysis showed that D-dimer ≥0.75 mg/L was an independent risk factor for OS of DLBCL patients ( HR=0.368, 95% CI 0.144-0.944, P= 0.038). Conclusion:The level of D-dimer can be used as a clinical indicator to judge the prognosis of DLBCL patients, and the prognosis of patients with high D-dimer level is poor.

Objective:To construct an out-of-hospital health management content system for children with type 1 diabetes (T1DM) to provide a basis for clinical nursing staff to carry out targeted health education and evaluation.Methods:A research group was established in April 2019. Guided by mobile health, the first draft of out-of-hospital health management system for children with T1DM was constructed through literature review, semi-structured interviews and expert meetings. A total of 20 experts were selected from pediatric wards of 11 Class Ⅲ Grade A children's specialties or general hospitals in Beijing, Shanghai, Henan Province, Zhejiang Province and other provinces, and the Delphi method was applied for 2 rounds of consultation. The out-of-hospital health management content system for T1DM children based on mobile health was constructed and revised to form the final draft.Results:After 2 rounds of expert consultation, the opinions of 20 experts reached consensus. The recovery rates of the 2 rounds of expert consultation questionnaire were both 100.0%, the expert familiarity was 0.96, the expert judgment basis was 0.98 and the authority coefficient was 0.97. Finally, out-of-hospital health management content system for T1DM children consisted of 6 first-level indicators, 14 second-level indicators and 69 third-level indicators.Conclusions:The out-of-hospital health management content system for T1DM children in this study is scientific and comprehensive, which can provide theoretical references and unified standards for clinical nurses to conduct out-of-hospital health management and evaluation effect based on mobile health.

Objective To investigate in children with type 1 diabetes mellitus and provide evidence for nursing education. Methods From January to December 2016, 450 patients with T1DM were enrolled in this research,all of them were outpatients of diabetes clinic of Beijing Children′s Hospital Affiliated to Capital Medical University. The clinical data of the patients were collected through questionnaires and physical examinations to assess the insulin treatment and related factors. Results Among 450 patients, 221 were males and 229 were females, aged 9.40 (0.83-17.97) years old; body mass index was 17.43 (12.81-28.22) kg/m2; course of disease was 2.32 (0.05-12.89) years; daily insulin dosage was 0.66 (0.11-1.78) IU·kg-1·d-1; glycosylated hemoglobin (HbA1c) was 7.54 (4.4-14.9)%, of which HbA1c<7.5% accounted for 55.8%(251/450). 7.5%-9.0% accounted for 30.0(135/450)% , and >9.0% accounted for 14.2% (64/450). 44.9% ,47.1% ,8.0% (202, 212,36 cases) patients were treated respectively with routine treatment, multiple daily injection or continuous subcutaneous insulin infusion. There was no significant difference in HbA1c between patients with different insulin regimens (P>0.05), but there were significant differences in age, course of disease, body mass index and insulin dosage (P< 0.05). Conclusion Because children with type 1 diabetes have different physiological and psychological characteristics in different stages, the content of health education should be adjusted according to the patient's condition.