Objective To investigate the immunologic etiology of pregnancy induced hypertention (PIH)by studying the changes of T H1 and T H2 cell ratio in the peripheral blood from patients with severe PIH. Methods We examined the cell percentage of T H1 cell(secreting cytokine IFN ?) and T H2 cell(secreting cytokine IL 4),which were from CD4 positive, by flow cytometry tri stained with PerCP CD4,FITC IFN ? and PE IL 4 monoclonal antibody. The blood samples were from severe PIH patients and normal third trimester patients. Results The percentage of T H1 cell 38.01?9 04% from the peripheral blood of severe PIH partuients was significantly higher than that of the normal partuients of the third trimester 30.26?8.65%, while the percentage of T H2 cell 2.25? 0.61% was much lower P

Objective To evaluate the effects of mindfulness-based stress reduction(MBSR) on fatigue and sleep quality for breast cancer patients undergoing chemotherapy. Methods Totally 96 patients with breast cancer under-going chemotherapy were assigned into the intervention group and the control group with 48 cases in each group from a tertiary hospital in Zhengzhou city. Both groups received routine care,and the intervention group also received 8 weeks of MBSR. The Revised Piper Fatigue Scale(PFS-R) and Pittsburgh Sleep Quality Index(PSQI) were used to assess fatigue and sleep quality of two groups during chemotherapy before the intervention(T1),after the interven-tion(T2) and 3 months after the intervention (T3). Results There were significant differences in sensory,behav-ioral,emotional and total fatigue scores between the two groups(P<0.05);the time effect on fatigue of the various dimensions scores and total fatigue scores was significant(P<0.05);sensory aspects,emotional aspects,behavioral aspects,and total fatigue scores were interfered between intervention and time factors(P<0.05). There were signifi-cant differences in sleep quality,fall sleep time,sleep time,sleep efficiency and sleep scores between the two groups(P<0.05);the time effect on sleep quality,sleep time, fall sleep time was significant(P<0.05);there were interac-tion effects between intervention and time on sleep quality,sleep time,sleep disturbance and sleep total score(P<0.05). Conclusion MBSR can effectively relieve fatigue and improve sleep quality for breast cancer patients undergoing chemotherapy.

Objective To observe the influence of bezafibrate on the apoptosis and expression of lectin-like oxidized low density lipoprotein receptor-1(LOX-1) mediated by oxidized low density lipoprotein(ox-LDL) in cultured human umbilical vein endothelial cells(HUVECs).Methodes The apoptosis of HUVECs mediated by ox-LDL were evaluated by flow cytometry and the expression of LOX-1 mRNA were detected by RT-PCR.Results Compared with the control group,ox-LDL could increase apoptosis and the expression of LOX-1(P<0.05),and Bezafibrate could decrease the apoptosis and the expression of LOX-1 in a concentration -dependent manner(P<0.05).Preincubation of HUVECs with polyinosinic acid for 2 hours,the apoptosis and the expression of LOX-1 decreased(P<0.05).Conclusions Bezafibrate inhibits the apoptosis of HUVECs mediated by ox-LDL by reducing the expression of LOX-1,which may be part of the reasons for bezafibrate to prevent and treat atherosclerosis.

The rapid development of aging has brought new challenges to the elderly nursing service.Traditional nursing education is difficult to meet the needs of elderly nursing personnel cultivation.The training experience of other countries will provide a reference for the training of elderly nursing talents in China,so as to meet the needs of the society.This paper analyzes the current status of the geriatric nursing personnel cultivation in the United States from three aspects:the elderly nursing education in the United States,the training of the senior practice nurses and the training of the elderly nursing teachers,and according to the national conditions of our country,it is pointed out that the training of elderly nursing personnel should pay attention to curriculum setting to cultivate senior nursing professionals,pay attention to professional qualification certification and train advanced specialist nurses in geriatric nursing,pay attention to evidence-based practice and train characteristic TCM nurses in geriatric nursing,pay attention to teachers' leadership and cultivate high-level talents especially elites in geriatric nursing.

Objective To investigate the effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in elderly patients.Methods One hundred and twenty ASA Ⅰ-Ⅲ patients,aged 65-80 yr,undergoing elective lower abdominal surgery under general anesthesia,were randomly divided into 2 groups (n=60 each): routine ventilation group (group R) and permissive hypercapnia ventilation group (group H).In group H,VT=6-8 ml/kg,RR=12-14 bpm,I: E=1: 2,and PaCO2 was maintained at 45-65 mm Hg and pH value ＞ 7.2,while in group R,VT=10-12 ml/kg,RR=14-16 bpm,I:E=1:2,and PaCO2 was maintained at 35-45 mm Hg.Blood samples were taken from the radial artery and jugular bulb for blood gas analyses at 0,5,15 and 30 min after tracheal intubation (T0.3).Cerebral A-V O2 content differences (Da-jvO2)and cerebral O2 extraction rate (CERO2) were calculated at the same time.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation,and 24 h,48 h,1 week and 2 weeks after operation.Results Compared with group R,PEr CO2 andPaCO2 were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased at T1.3,MMSE score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05 or0.01).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased at T1-3 in both groups,PETCO2 and PaCO2 were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased at T1-3 in group H,and MMSE score was significantly decreased at 24 h,48 h,1 week and 2 weeks after operation in both groups (P ＜ 0.01).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during operation,and reduce post-operative cognitive dysfunction in the elderly patients.

Objective To evaluate the efficacy and safety of wireless analgesia system percutaneous morphine pumping in patients with refractory cancer pain. Methods A total of 19 patients with refractory cancer pain underwent continu-ous percutaneous morphine via wireless patient-controlled analgesia pump to replace the oral morphinefrom Feb 2013 to Oct 2013 were included. Recorded the pain relief time,degree and remission rate,dosing adjustment completion time and adverse reactions. And compare visual analogue scale(VAS﹚before and after 3 days and morphine consumption 24 hours of total. Results The average time of beginning of pain relief was 35 min. The VAS before and after treatment were 7(1﹚and 1(1﹚respectively(P﹤0.01﹚, morphine consumptions were (92.6±21.3﹚mg and (31.0±9.34﹚mg. The de-gree of pain relief was 94.7%(18/19﹚. The average completion time of morphine titration was 38.4 hours. The main adverse reaction of constipation,nausea and vomiting,urinary retention and psychiatric symptoms were recorded. Conclusion Wireless analgesia system continuous percutaneous morphine pumping can effectively control the in-tractable cancer pain, is safe, efficient, convenient, and reduce morphine refractory cancer pain patientsdosage.

OBJECTIVE: To investigate the effect of 5-Aza-dC and TSA to tumor suppressor gene RASSF1A expression and methylation level in Hep-2 cell line. METHOD: Hep-2 cell line were cultured in vitro and handled with 5-Aza-dC and TSA. Detected RASSF1A expression and methylation level were detected before and after drug intervention using Realtime PCR and MSP. RESULT: (1) Before intervention with drug, tumor suppressor gene RASSF1A was weakly expressed and methylated in Hep-2 cell line. (2) With the effect of 5-Aza-dC and TSA, the methylation of RASSF1A gene was reversed. And the effect of combination of 5-Aza-dC and TSA was similar with 5-Aza-dC alone. There was no obvious effect using TSA alone. (3) With the effect of 5-Aza-dC and TSA, the expression of RASSF1A was improved. And the effect of 5-Aza-dC was stronger than TSA. Synergetic effect was found when using 5-Aza-dC and TSA simultaneously. CONCLUSION In Hep-2 cell line, Promoter methylation of tumor suppressor RASSF1A may play a very important role in loss of gene expression, but it is not the only cause. 5-Aza-dC and TSA can improve RASSF1A expression by reversing DNA methylation and histone deacetylation.
Antimetabolites, Antineoplastic ; pharmacology ; Azacitidine ; analogs & derivatives ; pharmacology ; Cell Line, Tumor ; DNA Methylation ; Gene Expression ; Gene Silencing ; Genes, Tumor Suppressor ; Humans ; Hydroxamic Acids ; pharmacology ; Promoter Regions, Genetic ; Tumor Suppressor Proteins ; genetics

Objective:To construct a scientific and reasonable early warning evaluation index system for high-risk pregnancy during childbirth, so as to provide a content framework for the establishment of an information management platform.Methods:Convenience sampling was used to select 15 experts from 2 colleges and universities, 5 ClassⅢ Grade A general hospitals and 2 ClassⅢ Grade A maternal and child health hospitals in Henan Province as the subject of consultation. The early warning evaluation indicators of high-risk pregnancy during childbirth were determined through literature research, group discussion, and Delphi expert consultation method. Convenience sampling method was adopted to select 288 pregnant women admitted to the hospital for delivery from February to April 2020 in a ClassⅢ Grade A hospital in Henan Province as the research object. The early warning evaluation index system for high-risk pregnancy during childbirth was used to evaluate pregnant women.Results:The final early warning evaluation index system for high-risk pregnancy during childbirth included 7 first-level indicators and 27 second-level indicators. The expert authority coefficients of the two rounds of consultation were 0.91 and 0.93, respectively, and the Kendall harmony coefficients were 0.241 and 0.385, respectively ( P<0.001) . The area under the ROC curve predicted by the early warning evaluation index system for high-risk pregnancy during childbirth was> 0.85, and the best cut-off point was 9.98. Conclusions:The constructed early warning evaluation index system for high-risk pregnancy during childbirth has comprehensive content and high reliability, which will help midwives to identify high-risk pregnancy during childbirth.

To improve the current situation of multiple preoperative visits and evaluations for elderly patients and other patients with complex conditions, in December 2022, Peking Union Medical College Hospital established preoperative multidisciplinary evaluation clinic (shorted as joint clinic). The joint clinic established a multidisciplinary team, clarified service targets, and developed standardized clinic workflows to provide patients with a " one-stop" preoperative assessment(physical fitness assessment, nutritional assessment, and frailty assessment, etc.), nutritional optimization intervention, and prerehabilitation education and guidance services. This practice strengthened preoperative risk management, improved preoperative assessment efficiency, and ensured the safety of patients during the perioperative period. As of September 2023, the joint clinic had received a total of 128 patients, of which 86 underwent surgery after preoperative evaluation and prehabilitation optimization. The obesity rate, smoking rate, and number of frailty cases of these patients had decreased from 13.96%, 11.63%, and 18 at the time of visit to 9.30%, 4.65%, and 14 on the day before surgery, respectively. They had recovered well after surgery. This practice had improved the preoperative status of patients and created conditions for high-risk patients to undergo surgery smoothly, so as to provide references for other hospitals to carry out multidisciplinary collaborative preoperative evaluation works.

OBJECTIVE To systematically evaluate the risk factors for ineffective eradication therapy of adult Helicobacter pylori （Hp） infection. METHODS Retrieved from PubMed，Web of Science， the Cochrane Library， Embase， CNKI， VIP and Wanfang Data， cohort studies and case-control studies on the eradication therapy for Hp infection in adult patients were searched from Jan. 2000 to Jul. 2024. After screening literature， extracting data， and evaluating the quality of literature， RevMan 5.3 software was used for meta-analysis， and sensitivity analysis and publication bias analysis were also performed. RESULTS A total of 19 articles were included， all of which were cohort studies， involving 9 931 patients in total. Among them， 1 929 patients were ineffective in eradication therapy， with the ineffective rates ranging from 8.02% to 33.33%. Meta-analysis showed that age＜50 years [OR＝1.33， 95%CI （1.12，1.57）， P＜0.001]， body mass index （BMI）＞25 kg/m2 [OR＝1.87， 95%CI （1.35， 2.59）， P＝ 0.000 2]， a history of smoking [OR＝1.62， 95%CI（1.35， 1.95）， P＜0.001]， a history of drinking [OR＝1.93， 95%CI（1.47， 2.54）， P＜0.001]， living in a rural area [OR＝1.74， 95%CI（1.41， 2.15）， P＜0.001]， having non-peptic ulcer [OR＝3.45， 95%CI （1.75， 6.67）， P＝0.000 3]， a family members’ infection history [OR＝4.72， 95%CI（3.32， 6.74）， P＜0.001]， poor treatment compliance [OR＝4.89， 95%CI （3.07， 7.79）， P＜0.001]， amoxicillin resistance [OR＝3.42， 95%CI （1.95， 6.00）， P＜0.001] and clarithromycin resistance [OR＝8.14， 95%CI（5.00， 13.24）， P＜0.001] had significant impacts on ineffective eradication therapy of Hp infection in adults. Sensitivity analysis and publication bias analysis showed that the result of this study was robust and reliable. CONCLUSIONS Age＜50 years， BMI＞25 kg/m， a history of smoking， a history of drinking， living in a rural area， having non-peptic ulcer， a family members’ infection history， poor treatment compliance， amoxicillin resistance and clarithromycin resistance are risk factors for failure of Hp infection eradication therapy in adults.