Objective To explore the application of nursing project improvement in improving the compliance of late night snack and the albumin level in patients with liver failure.Methods From August 2016 to November 2017,a total of 96 chronic and acute liver failure patients who were hospitalized in He'nan People's Hospital were selected as the research subjects by convenience sampling method.All the subjects were divided into two groups according to the time of hospitalization.The patients who were hospitalized before the application of nursing project improvement,from August 2016 to March 2017,were assigned as the control group.After the application of nursing project improvement,from April 2017 to November 2017,the patients were assigned as the intervention group.The nursing project improvement activities has been implemented from April 2017.The causes of low compliance rate of patients with pre-bedtime meal addition were explored.Nursing project improvement group was established to formulate measures to improve the compliance of patients with liver failure before bedtime meal addition.The compliance of late night snack and the albumin level of the patients were compared between the two groups.Results The compliance of late night snack in patients with liver failure increased from 66.7％to 85.9％,and the difference was statistically significant(P < 0.01).The albumin level of the intervention group was higher than that of the control group after the improvement,and the difference was statistically significant(P<0.01).Conclusions Through the implementation of nursing project improvement,we could improve the compliance of late night snack in patients with liver failure,and improve the nutritional status of patients with liver failure.

Objective: To observe ascitic interleukin-7 expression level in cirrhotic patients complicated with spontaneous bacterial peritonitis, and to detect the effect of recombinant human IL-7 on CD4⁺ and CD8⁺T lymphocyte function. Methods: A total of 84 patients with liver cirrhosis who were hospitalized from August 2017 to April 2018 were selected. Among them, 51 cases were complicated with cirrhosis and untainted ascites, and 33 cases were cirrhosis complicated with spontaneous bacterial peritonitis. Peripheral blood and ascites were collected routinely. The levels of IL-7 in peripheral blood and ascites were measured by enzyme-linked immunosorbent assay. CD4⁺T cells and CD8⁺T cells were purified from ascites, and were stimulated with recombinant IL-7. Cellular proliferation, key transcription factors for mRNA, and cytokines production by CD4⁺T cells in response to IL-7 stimulation was measured. mRNA expression corresponding to perforin, granzyme B, and granulysin as well as cytokines production by CD8⁺T cells was also measured in response to IL-7 stimulation. Cytolytic and non-cytolytic activity of CD8⁺T cells in response to IL-7 stimulation was also investigated in both direct and indirect contact co-culture system. Measurement data of the normal distribution were compared between the two groups by Student’s t-test and the data before and after stimulation were compared by paired t-test. Measurements that did not conform to normal distribution were compared between the two groups using Mann-Whitney U test, and data before and after stimulation were compared using Wilcoxon paired test. Results: There was no significant statistical difference in serum IL-7 levels between the two groups [(5 001 ± 1 458) pg/ml vs. (4 768 ± 1 128) pg/ml, P = 0.41]. The level of ascitic IL-7 in cirrhotic patients complicated with SBP was significantly lower than cirrhosis patients with untainted ascites [(966.4 + 155.8) pg/ml vs. (792.1 + 126.4) pg/ml, P < 0.01]. Recombinant IL-7 stimulation promoted the proliferation of CD4⁺ and CD8⁺T cells from ascites in patients with liver cirrhosis complicated by SBP. T-bet mRNA relative expression and IFN-γ secretion in CD4⁺T cells was also elevated in response to IL-7 stimulation in vitro. Moreover, IL-7 stimulation also increased the mRNA expressions of perforin, granzyme B, and granulysin as well as productions of IFN-γ and TNF-α by CD8⁺T cells. Recombinant IL-7 stimulation elevated cytolytic and non-cytolytic activity of CD8⁺T cells from ascites in patients with liver cirrohosis complicated by SBP, which manifested as increased target cell death and IFN-γ production in both direct and indirect contact co-culture system. Conclusion Ascitic IL-7 promotes T lymphocyte function in patients with liver cirrhosis complicated with SBP.