Objective To analyze the influence of individualized health education on self nursing ability of patients with colon stoma.Methods 120 patients with colon stoma were divided into the observation group and the control group,60 cases in each group.The patients of the control group were given conventional basic knowledge education,and the patients of the observation group were given personalized custom health education.Self score,health responsibility score,HAMD score,Barthel index,postoperative complications of the two groups of patients were compared.Results The observation group with self realization (32.16 ±7.25)points,health responsibility (28.62 ± 7.99)points,Barthel index (47.56 ±30.11 )points,HAMD score (3.15 ±1.44)points,stoma necrosis rate (1.67%)mucosal prolapse rate (0.00%),stoma retraction rate (3.33%)and stoma hernia rate (1.67%)were significantly better than the control group with self realization (27.98 ±9.53)points,health responsibility (24.87 ± 8.03)points,Barthel index (33.37 ±24.49)points,HAMD score (5.99 ±3.66)points,stoma necrosis rate (13.33%)mucosal prolapse rate (11.67%),stoma retraction rate (23.33%)and stoma hernia rate (15.00%), with statistically significant difference (t =2.71,2.56,2.83,7.56,χ2 =4.32,5.46,8.72,5.35,all P <0.05). Conclusion To implement personalized health education on health behavior of the patients with colon stoma has a positive role,to promote the stability of the patient's condition,strengthen the patient's awareness of disease,improve patient self -care ability,reduce the occurrence of complications.

Objective To investigate the safety and efficacy on early treatment of large pancreatic pseudocyst by endoscopic ultrasound (EUS)-guided transgastric drainage. Methods The clinical data of 23 cases of large pancreatic pseudocyst treated with EUS-guided transgastric drainage from 2003 to 2008 was retrospectively analyzed. Results All were of single pseudocyst. Pseudocyst was present in the head of the pancreas in 3 cases, in the body of the pancreas in 11 cases, in the tail of the pancreas in 9 cases. Mean diameter of pancreatic pseudocysts was 11 cm( range 8 - 18 cm ). The interval between the finding of pseudocysts and EUS-guided transgastric drainage ranged 17 -65 d, averaging 31 d. Two had postoperative infection of the pseudocyst, one received percutaneons external drainage and the other one received surgical internal drainage. Three had postoperative gastrointestinal bleeding and were treated with antacid and hemostatic drugs. Patients were examined by CT two to three months later. Pancreatic pseudocysts disappeared completely in 6 cases and significantly shrank in the rest. The clinical symptoms of all patients,such as abdominal pain, abdominal bloating were significantly relieved. All patients were followed-up for 1 year, there was no pseudocyst recurrence, ulcer,bleeding or infection. Conclusions Early treatment of large pancreatic pseudocyst by EUS-guided transgastric drainage is safe and effective.

Objective To investigate the role of miR-223 in the pathogenesis of acute gouty inflammation.Methods The subjects were divided into 3 groups:65 acute gout patients (AG),50 inter-critical gout patients (IG),and 45 healthy controls (HC).The peripheral blood mononuclear cells (PBMCs) and the clinical laboratory parameters were all collected.The expression of miR-223 in the PBMCs was detected using realtime fluorescent quantitative polymerase chain reaction (RT-qPCR) (TaqMan probe).The PBMCs of 5 healthy people were stimulated with monosodium urate (MSU) (100 μg/ml) for 12 h,and then,miR-223,NLRP3 mRNA and IL-1β production were all measured using RT-qPCR and ELISA respectively.All data were analyzed by SPSS 17.0 statistical software,Wilcoxon rank sum test,t test and Spearman's correlations analysis were used for statistical analysis.Results ① The expression of miR-223 in AG and IG groups was both significantly decreased than that in the HC group (8±17 vs 26±76,P＜0.05;9±17 vs 26±76,P＜0.05;respectively),AG group was significantly decreased than that in the IG group [8(17) vs 9(17),Z=11.387,P＜0.01].② After stimulated with MSU in healthy controls,IL-1β production and NLRP3 mRNA were both significantly increased [(86±5) pg/ml vs (13±6) pg/ml,t=21.042,P＜0.01;5.2±0.4 vs 1.2±0.4,t=14.640,P＜0.01;respectively],while the expression of miR-223 was significantly decreased (0.34±0.20 vs 1.05±0.24,t=-5.164,P＜0.01).Conclusion The data suggests that miR-223 might be involved in the patho-genesis of spontaneous regulation,but further study is needed to discover the exact mechanism.

Objective To investigate the effect of personalized continuing education on the compliance of permanent colostomy patients. Methods A total of 160 cases to accept a permanent colostomy were selected from October 2011 to December 2013, and were averagely divided into experimental group and control group according to random number table method in accordance with the composition. The patients of the control group were given conventional educational methods while the patients of the experimental group were given personalized continuing health education on the basis of the control group. The Excise of Self-care Agency Scale ( ESCA) had been used for the assessment of patient′s self-care ability about colostomy. Results The score of the experimental group was higher than that of the control group at ESCA ( P <0. 05 ); the color judgment of colostomy, subsidiary products application of colostomy, the prevention and its nursing of colostomy complications in the experimental group were better than those of the control group (P <0. 05). The higher score in the experimental group also represented at aspects of patient′s self-care knowledge control (97. 5%), self-care implementation (92. 5%), achieving personalized health goal (97. 5%) and complier (96. 3%) compared with those of the control group (χ2 =4. 574, 6. 874, 7. 873, 9. 872,respectively;P <0. 05). Conclusions The personalized continuing health education can improve the compliance of permanent colostomy patients.

Objective To investigate the impact of ropivacaine on apoptosis of lippolysaccharide(LPS)-induced ulcerative colitis cell line NCM-460 and on activity of nucleotide oligomerization domain(NOD)-like receptor protein-3(NLRP3)inflammatome.Methods Human colon epithelial cell line NCM-460 was cultured in vitro and divided into control group(no intervention),model group(10 μg/mL LPS treatment),low/medium/high concentration ropivacaine group(10 μg/mL LPS and 0.5,1,1.5 mmol/L ropivacaine co-treatment,respectiv-oly).Cell viability was determined by cell counting kit 8(CCK-8)and the appropriate concentration was selected.The cells were then divided into control group,model group,ropivacaine group(10 μg/mL LPS and 1.5 mmol/L ropivacaine treatment)and ropivacaine+inhibitor group(10 μg/mL LPS,1.5 mmol/L ropiva-caine and 1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment),inhibitor group(10 μg/mL LPS+1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment)and ropivacaine+activator group(10 μg/mL LPS,1.5 mmol/L ropivacaine and 1 μmol/L NF-κB pathway activator Prostratin),all groups were treated for 24 h.The level of IL-6,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay(ELISA).The proliferation rate was detected by EdU incorporation.Hoechst 33258 staining microscopy was used to detect the apoptosis rate.Level of cyclinD1,caspase-3,NLRP3 and NF-κB pathway-related proteins were detected by Western blot.Results Compared with the control group,the cell viability of the model group was significantly decreased and the cell viability of high-concentration experimental group was increased after adding ropivacaine(P＜0.05).So,1.5 mmol/L ropivacaine was selected for the follow-up experiment.Compared with the control group,the concentration of inflammatory cytokines IL-6,IL-8,TNF-α,apoptosis rate and the protein expression of caspase-3,NLRP3 and phosphorylated p-NF-κB in model group were all significantly increased(P＜0.05),while the proliferation rate and cycilnD1 protein expression were decreased(P＜0.05).Com-pared with model group,the concentrations of IL-6,IL-8,TNF-α,apoptosis rate and the expression of caspase-3,NLRP3 and p-NF-κB protein in ropivacaine group and inhibitor group were significantly decreased(P＜0.05),while the proliferation and cycilnD1 protein expression were increased(P＜0.05).Compared with ropivacaine group,the trend of the above indexes in ropivacaine+inhibitor group was more significant(P＜0.05),and the trend of these indexes in ropivacaine+agonist group was significantly reversed(P＜0.05).Conclusions Ropivacaine can inhibit the activation of NLRP3 inflammasome and block the signal transduction of NF-κB pathway,further inhibit LPS-induced apoptosis of NCM-460 cells and promote proliferation.

Objective To investigate the status of self-management in patients with chronic heart failure (CHF) in Zhejiang province, and to explore the relationship between the self-management level and medical coping styles. Methods From March to September 2016, using the convenient sampling method, a total of 450 aged patients with chronic heart failure from 5 Class Ⅲ Grade A hospitals in 3 districts including Ningbo, Pinghu and Jiaxing of Zhejiang province, who were hospitalized in the Cardiovascular Department, were recruited as research subjects. The Self-Management Scale of Heart Failure Patients and Medical Coping Modes Questionnaire (MCMQ) were applied in the investigation to carry out the correlation analysis. Results A total of 450 questionnaires were distributed, and 437 valid questionnaires were collected. The Self-Management Scale of Heart Failure Patients in the 437 patients were (51.48±10.77) in total score, (18.90±3.10) in facing coping style, (16.12±2.18) in avoiding coping style and (11.85±1.82) in yielding coping style. Pearson correlation analysis showed that the total score of self-management was positively correlated with facing coping style (r=0.303, P＜0.01), negatively correlated with yielding (r=-0.157, P＜0.01), and positively correlated with avoiding coping style (r=0.117, P＜0.01). Multiple linear stepwise regression analysis showed that family monthly income, self-care ability and marriage were the main factors affecting self-management of patients with chronic heart failure. Conclusions Self-management level in patients with chronic heart failure in Zhejiang province is relatively low, and effected by family income, self-care ability, marriage and other factors. Nursing staff should understand different characteristics of different patients to provide personalized health education, improve their self management level, and promote the patients more actively face the disease, reduce and avoid negative medical coping.

Objective:To explore effects of transitional nursing with multidisciplinary cooperative model in management of postoperative pain in patients with hemorrhoids.Methods:By the convenient sampling method, a total of 80 patients who underwent hemorrhoids surgery in Department of Anorectal Surgery in the Second Affiliated Hospital of Wenzhou Medical University from January 2019 to January 2020 were selected. They were randomly divided into the observation group (40 cases) and the control group (40 cases) . The observation group adopted transitional nursing with multidisciplinary cooperative model, while the control group adopted routine nursing. The Numerical Rating Scale (NRS) score of pain, edema regression time, wound healing time and nursing satisfaction of two groups were compared before and after the intervention.Results:After 7 days of intervention, the NRS score of pain in the observation group was lower than that in the control group, and the difference was statistically significant (t=2.106, P=0.038) . After 1 month of intervention, the NRS score of pain in the observation group was lower than that in the control group, and the difference was statistically significant ( t=9.159, P<0.01) . The time of edema regression and wound healing after intervention in the observation group were shorter than those in the control group, and the differences were statistically significant ( t=8.754, 4.111; P<0.01) . The total satisfaction degree of patients in the observation group was higher than that of the control group after intervention, and the difference was statistically significant ( χ2=7.314, P<0.01) . Conclusions:Transitional nursing with multidisciplinary cooperative model can reduce pain of patients after hemorrhoids surgery, promote time of edema regression and wound healing and improve nursing satisfaction of the patients.

Objective Using bioinformatics methods to study the immune infiltration mechanism of Primary Sj?gren's syndrome(pSS)and to explore potential target Chinese medicines,which can provide new directions for the clinical treatment of pSS.Methods Gene expression profile microarray dataset of pSS was downloaded from the GEO database,differential genes were screened using R software,and gene ontology(GO)and gene pathway enrichment(KEGG)enrichment analysis was performed on these differential genes.Protein interaction network analysis of differential genes was performed by applying the STRING database,key genes were screened by using Cytoscape,and ELISA for the verification of key genes expression.Immune infiltration and correlation of immune cells in pSS were calculated by CIBERSORT inverse convolution method in 22.Finally,the herbal prediction of key target genes was performed by using the Coremine Medical database.Results A total of 232 differential genes were obtained,of which 207 were up-regulated and 25 were down-regulated.GO was mainly enriched in:leukocyte mediated immunity,lymphocyte mediated immunity,leukocyte cell-cell adhesion,etc;KEGG was mainly enriched in Hematopoietic cell lineage,Primary immunodeficiency,Intestinal immune network for IgA production,Phagosome,Leishmaniasis.Ten key genes were screened:PTPRC,CD19,LCP2,CCR5 and CD69 etc.The hub genes expression in the pSS is the same as that of GSE40611.Immune infiltration showed that memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve were highly expressed in the pSS.Immune cell correlation analysis showed a positive correlation between initial Monocytes and T cells regulatory(Tregs),a positive correlation between Macrophages M1 and B cell na?ve,and a negative correlation between Plasma cells and T cells CD4 memory activated.COREMINE Medical predicted that Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,and Strychni may treat pSS.Conclusion The development and progression of pSS are the results of the combined involvement of multiple genes and pathways.Memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve may promote the development of pSS.The predicted Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,Strychni may be used as target herbs for the potential treatment of pSS.

Objective:Using bioinformatics methods to study the immune infiltration mechanism of lupus nephritis(LN)and to explore potential target Chinese medicines,which can provide new directions for clinical treatment of LN.Methods:Gene expres-sion profile microarray dataset of LN was downloaded from GEO database,differential expressed genes(DEGs)were screened using R software,and GO and KEGG enrichment analysis were performed on these DEGs.Protein interaction network analysis of DEGs was performed by applying STRING database,key genes were screened by using Cytoscape,core gene expression was validated by Nephro-seq database,and the infiltration and correlation of 22 kinds of immune cells in LN were calculated by CIBERSORT deconvolution algorithm.Finally,herbal prediction of significantly enriched immune-related biological processes and key target genes were performed by Coremine Medical database.Results:A total of 367 LN-related DEGs were obtained,of which 253 were up-regulated and 114 were down-regulated.GO was mainly enriched in response to viruses,defense response to viruses,regulation of viral life cycle,regulation of viral processes,etc;KEGG was mainly enriched in S.aureus infection,COVID-19,influenza A,complement and coagulation cascade,pertussis,etc.Ten key genes were screened:IFIT3,OAS2,MX1,OAS1,RSAD2,XAF1,ISG15,IFIT1,ITGAM and PTPRC.Immune infiltration by CIBERSORT deconvolution algorithm showed that monocytes and initial B cells were highly expressed in LN,while memory B cells,naive CD4+T cells,follicular helper T cells and resting natural killer cells were lowly expressed in LN.Immune cell correlation analysis showed a positive correlation between initial B cells and plasma cells,a positive correlation between resting natural killer cells and resting dendritic cells,a negative correlation between monocytes and regulatory T cells,and a negative correlation between resting CD4+memory T cells and monocytes.Coremine Medical predicted that Salvia miltiorrhiza,Panax notogin-seng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony were found to be most closely related to immunity in LN.Conclusion:The development and progression of LN are results of the combined involvement of multiple genes and pathways.Mono-cytes,memory B cells,initial CD4+T cells and initial B cells are most closely associated with LN.The predicted Salvia miltiorrhiza,Panax notoginseng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony may be used as target herbs for the poten-tial treatment of LN.

Objective To analyze of the therapeutic effect of Weifuchun capsules combined with quadruple therapy on elderly patients with chronic atrophic gastritis(CAG)infected with Helicobacter pylori(Hp).Methods Elderly Hp-infected CAG patients admitted to Affiliated Hospital of Shaoxing University from April 2019 to April 2023 were divided into a control group(treated with classic quadruple therapy)and an experimental group(treated with Weifuchun capsules combined with classic quadruple therapy)according to different regimens.The clinical treatment effects of two groups of patients were compared,the clinical symptom scores,changes in serum gastrointestinal hormones,inflammatory factors levels before and after treatment,and the adverse reactions and Hp recurrence were compared.Results A totol of 300 patients were included in the study,with 150 cases in each group.After treatment,the clinical symptom score,pepsinogen(PG)Ⅱ,high-sensitivity C-reactive protein(hs-CRP),serum tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-8 levels in the experimental group were lower than those in the control group(P＜0.05),and the levels of PG Ⅰ,gastrin-17(GAS-17)in the serum,and total effective rate were higher than those in the control group(P＜0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P＞0.05),and no Hp recurrence was seen in either group.Conclusion The combination of Weifuchun capsules and classic quadruple therapy has shown good efficacy in treating elderly Hp-infected CAG patients,which can effectively improve the clinical symptoms,regulate gastrointestinal hormone secretion,and has good safety.