Objective To investigate the relationship of compression area, time and weight as risky factors with local injury and systemic pathophysiological responses in rats so as to establish repeatable experimental model of crush syndrome. Methods A total of 144 male SD rats were divided into two groups, ie, mortality investigation group and biochemical indicator investigation group. Every group included the same 18 subgroups based on 18 kinds of combination with different levels of compression area (the right or both hind limbs), time (4, 6, 8 hours) and weight (2, 3, 4 kg). The circumference of the compressed hind limbs of all rats were measured and serum potassium (K+), serum creatine phosphokinase (CK), creatinine and carbamide were measured too before compression and three hours after decompression. Incidence of myoglobinuria of all rats was recorded. Muscles and kidneys were evaluated morphologically. Results The compressed hind limbs of all rats swelled significantly after three hours of reperfusion (P ＜ 0. 05). All serum K + , CK, CR and BUN were increased significantly with the increase and prolongation of the compression area, time and weight (P ＜ 0.05). Signs of direct cellular damage and ischemia-reperfusion injury were found in histology specimens of local compressed muscle.Hyperemia of glomeruli and renal tubule was found in the kidneys. Renal tubular necrosis and renal tubular cast were observed in group with compression weight ≥3 kg and compression duration ≥6 hours.Conclusions Increase and prolongation of the compression area, time and weight can aggravate the severity of crush injury. Compression area is more risky factor of severe crush injury. Both hind limbs ascompression area, compression weight ≥ 3 kg and compression duration ≥ 6 hours can be the effective experimental conditions for establishment of crush syndrome model in rats.

Objective To investigate the relationship of STAT3 signal transduction pathway with proliferation,apoptosis and COX-2 expression of human esophageal carcinoma Eca-109 cell lines.Methods Eca-109 cells were treated with selective JAK2 inhibitor,AG490.MTT assay was used to detect the proliferation of Eca-109 cells,apoptosis was detected by flow cytometry,agarose gel electrophoresis of DNA and transmission electron micrograph(TEM).The expression of JAK2、p-JAK2、p-Stat3 and COX-2 was examined by Western blot.RT-PCR was performed to detect the levels of COX-2 mRNA expression.Results AG490 significantly inhibited the growth of human Eca-109 cells in a dose and time-dependent manner and induced apoptosis.AG490 inhibited the expressions of JAK2/STAT3 signal transduction pathway protein and down-regulated the expressions of p-JAK2 and p-Stat3(P

Objective To study the association of serum L-kynurenine changes with nutritional status and vascular stiffness in maintenance hemodialysis (MHD) patients. Methods Twenty gender- and age-matched healthy volunteers (healthy group) and 40 MHD patients,including 20 cases with α-keto aicd(α-keto acid group)and 20 cases without α-keto aicd(non-α-keto acid group)were enrolled in the study.Serum L-kynurenine was measured by high performance liquid chromatography.C-reactive protein (CRP)and interleukin 6 (IL-6)were detected.Subjective global assessment(SGA)and malnutrition inflammation score(MIS)were applied to evaluate the nutritional status.Pulse wave velocity(PWV)was used to evaluate arterial stiffness for both groups of MHD patients. Results Serum L-kynurenine was significantly higher in MHD patients than that in healthy subjects[(3.20±1.12)μmol/L vs (1.74±0.27)μmol/L,P<0.01],while such difference was not found between α-keto aicd group and non-α-keto-aicd group [(3.20±0.88)μmol/L vs (3.29±1.34)μmol/L,P>0.05].IL-6 was significantly higher in MHD patients as compared to healthy subjects[(6.45±3.78)ng/L vs(1.38±1.59)ng/L,P<0.01],while such difference was found between α-keto aicd group and non-α-keto aicd group[(3.37±0.82)ng/L vs (9.62±2.48)ng/L,P<0.051.There was no difference of CRP concentration between two MHD groups.As compared to non-α-keto acid group,higher SGA score(26.00±1.75 vs 22.67±2.61,P=0.001),lower MIS score(5.82±2.27 vs 10.00±2.62,P=0.002),lower left side PWV[(21.11±8.21)m/s vs(24.57±5.45)m/s,P=0.244]and lower right side PWV[(19.27±3.22)m/s vs (24.19±5.41)m/s,P=0.015]were observed in α-keto aicd group.Pearson analysis showed positive correlation between serum L-kynurenine and IL-6(r=0.352,P=0.011)and negative correlation between L-kynurenine and pre-dialysis Scr(r=-0.412,P=0.019). Conclusions Inflammation is common in MHD patients.Tryptophan degeneration product L-kynurenine may indicate inflammation status.α-keto acid improves nutritional status,anemia and arterial stiffness maybe through the alleviation of inflammation in MHD patients.

Xerostomia, as a common symptom in surgical patients, is mainly caused by factors such as strict food and liquid fasting, body change in metabolism and secretion function during the operation period, and decrease of patients' comfort during perioperative period. In this paper, Chinese and foreign researches on current status, influencing factors, assessment methods and mechanisms of secondary xerostomia during perioperative period were reviewed, and current nursing interventions were described, so as to arouse attention of medical staff to the symptom of xerostomia in surgical patients and to provide references for conducting quality nursing.

Objective To understand outpatients' mastering situation on cognition and maintenance knowledge of venous indwelling needle, to promote the proper use and maintenance of venous indwelling needle in outpatients. Methods A questionnaire survey was done among 135 patients with venous indwelling needle. Results Patients showed higher cognition on venous indwelling needle,poorer maintenance knowledge andmisunderstanding,and higher expectations on nurses' health education.Conclusions Nurses should do a goodjob of health education on the knowledge and maintenance guidance of venous indwelling needle to outpatients,to further promote its application,and to ensure the correct use of indwelling needle.

Objective:To develop the Health Promotion Behavior Intention Questionnaire for enterostomy patients and test its reliability and validity.Method:Based on the theory of planned behavior, the first draft of the questionnaire was formed through literature review, group discussion, correspondence with Delphi experts and pre-test. The convenient sampling method was used to select 419 patients with enterostomy who visited Stoma Outpatient Department of the Affiliated Hospital of Qingdao University from December 2020 to June 2021 to conduct a questionnaire survey. Item analysis and reliability and validity tests were carried out on the questionnaires.Results:The Health Promotion Behavior Intention Questionnaire for enterostomy patients included 15 items. Exploratory factor analysis extracted four common factors, namely, attitude, subjective norm, perceived behavioral control and behavioral intention. The cumulative variance contribution rate was 83.166%. The content validity index of item level was 0.875-1.000 and the content validity index of questionnaire level was 0.983. The Cronbach's α coefficient of the total questionnaire was 0.921 and the retest reliability coefficient was 0.848.Conclusions:The Health Promotion Behavior Intention Questionnaire for enterostomy patients has good reliability and validity and it can be used as a tool to evaluate the health promotion behavior intention of patients with enterostomy.

Objective To explore the effects of self-management intervention on the self-management ability and health service utilization of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 84 COPD patients in stable condition with permission of being discharged in respiratory department of a tertiary comprehensive hospital in Wenzhou city,were selected as research objects from May to November 2014 by convenience sampling method,and were randomly divided into the intervention group (n=42) and the control group (n=42). Patients in the control group received routine care,while patients in the intervention group received self-management intervention and all patients were followed up. The self-management scale of chronic obstructive pulmonary disease was used investigate the self-management status of patients three months,six months and 12 months after intervention. The times of emergency services and the times of re-hospitalization were also recorded.Results The self-management ability of patients at the third month,sixth month and 12th month after intervention in the intervention group was significantly improved compared with the control group (P<0.05). There was no significant difference in the aspect of health service utilization at the third month after intervention between two groups (P>0.05);the times of health service utilization in the intervention group at the sixth month and 12th month after intervention were less than the control group (P<0.05).Conclusions Self-management intervention can improve the self-management ability of patients with COPD in stable period,and reduce the times of emergency visits and re-hospitalizations. It is an effective method for the management of chronic diseases.

Objective:To explore the effects and dose-response relationship of Tai Chi for type 2 diabetes mellitus(T2DM)and to evaluate the methodological quality of the included trials and evidence quality of the outcomes.Methods:Nine major English and Chinese databases were searched for randomized controlled trials of Tai Chi for T2DM from inception to December 2021.The effects and dose-response relationships were assessed with a meta-analysis and meta-regression using Stata.16.The methodological quality of the included studies was assessed using the risk of bias tool.The evidence quality of the outcomes was assessed using the GRADE tool.Results:A total of 24 studies with 1314 patients were included.Compared with the usual care,Tai Chi improved HbA1c(MD=-0.80％,95％Cl[-1.05,-0.54],P＜.001,I2=18.29％,very low-quality evidence),FBG(SMD=-0.58,95％Cl[-0.86,-0.31],P＜.001,I2=53.2％,low-quality evidence),fasting insulin(FIN),diastolic blood pressure,BMI,and the outcomes of quality of life(QoL)in patients with T2DM.However,when Tai Chi was compared with other exercise,there was no between-group difference in the HbA1c,FBG,TC,TG,HDL,LDL,BMI,and waist circumference(WC).Furthermore,the findings showed that an increase at every 18 weeks in length or an 823-h increase in the total time of Tai Chi intervention resulted in approximately a one unit reduction in the SMD of FBG.Conclusion:Compared with usual care,Tai Chi may improve HbA1c(with clinical significance),FBG,FIN,BMI,diastolic blood pressure,and outcomes of QoL in T2DM patients.The effects of Tai Chi were similar to those of other exercises on the HbA1c,FBG,TC,TG,HDL,LDL,BMI,and WC.Given the overall poor methodological quality and evidence quality,these findings should be treated cautiously.

Objective To explore the influencing factors of massive hemorrhage during cesarean section of pernicious placenta previa,and establish a risk prediction model.Methods The clinical data of 340 pregnant women with pernicious placenta previa who underwent cesarean section for termination of pregnancy in this hospital from January 2017 to December 2021 were collected.They were divided into the common hemorrhage group (the amount of intraoperative blood loss<2000 mL,n=200) and massive hemorrhage group (the a-mount of intraoperative blood loss ≥2000 mL,n=140).The clinical characteristics of pregnant women,clini-cal data of this pregnancy,situation of the fetus,and imaging information were compared between the two groups.Combining the variables with a P value<0.05 in the univariate analysis and the possible influencing factors of massive hemorrhage during cesarean section in pregnant women with pernicious placenta previa in clinical practice,the binary multivariate logistic regression analysis was conducted,and a risk prediction model was established.Hosmer-Lemeshow goodness of fit test and receiver operating characteristic (ROC) curve were used to evaluate the fitting effect and discrimination of the model.Results The results of multivariate logistic regression analysis showed that the number of abortions,placental thickness,combining with placental implantation,number of previous cesarean sections and fetal gender were the independent influencing factors for massive hemorrhage (≥2000 mL) during cesarean section in pregnant women with pernicious placenta previa (P<0.05).The prediction model formula:P=Log (Y/1-Y),Y=0.396+1.371×(number of abor-tions=three times)+1.248×(number of abortions ≥ four times)-0.351×(placental thickness)+0.624× (combining with placental implantation)+0.974×(two or more previous cesarean sections)+0.638 × (female=0,male=1).The results of Hosmer-Lemeshow goodness of fit test showed that the prediction mod-el had good calibration ability (x2=77.825,P<0.001).The area under the ROC curve was 0.768 (95％CI:0.717-0.820),the specificity was 83.0％,the positive predictive value was 70.2％,and the negative predic-tive value was 73.5％.Conclusion The risk prediction model of massive hemorrhage during cesarean section in pregnant women with pernicious placenta previa has good performance.It is helpful to identify high-risk pregnant women in the prenatal evaluation,and provide a basis for formulating the blood transfusion plan in clinic,and prevention and treatment of adverse pregnancy outcomes.

Objective To use color Doppler ultrasound to measure the hemodynamic indexes,and to es-tablish the diagnostic prediction model of inflammatory fetal distress.Methods A total of 213 pregnant women admitted to the obstetrics department of the First Affiliated Hospital of Air Force Military Medical U-niversity were collected as the research subjects and divided into the control group and case group according to whether or not fetal distress occurred,including 93 cases in the control group and 120 cases in the case group.The predictive value of PI,RI,S/D values of middle cerebral artery,umbilical artery and uterine artery for pre-dicting fetal distress was analyzed The diagnostic model was constructed by logistic regression analysis.The receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve were adopted to an-alyze and evaluate the diagnostic efficiency of the model for adverse perinatal outcome and the clinical benefit of the patients.Results The univariate analysis results showed that MCA-PI,MCA-RI,MCA,S/D and CPR in the case group were lower than those in the control group,while UA-RI,UA,S/D and UtA-RI were higher than those in the control group.The multivariate regression analysis further showed that MCA-PI,MCA-RI and CPR were the independent protective factors for predicting fetal distress,while UA-R1 and UA-S/D served as the independent risk factors affecting the fetal outcome.Based on five independent influencing fac-tors,the risk prediction model was constructed,and the area under the receiver operating characteristic curve was 0.880(95％CI:0.834-0.925).The sensitivity,specificity and accuracy were 0.93,0.70 and 0.83 respec-tively,and the goodness of fit was good.Conclusion The hemodynamic indexes measured by color Doppler ul-trasound have good predictive value for the diagnosis of fetal distress.The risk prediction model established by the combined indexes has a certain reference value for the intervention in advance of pregnant women with fe-tal distress occurence.