Objective To investigate the mechanism of fibroblast growth factor(FGF)21 in liver lipid deposition.Methods HepG2 cells were divided into control group and induction group.Fatty liver cell model was constructed using oleic acid and palmitic acid in induction group.Lipid deposition under the microscope was observed between two groups by oil red O staining,and the protein expression of FGF21 and glutathione peroxidase 4(GPX4)in two groups were detected.FGF21 lentivirus-infected fatty liver cells were used as interference group,and scramble lentivirus-infected fatty liver cells were used as non-interference group.The expression level of FGF21 mRNA,lipid deposition and expression level of GPX4 protein were compared between two groups.Results Compared with control group,induction group had significant lipid deposition,significantly increased expression level of FGF21 protein,and significantly decreased expression level of GPX4 protein(P＜0.05).After the interference of FGF21 lentivirus,expression level of FGF21 mRNA was significantly decreased,lipid droplets were decreased,lipid deposition was significantly improved,and GPX4 protein expression level was significantly increased in interference group(P＜0.05).Conclusion FGF21 may promote liver lipid formation by inhibiting lipid peroxidation.

Objective:To apply the best evidence of hypoglycemia management for neonates delivered by mothers with gestational diabetes mellitus (GDM) in clinical practice and evaluate its curative effects.Methods:This study was a historical controlled study. The newborns delivered by GDM mothers who were admitted to the neonatal intensive care unit of a Class A hospital in Hefei from February to December 2019 were selected as the research objects by convenient sampling. Newborns delivered by GDM mothers admitted to the hospital during the application of evidence-based practice were the subjects of the pre-evidence study ( n=53) , and newborns delivered by GDM mothers admitted to the hospital after applying the evidence-based practice from September to December 2019 were used as evidence Post-application research subjects ( n=59) . Evidence-based nursing was used to obtain best evidence. Based on the evidence-based continuous quality improvement model as the theoretical framework, the evidence-based practice plan for neonatal hypoglycemia management of gestational diabetes mothers during delivery was constructed and applied. Before and after the application of evidence-based practice, 63 neonatal nurses and parents of neonates were surveyed with the self-made GDM Mothers' Newborn Hypoglycemia Management Questionnaire and the Chinese version of the Uncertainty of the Disease Parents Scale, respectively. And the changes in the incidence of hypoglycemia within 2 hours after birth was compared before and after the application of evidence-based practice. Results:A total of 7 pieces of evidence were used in the evidence-based practice. After the application of the evidence-based practice, the incidence of hypoglycemia in neonates delivered by mothers with gestational diabetes within 2 hours after birth decreased from 20.8% (11/53) to 3.4% (2/59) , and the difference was statistically significant (χ 2=8.206, P<0.05) . The score of the questionnaire on knowledge of hypoglycemia management of neonates delivered by mothers with gestational diabetes mellitus in 63 department nurses was increased from (7.00±1.43) to (7.84±1.18) , and the difference was statistically significant ( t=-12.253, P<0.05) . Before and after the application of evidence-based practice, scores of Mishel Uncertainty in Illness Scale for newborn parents were respectively 87.00 (65.00, 99.50) and 59.00 (43.00, 74.00) , and the difference was statistically significant ( U=728.500, P<0.01) . Conclusions:Evidence-based practice for blood glucose management of newborns delivered by gestational diabetic mothers can reduce the incidence of neonatal hypoglycemia and the uncertainty of their parents' diseases, improve nurses' neonatal hypoglycemia management level, and promote continuous improvement of nursing quality.

Objective To explore the relationship between the serum neuropeptide Y (NPY) levels and the pathogenesis,therapeutic intervention of schizophrenia. Methods One hundard twenty-five patients with schizophrenia (case group) with no medication for at least 4-week and 136 healthy controls (control group) were evaluated by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Positive and Negative Syndrome Scala (PANSS). Simultaneously blood tests were performed to detect serum NPY levels. In the case group, PANSS was evaluated and blood collected again after 4 weeks of treatment with olanzapine. Result At the baseline,the serum NPY concentration was significantly lower in the case group than in control group (t=-5.79, P<0.01). The scores of RBANS and its factors were significantly lower in the case group than in control group (all P<0.01). The concentration was positively correlated with the score of the attention factor for RBANS scale (r=0.20, P=0.04). After treatment with olanzapine for 4 weeks,the serum NPY level in the case group was significantly increased (t=-2.23,P=0.03).The scores of PANSS total scale and subscale were significantly decreased(all P<0.01).There was no significant correlation between alterations of the serum level of NPY and PANSS total or subscale scores from baseline to 4-week (all P>0.05). Conclusion The present study has revealed a significant decrease in serum NPY levels in patients with schizophrenia which can be attenuated by treatment of Olanzapine.The action of Olanzapine may be related to the mechanism of action of Olanzapine.However,there is no correlation between alterations of the serum level of NPY and the improvement in the patientˊs clinical symptoms.

Objective To investigate the distribution and changes of microorganisms on the skin of submariners under a chronically closed environment , and provide reference for targeted medical support .Methods One hundred and twenty-two samples were collected using swab.After culture and isolation, the microbes were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF-MS) .Results A total of 52 types of 229 bacteria and 2 types of fungi were isolated . Major opportunistic pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae, while major dwelling bacteria included Micrococcus luteus, Oslo Mora bacteria, Acinetobacter, Staphylococcus epidermidis, and Serratia marcescens.Compared with the early period of the task, major opportunistic pathogens and dwelling bacteria were significantly increased in the middle and late period of the task .Conclusion The skin microbes of the submariners are investigated , targeted drugs need to be prepared for daily medical support and war trauma .

Objective To understand the situation of psychological distress, self-disclosure and intimate relationship in spouses of patients with breast cancer and analysis their interrelationship. Methods Totally 240 spouses of breast cancer patients from 3 class Ⅲ grade A hospitals in Jiangsu Province were investigated with distress thermometer (DT), distress disclosure index(DDI), short marital adjustment and prediction test as well as general information questionnaire from July 2015 to July 2016. Single factor analysis was performed using rank test, and correlations analysis was performed by Spearman analysis. Results The average score of psychological distress was(5.2±4.7) points, self-disclosure (36.5±32.7) points, intimate relationship (118.2±36.5) points and marital disorder detection rate was 25.9%. The prevalence of psychological distress was 67.4% and there was a significant difference in DT score among the spouses of patients with different education level (Z= 7.519,P<0.05). Spouse psychological distress was negatively correlated with self-disclosure degree and the degree of intimacy(r=-0.673,-0.721;P<0.01). Intimate relationship took a partial effects as mediator between the psychological distress and the degree of self-disclosure. Conclusions The incidence of psychological distress is high in spouses of patients with breast cancer, and the severity is influenced by self-disclosure and intimate relationship. Intimacy takes a partial effects as mediator between the psychological distress and the degree of self-disclosure.

Objective To explore the application effect of concept map teaching of group-discussing mode in standardized nursing training. Methods A total of 80 standardized training nurses in Wuxi No.2 People's Hospital from January 2016 to December 2016 were selected by purposive sampling and randomly divided into the intervention group and the control group, with 40 students in each. The control group was taught according to the conventional teaching method, and the intervention group was taught with the concept map teaching of group-discussing mode. The scores of the independent learning ability assessment scale and the scores of theoretical examination were compared before and after the intervention. The scores of the feedback evaluation scale of concept map teaching of group-discussing mode in the intervention group were observed. Results The score of each dimension and the total score of the independent learning ability assessment scale of the intervention group after intervention were higher than those in the control group, and the difference was statistically significant (P<0.05). The score of theoretical examination in the intervention group was higher than that in the control group with statistical difference (P<0.001). The nurses in the intervention group had a better feedback on the concept map teaching of group-discussing mode. Conclusions The concept map teaching of group-discussing mode obtains good application results in clinical nursing teaching and training, and it can improve the nurses' independent learning ability.

Objective To investigate the effects of companion support on oral medication compliance and anxiety in tumor patients.Methods A total of 78 cases of tumor patients with pain were randomly divided into intervention group (n=39) and control group (n=39) and investigated using randomized controlled study. Patients in control group received routine analgesic care, while patients in intervention group received additional 3-month companion support intervention. Treatment compliance and anxiety of patients were compared between two groups.Results After the intervention, patients′ treatment and medication compliance including number of oral medication, medication time, dosage, adherence to continuous medication in intervention group were better than patients in control group. The differences were statistically significant (t=6.366, 2.646, 3.552, 2.588, 3.551;P<0.05). The scores of anxiety of the patients in intervention group were significantly lower than that in control group (t=-2.542,P<0.05).Conclusions Companion support intervention can increase oral medication compliance and improve the anxiety of tumor patients.

Objective To analyze the effects of Orem support-education system on negative emotions and self-management capabilities of lung cancer patients with chemotherapy.Methods A total of 85 cases of lung cancer patients treated with chemotherapy were selected and divided into,according to random number table method,observation group with 44 cases intervened by Orem support-education system,and control group with 41 cases treated by conventional health education.Changes of anxiety,depression and self-management capabilities before and after the intervention in the two groups were compared.Results After the intervention, anxiety and depression scores in the observation group were (41 .55 ±4.81 )points and (43.36 ±5.58)points, significantly lower than (46.73 ±3.91 )points and (48.22 ±6.1 0)points in the control group;capabilities of stress reduction,positive attitude,decision-making and self-management in the observation group were all higher than that in the control group (P <0.05).Conclusions Orem support-education system is significant for lung cancer patients with chemotherapy in alleviating their emotions of anxiety and depression,and enhancing their self-management capabilities.

With the rapid development of early diagnosis and cardiac surgery technology, the survival rate of children with congenital heart disease ( CHD ) was improved; survival time was prolonged, and the quality of life drew more and more attention. This article summarizes the internal and external influencing factors that affect the quality of life of children with CHD, in order to know better about the influencing factors of quality of life in children with CHD, and provides the intervention basis for the children with CHD.

Objective To explore innovative forms of health education in nursing management of ambulatory surgery under the health care reform situation.Methods Single disease health education guidelines were established according to standard clinical nursing path.Health education manager model was formed by combination of health education information platform and personal responsible nurses.By applying four-grade quality control management,individualized and overall health education was conducted to the patients.Therapeutic effect of patients in the ambulatory surgery ward was evaluated.1 300 discharged patients were surveyed by phone about their satisfaction to the nursing.Results Hospitalized days and expenses of patients undergone ambolatory surgery were fewer than patients with the same disease yet in general wards;0.08％ of the patients were transferred to general wards,and another 0.08％ were readmitted because of accident.Patients' satisfaction to the nurses' technique,service,communication and education was 100.0％,98.2％,100.0％ and 100.0％.Conclusions Health education manager model in ambulatory surgery ward can guarantee therapeutic effect of the surgery and meet the patients' need of health education.