This paper introduces the development and implementation of hospital-community interactive nursing mode for patients with diabetes. The interactive mode between community and hospital,specialist nurses and community nurses,as well as patients and nurses was formed to provide timely,convenient,continuous and whole-process nursing care for diabetic patients through the setting up and services of hespital-based diabetes care team,two-way transfer center between hospital and commu-nity,hospital-based education and community-based visit team,community-based self-management group as well as green chan-nel of priority treatment,inspection and hospitalization for diabetic patients. The implementation of the interactive mode achieved good effect and was approved by the patients. The patient satisfaction rate was 96.5%.

Objective To investigate the dynamic change of pro‐and anti‐inflammatory eytokines of sepsis patients and its signif‐icance in clinical condition .Methods Forty‐three sepsis patients from 2010 to 2011 were divided into the survival group and the death group .Morning serum samples were collected on the first ,third ,firth and seventh day morning ;ELISA method was used to quantify the serum level of TNF‐α,IL‐1 ,IL‐4 and IL‐10 .The severity of patient′s condition was assessed according to the APACHEⅡsystem .Results In the early stage ,TNF‐α and IL‐1 in of both group increased and reached the peak on the third day ;then there was a gradual decline .Test in the same time point showed that the indexes of death group were all higher than that of survival group (P<0 .05) .IL‐4 of the two groups reached its peak on the fifth day and then declined ,and in the same time point ,indexes of death group were much more higher than that of survival group (P<0 .05) .IL‐10 of the survival group reached its peak on the fifth day and then declined;in the death group ,IL‐10 level kept increasing and maintained high ,there was no significant difference among the serum levels of the third ,fifth and seventh day(P>0 .05) .The APACHE Ⅱ of the survival group declined significantly while in death group it kept increasing and stay high .Conclusion Pro‐inflammatory eytokines(TNF‐α,IL‐1) ascended earlier than anti‐in‐flammatory eytokines(IL‐4 ,IL‐10) ,and the serum level of IL‐10 keep high level prompt the poor prognosis .

Objective To investigate the application of the central venous catheter (CVC) specialized for drainage intervention in severe acute pancreatitis (SAP) patients.Methods Sixty-two severe acute pancreatitis patients with seroperitoneum were randomly (random number) assigned into two groups:the drainage group (n =31) and the control group (n =31).All patients were treated with conventional internal medicine therapy.Patients of drainage group were treated with continuous peritoneal drainage by using the central venous catheter.The intra-abdominal pressure (IAP),lactic acid (LAC),and procalcitonin (PCT) were detected before and 12 h,24 h,48 h,72 h,5 days after intraperitoneal drainage.The symptoms of abdomen pain,abdomen distention,resume of bowel movement and the rate of MODS were observed.Results All patients with drainage got catheter successfully inserted.Compared with the control group,the IAP,LAC and PCT decreased significantly in the patients of drainage group.And the duration of abdomen pain,abdomen distention and resume of bowel movement function in the drainage group were shorter and the rate of MODS was lower.Conclusions Application of CVC specialized for intraperitoneal drainage is a safe and effective method for the treatment of pancreatitis with seroperitoneum.It is worthwhile to be widely used in clinic.

It is well established that neural stem cells (NSCs) are not randomly distributed throughout the brain, but rather are concentrated around blood vessels. Although NSCs lie in a vascular niche, there is no direct evidence for a functional relationship between the NSCs and blood vessel component cells. It is reported that endothelial cells release soluble factors that stimulate the self-renewal of NSCs, inhibit their differentiation, and enhance their neuron production. Endothelial coculture can activate Notch to promote self-renewal. Furthermore, vascular endothelial growth factor (VEGF) plays a significant role in neural cells; it stimulates the growth and differentiation of astrocytes in the central nervous system (CNS). Therefore, beyond their traditional role as structural components of blood vessels, endothelial cells are not only critical component of the neural stem cell niche, but they also are able to enhance neurogenesis, possibly through the secretion of brain-derived neurotrophic factor.
Brain-Derived Neurotrophic Factor ; secretion ; Cell Differentiation ; physiology ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Endothelial Cells ; cytology ; physiology ; Humans ; Neurons ; cytology ; Stem Cells ; cytology ; Vascular Endothelial Growth Factor A ; physiology

Objective:To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods:A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels: Group A(uric acid≤199 μmol/L), Group B(uric acid 200~399 μmol/L)and Group C(uric acid≥400 μmol/L). Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results:There was no significant difference in the degree of left main stenosis between Group A and Group B, but it was less severe in both groups than in Group C( F=5.625, P=0.039). Plaque fibrous cap thickness showed no significant difference between Group B and Group C, but it was smaller than in Group A( F=7.825, P=0.020). Group C had the largest plaque area and maximum thickness among the three groups, followed by Group B[(11.12±1.73)mm 2 and(1.76±0.24)mm]and Group A[(8.29±3.14)mm 2 and(1.38±0.09)mm]( F=6.384 and 6.827, P=0.028 and 0.015). Conclusions:Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques, and reduce plaque fibrous cap thickness, leading to an increased risk of formation of unstable plaques, which can be life-threatening for these patients.Thus, monitoring and managing uric acid levels should be stressed in elderly CHD patients.

Objective This study investigated the protective effects of Corni Fructus ethanol extract on β-amyloid protein 25-35 (Aβ25-35)-induced Alzheimer's disease (AD) mice by regulating histone lysine-specific demethylase 1 (LSD1) / postsynaptic density protein 95 (PSD95) on synapses and neuroinflammation. Methods Specifically, according to the body weight, 40 C57BL/6N mice were randomized into four groups: the sham operation group, the model group, the low-dose (0.1mg/g) and the high-dose (0.3 mg/g) Corni Fructus ethanol extract groups. Aβ25-35 was injected into the hippocampus of mice in three groups except for the sham operation group to established AD model. All mice were orally administered with either Corni Fructus ethanol extract or vehicle by gavage for 7 days before molding and continued 5 days after surgery for a total of 60 days. Morris water maze, Y maze and open field tests were performed to evaluate the recognition memory and space exploration ability of mice. The expression of LSD1, PSD95, synaptophysin (SYN), interleukin-1β (IL-1β), tumor necrosis factor-α(TNF-α) and H3K9me2 level were measured by Western blotting. Chromatin immunoprecipitation (CHIP) combined with qPCR was used to detect H3K9me2 modification of PSD95 promoter region and mRNA levels of PSD95. The correlation between the expression of H3K9me2 and PSD95 and the expression of IBA1 in the hippocampus were detected by immunofluorescence assay.Results The result showed that Corni Fructus ethanol extract significantly reversed Aβ25-35-induced learning and memory impairment in AD mice. Compared with the model group, Corni Fructus ethanol extract demonstrated shorter escape latency, increased number and time of autonomous activities and the rate of autonomous alternation. Moreover, it increased the expression of LSD1 in hippocampus of AD mice(P<0.05), and reduced H3K9me2 modification level in the promoter region of PSD95 gene, and then promoted the mRNA transcription and protein expression of PSD95. Immunofluorescence staining indicated the reduction of H3K9me2 modification level in hippocampus was accompanied by the enhancement of PSD95 expression. Corni Fructus ethanol extract could also inhibit the activation of microglia and reduce the expression of proinflammatory factors IL-1β and TNF-α.Conclusion Corni Fructus ethanol extract may regulate PSD95 gene transcription by up-regulating the expression of LSD1 and reducing the H3K9me2 modification level in its promoter region, thereby increasing the expression of PSD95, a key protein in synaptic plasticity regulation, which alleviate neuroinflammatory response, improve learning and memory dysfunction in AD model mice, and thus play a protective role in Aβ25-35-induced nerve damage.

Objective To compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)and High Aspheric Lenslet(HAL)defocus lenses in controlling myopia.Methods A total of 214 children and adolescents who were fitted with defocus lenses(DIMS or HAL)in our hospital from January to June 2023 were selected,including 100 cases in DIMS group and 114 cases in the HAL group.Changes in parameters such as spherical lens power,cylindrical lens power,spherical e-quivalent(SE),corneal curvature(K),axial length(AL),binocular accommodative response(BCC),positive/negative relative accommodation(PRA/NRA),distance/near latent phoria(DLP/NLP),and accommodative convergence to accommodation ratio(AC/A)were compared between the two groups before wearing and after wearing the lenses for 6 months,and the effectiveness of myopia control between DIMS and HAL was further compared.Results After wearing the lenses(DIMS or HAL)for 6 months,the average increase in axial length was(0.09±0.14)mm,the average in-crease in spherical lens power was(-0.11±0.23)D,the average increase in astigmatism was(-0.07±0.16)DC,and the average increase in spherical equivalent was(-0.15±0.24)D,with statistically significant differences observed for all these changes(t=9.24,-7.27,-6.60,-9.03,respectively,P＜0.001).Compared with parameters before wearing the lenses,statistically significant differences were noted after wearing for 6 months in spherical lens power,cylindrical lens power,SE,BCC,PRA,DLP,average K,and AL(P≤0.001),except for NRA(t=-0.12,P＞0.05),NLP(t=-0.28,P＞0.05),and AC/A(t=0.33,P＞0.05).The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically signifi-cant difference only in the AL difference(t=4.38,P≤0.001),with no statistically significant differences observed for other parameter differences(P＞0.05).Conclusion Wearing defocus lenses has a positive effect on controlling myopia,delaying axial length elongation,and maintaining binocular visual function balance.

Objective To compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)and High Aspheric Lenslet(HAL)defocus lenses in controlling myopia.Methods A total of 214 children and adolescents who were fitted with defocus lenses(DIMS or HAL)in our hospital from January to June 2023 were selected,including 100 cases in DIMS group and 114 cases in the HAL group.Changes in parameters such as spherical lens power,cylindrical lens power,spherical e-quivalent(SE),corneal curvature(K),axial length(AL),binocular accommodative response(BCC),positive/negative relative accommodation(PRA/NRA),distance/near latent phoria(DLP/NLP),and accommodative convergence to accommodation ratio(AC/A)were compared between the two groups before wearing and after wearing the lenses for 6 months,and the effectiveness of myopia control between DIMS and HAL was further compared.Results After wearing the lenses(DIMS or HAL)for 6 months,the average increase in axial length was(0.09±0.14)mm,the average in-crease in spherical lens power was(-0.11±0.23)D,the average increase in astigmatism was(-0.07±0.16)DC,and the average increase in spherical equivalent was(-0.15±0.24)D,with statistically significant differences observed for all these changes(t=9.24,-7.27,-6.60,-9.03,respectively,P＜0.001).Compared with parameters before wearing the lenses,statistically significant differences were noted after wearing for 6 months in spherical lens power,cylindrical lens power,SE,BCC,PRA,DLP,average K,and AL(P≤0.001),except for NRA(t=-0.12,P＞0.05),NLP(t=-0.28,P＞0.05),and AC/A(t=0.33,P＞0.05).The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically signifi-cant difference only in the AL difference(t=4.38,P≤0.001),with no statistically significant differences observed for other parameter differences(P＞0.05).Conclusion Wearing defocus lenses has a positive effect on controlling myopia,delaying axial length elongation,and maintaining binocular visual function balance.

Objective:To document the clinical features of children with cerebral palsy (CP) using magnetic resonance imaging (MRI).Methods:The gross motor functioning of 325 children diagnosed as having CP was graded using the gross motor function classification system (GMFCS). The GMFCS grades were correlated with MRI results in univariate and multivariate logistic regression analyses. The significance of any relationship between the MRI results and co-morbidities was tested using chi-squared tests.Results:Cerebral dysplasia, cerebroventricular enlargement, periventricular leukomalacia (PVL), abnormal signals in the thalami, and morphological changes after hypoxic ischemic encephalopathy were all found to be significantly correlated with GMFCS grading. Moreover, the chi-squared tests indicated that PVL children, children with thinning of the corpus callosum and/or abnormal signals in the thalami were significantly more likely to have visual, auditory or speech impairment complications and/or mental retardation.Conclusions:The findings from MRI correlate well with types of CP, GMFCS grades and co-morbidities among CP children. MRI can be an effective tool for early diagnosis and prognosis of CP in children, indicating needs for clinical rehabilitation.

Objective: To analyze the silver content, homogeneity, and cytotoxicity of silver-containing products. Methods: (1) Five kinds of silver-containing products A, B, C, D, and E were purchased from the market, and products A, B, C, and D are liquid or gel form while product E was dressing form. The silver content of each product and the homogeneity of product E were determined by flame method. The sample number was 3. (2) Human hepatocellular carcinoma cell line (HepG2) was selected as the evaluation model. Four silver-containing products A, B, C, and D were diluted with high-glucose dulbecco′s modified eagle medium (DMEM) at multiple ratios of 1∶100, 1∶200, 1∶400, and 1∶800, and then they were used for cell culture. Cells cultured with high-glucose DMEM and high-glucose DMEM containing 20 μg/mL silver nitrate were used as blank control and positive control, respectively. The cell viability was determined by methyl thiazolyl tetrazolium assay, and each sample number was 5. (3) Four mass concentrations of 0.031 3, 0.062 5, 0.125 0, and 0.250 0 μg/mL were prepared from silver-containing product A, and then they were used to culture HepG2 cell. Cells cultured with high-glucose DMEM containing fetal calf serum and 294 μg/mL potassium dichromate were used as positive control, while those containing fetal calf serum were used as blank control. Hoechst 33258 staining method was used to detect apoptosis rate of cells. The tail moment, tail length, and the percentage of DNA in the tail of cells were observed by comet assay to evaluate DNA damage. The sample numbers were all 3. Data were processed with one-way analysis of variance and least significant difference-t test. Results: The silver content of products A, B, C, and D was (256.5±1.5) μg/mL, (271.5±1.3) μg/mL, (652.4±2.6) μg/g , (330.0±2.1) μg/g, which was in accordance with labelled amount. The silver content of product E was (0.158±0.013) mg/g, and the silver content of each piece of product E was (0.125±0.017) mg/g, showing good uniformity of product E. (2) Compared with the rate of blank control, the cell survival rates of product A at the dilution ratio of 1∶100, product B at the dilution ratio of 1∶100, and product C at the dilution ratio of 1∶100 and 1∶200 were significantly reduced (t=35.506, 8.914, 37.594, 30.693, P<0.01). Compared with the rate of positive control, the cell survival rates of product A at the dilution ratio of 1∶200, 1∶400, and 1∶800, product C at the dilution ratio of 1∶400 and 1∶800, products B and D at each dilution ratio were increased significantly (t=27.537, 18.262, 18.709, 26.333, 41.762, 15.776, 19.759, 20.443, 15.715, 26.792, 24.963, 31.803, 30.537, P<0.01). (3) The apoptosis rates of cells treated by 0.250 0 μg/mL product A and positive control were (6.1±0.4)% and (62.2±3.9)% respectively, which were significantly higher than the apoptosis rate of blank control [(3.3±0.7)%, t=13.327, 30.475, P<0.05]. The apoptosis rates of cells treated by 0.031 3, 0.062 5, 0.125 0 μg/mL product A were (2.9±0.4)%, (3.1±0.4)%, and (4.2±0.9)% respectively, which were close to the apoptosis rate of blank control (t=1.181, 0.133, 1.097, P>0.05). (4) The tail moment, tail length, and tail DNA percentage of cells cultured with 0.125 0 and 0.250 0 μg/mL product A were significantly higher than those cultured with blank control (t=29.026, 51.194, 21.851, 36.138, 24.721, 50.455, P<0.05 or P<0.01). However, the tail moment, tail length, and tail DNA percentage of cells cultured with 0.031 3 and 0.062 5 μg/mL product A were close to those cultured with blank control (t=5.878, 3.429, 2.779, 1.960, 1.328, 7.763, P>0.05). Conclusions The silver content of silver-containing products meets the requirements of the labeling. The concentration of product C is higher than that of other products, leading to a greater possibility of decreasing the survival rate of HepG2 cells. It is suggested that the products A and B should be taken as reference in the concentration setting of silver ion products. The product solution with higher concentration may have higher risk of damage to cell DNA. Therefore, it is not recommended to upregulate silver content of relevant products blindly in order to achieve better antibacterial effect.