Objective To observe the influence of Simvastatin on immature rabbit model of chronic heart failure(CHF),and to explore the possible protective mechanism of Simvastatin for the rabbits with CHF.Methods Thirty immature male rabbits were divided into 3 groups randomly:control group,heart failure group (HF group)and Simvastatin group(SIM group),10 rabbits in each group.The models of CHF were established by injecting Adrinmycin via the auricular vein of rabbits (1.5 mg/kg,once 1 week,for 12 weeks).The control group were injected the same amount of 9 g/L saline.SIM group were given both injection of Adrinmycin and Simvastatin [1.5 mg/(kg · d)for 12 weeks].The immature rabbit's cardiac function and myocardial morphology changes were evaluated.The expressions of chromogranin A (CgA) and apoptosis signal-regulating kinase 1 (ASK1) were evaluated.Results (1) In control group,the immature rabbits were all alive;in the other 2 groups,most immature rabbits were depressed and sluggish.The survival rate of HF group was 60％,while in SIM group the survival rate was 80％.(2)Compared with the control group,the left ventricular ejection fraction in HF group and SIM group decreased significantly [(40.05 ± 6.74)％,(50.18 ± 5.73) ％ vs.(65.93 ± 5.65) ％,all P ＜ 0.01],while in SIM group was higher than that of HF group,and the difference was significant (P ＜ 0.05);compared with HF group,the left ventricular end diastolic diameter and left ventricular end systolic diameter decreased in SIM group [(13.48 ± 1.24) mm vs.(16.23 ± 2.82) mm;(9.87 ± 0.85) mm vs.(11.13 ± 1.21) mm],and the differences were significant (all P ＜ 0.05).(3) Compared with the control group,the expression of CgA (mean optical density 142.24 ± 17.14,127.93 ± 12.12 vs.78.65 ± 6.78,P ＜ 0.05;integrated optical density 1 422.41 ± 167.34,1 279.37 ± 118.15 vs.786.54 ± 75.84,P ＜ 0.05) and ASK1 (mean optical density 140.32 ± 18.65,115.48 ± 12.30 vs.69.85 ± 6.54,P ＜ 0.05;integrated optical density 1 403.23 ± 165.67,1 158.79 ± 137.81 vs.698.58 ± 64.51,P ＜ 0.05) increased in the HF group and SIM group.While the expression in the SIM group decreased significantly compared with that of the HF group,and the difference was significant (P ＜ 0.05).Conclusions Simvastatin can improve cardiac function of immature rabbits with CHF.The mechanism of SIM may depress the expressions of CgA and ASK1.

Objective:This study aimed to achieve the early diagnosis and active treatment of adult hemophagocytic syndrome (HPS) and investigate the clinical characteristics and prognostic factors of this syndrome. Methods:A single-center retrospective analysis was performed to analyze clinical characteristics, laboratory findings, and survival data. Results:In 58 patients, the most common clinical manifestations were fever (100%) and splenomegaly (89.7%). The most common laboratory parameters were serum ferritin 500 g/L (100%) and peripheral cytopenia in two or more lineages (96.6%). platelet count, fibrinogen, and lactate dehydrogenase in the death group were significantly lower than in the survival group (P=0.000, 0.001, and 0.000). Survival analysis results showed that infections in the rheu-matological group exhibited good prognosis [the overall survival (OS) time was not reached in 190 d]. Patients with unexplained causes had moderate prognosis (OS time was 60 d);tumor-associated HPS patients had poor prognosis (the OS time was only 30 d). Univariate analysis results showed that patients with Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2000 U/L also exhibited poor prognosis (P=0.000). Multivariate analysis results showed that PLT<40 × 109/L was an independent adverse factor (HR=6.472, 95%CI:1.526-26.065, P=0.011). Conclusion:HPS exhibits complex clinical manifestations and varied etiology. Patients with infection and rheumatism-related HPS had good prognosiss compared with those manifesting tumor-associated HPS. Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2 000 U/L were the univariate factors that affected the survival time of patients. PLT<40×109/L is an independent adverse factor. These patients need systemic treatments as early as possible.

Objective To establish the Nifedipine-induced liver cell damage model,and to investigate the cellular or molecular mechanism for children's liver cell damage.Methods The HepG2 cells were utilized to establish liver cell damage models.The optimal concentration and the optimal pretreatment time of Nifedipine-induced liver cell injury were confirmed.Western blot and real-time PCR(RT-PCR)were used to check the alteration in proteins and mRNAs level of the liver function-associated classic markers,which contained alkaline phosphatase(ALP),aspartate amino transferase(AST),glutamyl transpeptidase(γ-GT)and alanine aminotransferase(ALT).Additionally,flow cytometry(FCM),colony formation assay(CFA)and cell wound healing assay(CWHA)were utilized to check the effect of Nifedipine on the cell cycle progression and proliferation of HepG2.Results (1)The optimal concentration of Nifedipine was 20 mg/L and the optimal treatment period was 21 days for liver damage.(2)Western blot:intracellular ALT protein content after Nifedipine group was less than that of control group,while the protein levels of AST,γ-GT and ALP in the culture medium after Nifedipine addition(3.55 ± 0.05,4.91 ± 0.055,3.51 ± 0.05,3.08 ± 0.08) were higher than those of control group(0.96 ± 0.02,1.03 ± 0.02,1.00 ± 0.05,0.90 ± 0.13),and the differences were all significant(t = -85.695,-117.582,-47.371,-33.260,all P<0.05).(3)The findings of RT-PCR showed that the mRNA levels of intracellular ALT,γ-GT and ALP in Nifedipine group(0.26 ± 0.02,0.05 ± 0.04, 0.05 ± 0.02)were lower than those of control group(1.13 ± 0.21,0.94 ± 0.10,1.03 ± 0.06),and the differences were all significant(t=7.233,127.436,25.687,all P<0.05).However,the mRNAs levels in purified culture me-dium in Nifedipine group(5.95 ± 0.05,3.13 ± 0.10,3.32 ± 0.08)were higher than those in control group(1.01 ± 0.08,1.00 ± 0.05,1.00 ± 0.05),and the differences were all significant(t= -92.339,-31.250,-43.007,all P<0.05).(4)The portion of G0/G1 phase in Nifedipine group[(84.09 ± 0.43)%]was more than that of control group[(30.93 ± 0.32)%],which had statistical significance(t=173.084,P=0.000).(5)In contrast with control group,the colony formation of cells in Nifedipine group declined from(97.10 ± 1.17)% to(38.56 ± 1.51)%(t=92.088,P=0.000)and the migration rate of cells wound healing was(56.37 ± 2.06)%,(25.00 ± 1.71)% sepa-rately(t=20.285,P=0.000).Conclusion Nifedipine may promote children's liver injury through regulating cell cycle related proteins.

Objective:To construct an evaluation index system for the risk factors of peripheral venous indwelling catheter failure in adults.Methods:Through literature review, focus group interview method and Delphi method, an evaluation index system for risk factors of peripheral venous indwelling catheter failure in adults was established.Results:The recovery rate of the two round were both 100%; the authority coefficient was 0.939, the coordination coefficient was 0.452 and 0.315 respectively ( χ2=607.88, 502.45, P<0.05). Finally an evaluation index system for adult peripheral venous indwelling needle catheter failure risk factors including puncture factors, patient factors, indwelling needle placement factors, indwelling needle maitenance and withdrawal factors and 54 second-level indicators were formed. Conclusions:The construction of adult peripheral venous indwelling needle catheter failure risk factor assessment system is reasonable and comprehensive in content, which provides reference for clinical nurses to evaluate and prevent the failure of adult peripheral venous catheter failure.

Objective:To understand the current status of health education competency of nursing staff in Anhui Province and explore its influencing factors, so as to provide a basis for nursing managers to improve the training effect of health education and do a good job in patient health education.Methods:This study was a cross-sectional study. The convenient sampling method was used to investigate 10 239 nursing staff from 23 ClassⅠ hospitals, 56 Class Ⅱ hospitals and 54 Class Ⅲ hospitals in Anhui Province from July to September in 2020 by using the general information questionnaire, Health Education Competency Self-Rating Scale for Nursing Staff, Self-efficacy Scale and Organizational Support Scale through electronic questionnaires. Totally 10 239 questionnaires were issued and 9 182 were effectively returned, with an effective recovery rate of 89.68%. Independent sample t test, variance analysis, Pearson correlation analysis and multiple linear regression analysis were used for data analysis. Results:The total score of health education competency of 9 182 nursing staff in Anhui Province was (347.47±50.66) , and the standard score was (78.08±11.38) . The total scores of Self-efficacy Scale and Organizational Support Scale were (29.45±6.16) , (48.49±11.26) , respectively. Multiple linear regression showed that initial degree, nursing level, teaching time, learning experience of school health education, training experience of hospital health education, work plan for health education, self-efficacy and organizational support were the factors influencing health education competency of nursing staff (adjusted R2=0.218, F=151.553, P<0.001) . Conclusions:The health education competency of nursing staff in Anhui Province is at the middle level, which still needs to be improved. Nursing managers should focus on improving the self-efficacy of nursing staff, and at the same time provide good organizational support for their clinical health education work, so as to improve the health education competency of nursing staff and provide better services to patients.

Objective To study the localization of the foramen of Monro on magnetic resonance image (MRI) and its clinical significance.Methods Cranial MRI was observed for 30 normal healthy subjects to study their location,shape and size of the foramen of Monro,as compared to those in 22 patients with hydrocephalus and 14 cases with tumor around their foramen.Results The the foramen of Monro is located between the fornix and the anterior part of thalamus in the normal healthy subjects,with a transverse diameter of 2.8 mm and a vertical diameter of 2.1 mm in average on MRI.Y-shaped structure is formed between their bilateral the foramen of Monro and the 3rd cerebral ventricle.Very obvious changes in shape and size of the foramen of Monro can be observed in patients with hydrocephalus,which sometimes can integrated with the 3rd cerebral ventricle and lateral ventricle,forming a"rabbit-head sign".Meanwhile, imaging of the foramen of Monro varied in patients with tumor around the foramen,depending on its location and size.Conclusions The foramen of Monro has a relative constant position in the brain.Changes in its position,size and shape are important signs suggesting intracranial lesions.An individualized operation plan for a patient should be determined based on those changes.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.