OBJECTIVE:To optimize the water extraction technology of Punica granatum peel and flowers in Muzha supposito-ry. METHODS:Using total tannin,ellagic acid contents as evaluation indexes,extration time,times,the amount of solvents as in-vestigation factors,L9(34)orthogonal test was adopted to optimize the water extraction technology of P. granatum flowers and peel. And verification test was conducted. RESULTS:The optimal extraction technology of total tannin and ellagic acid in P. granatum peel and flowers was as follow as 10-fold water reflux extraction for 3 times with 2 herbs,0.5 h every time. The average content of total tannin and ellagic acid extracted from 3 batches of herbs was 151.69 mg/g (RSD=1.15%,n=3),24.59 mg/g (RSD=1.41%,n=3)in the verification test,respectively. CONCLUSIONS:The optimized extraction technology is stable,feasible,and can be used for extracting the total tannin and ellagic acid in P. granatum peel and flowers.

By using SWOT method, we analyze the strengthen, weakness, existing opportunity and challenging of applying Mini-CEX which is named Mini Clinical Evaluation Exercise in theOrgan-system-based curriculum modelclinical nursing teaching, and propose related development strategy of Mini-CEX.

Objective:To evaluate the quality of root filling with Resilon/Epiphany Self-Etch(RESE).Methods:30 recently extrac-ted mandibular premolars were randomly divided into 2 groups.After root canal preparation,the roots in experimental group(n =1 4) were filled with RESE,those in control group(n =1 6)were filled with Gutta-percha/AH plus.The quality of the optical obturation was evaluated by X-ray photography.Results:The buccolingual X-ray scores of the two filling materials were higher than the mesiodistal sores(P <0.05),there was no statistical significance between the two kinds of filling materials(P >0.05).The mesiodistal X-ray score of RESE group was higher than that of Gutta-percha/AH plus group(P <0.05).Conclusion:The X-ray resistance of the RESE filling system is more favorable than Gutta-percha/AH plus for the evaluation of root filling quality by X-ray examination.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

Objective:To provide data support for acquired immunodeficiency syndrome (AIDS) clinical treatment by evaluating the antiviral therapy effect of integrase inhibitors (INIs) and analyzing the drug resistant mutations.Methods:Patients who exposed to INIs more than 1 year were analyzed retrospectively. Virus suppression failure subjects(viral load ≥1 000 copies/ml) were sequenced for drug resistance analysis.Results:Of 408 patients, 12 cases(2.9%) were virologic failure, 8 cases had drug resistance mutations. The proportion of drug resistance was 2.0%(8/408). Among them, only 1 case(0.2%, 1/408) was resistant to INIs with associated mutations: T66I, G118R and E138K; 7 cases(1.7%, 7/408) were resistant to nucleoside reverse transcriptase inhibitors(NRTIs) with major mutations: M184V/I, D67N for NRTIs; 5 cases(1.2%, 5/408) were resistant to non-nucleoside reverse transcriptase inhibitors(NNRTIs) with major mutation: K103N; 1 case(0.2%, 1/408) was resistant to protein inhibitors (PIs), and associated mutations was I50L.1 case was resistant simultaneously to INIs, NRTIs and NNRTIs, Dual-class mutations were observed in 4 cases(3 cases to NRTIs and NNRTIs, 1 case to PIs and NNRTIs).Conclusions:The study result showed that the drug resistance rate of INIs was low in Hunan province, however, the INIs drug resistance surveillance was necessary.

Objective To explore the application and effects of the cognitive evaluation theory-based family communication pattern in follow-up management in young stroke patients. Methods Totally 88 young patients with initial stroke admitted in the 2nd Affiliated Hospital of Wenzhou Medical University between June 2016 and June 2017 were selected, divided into the control group (n=44) and the intervention group (n=44) by governor-controlled study. Patients in the control group received conventional follow-up after discharge, while patients in the intervention group received follow-up management from the aspects of self-actualization needs, ability needs and belongingness needs based on the family communication pattern. The Self-management Behavior Scale for young stroke patients and Caregiver Burden Inventory (CBI) were used to compare the self-management behavior and caregiver burden between the two groups before and after the intervention. Results Six months after discharge, the intervention group's self-management behavior score was (73.69±11.65), while that of the control group was (66.37±16.78),the difference was statistically significant (t=2.377, P＜0.05). The caregiver burden score of the intervention group was (35.97±7.49), lower than that of the control group,the difference was statistically significant (t=3.866,P＜0.01). Conclusions The cognitive evaluation theory-based family communication pattern can effectively enhance the sense of coherence and reduce the caregiver burden in young stroke patients.

The update of multi-omics technology is a key means to promote the rapid development of accurate health model in the whole life cycle.It can formulate dynamic and accurate nursing measures and provide massive data information from the perspective of nursing biology of health and disease.At present,clinical nursing research faces many challenges such as insufficient application and transformation ability of multi-omics technology.This paper introduces the multi-omics technology,reviews the application status of multi-omics technology in cancer nursing,maternal and child nursing,chronic metabolic disease nursing and symptom management,and puts forward the cross integration and prospect of multi-omics technology and nursing research,so as to strengthen the information mining ability of nurses at different levels of health and disease,and provide an important basis for accelerating the clinical transformation of precision nursing.

Objective To analyze the effect of HIV/AIDS patients receiving antiretroviral therapy (ART) for the first time in Jiangyin, and to provide a reference for further improvement of Jiangyin's AIDS antiretroviral treatment. Methods The historical cards and related information in the treatment management database of Jiangyin City's cases who received ART for the first time from 2005 to 2019 were collected and statistically analyzed. The changes in viral load and CD4+ T lymphocytes (CD4 cells) before and after treatment were compared. Results Among 652 patients receiving ART, 507 cases (77.76%) were successful in virological treatment. The median natural change rate of annual average CD4 cell count was 90.8 cells/μL/year (χ²=37.915, P<0.05; H=9.781, P<0.05). There were statistically significant differences in virological treatment and immune recovery between different age groups (χ²=10.713, P<0.05; H =10.394, P<0.05) and different baseline CD4 count layers. The results showed that age and baseline CD4 value were the influencing factors of treatment effect. Conclusion Age and baseline CD4 value can affect the effect of ART treatment. The older the age and the lower the baseline CD4 value, the worse the virological efficacy and the recovery effect of CD4 cells. It is suggested that the infected patients should be involved in ART in time, which is conducive to shorten the time of initial treatment and further improve the effect of antiviral treatment.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.