Objective To explore the effect of triperygium wilfordii polyglucoside(TWP) on the podocytes of rats with diabetes nephropathy(DN). Methods One hundred SD rats were randomly divided into normal control group (Group A),DN group (Group B),TWP group(Group C).TWP group was divided into 3 subgroups(Ca,Cb,Cc)according to the different doses 4,8,16mg·kg-1·d-1,respectively.Rats in DN group and TWp group were given streptozocin(STZ)by intraperitoneal injection to establish animal model of diabetes.After 12 weeks,24 h urinary protein excretion rate(UAER),BUN,Scr,white blood cell(WBC),blood glucose(Glu),and kidney weight (KW)/body weight(BW)were determined.The renal pathological changes were evaluated by HE staining.The structural change of podocytes was observed by transmission electron microscope.The expressions of nephrin and podocin were evaluated by immunofluorescence staining. Results (1)Compared to group A,Scr,BUN,Glu,KW/BW,and UAER were significantly higher(P＜0.05)in group B and group C.Whereas the elevated liver enzymes and the decreased WBC were presented in group Cc (3/20). Compared to group A, the protein expressions of nephrin and podocin in nephridial tissue were lower, and the significant differences of pathomorphology in glomerulus,tubules and podocytes were observed in group B and group C. (2) Compared to group B, KW/BW and UAER were lower in group C (P＜0.01); the protein expressions of nephrin and podocin were higher in nephridial tissue; the pathomorphological improvements were exhibited in glomerulus,tubules and podocytes in group C, paralleled with the increase of TWP dose (P＜0.05 or P＜0.01).Conclusions TWP may exert the protective effect on podocytes in diabetic nephropathy rats,dependent on the dose of TWP. The mechanism may be associated with the up-regulatied expressions of nephrin and podocin.

Objective To understand the incidence of nosocomial infections for providing basis for the development of prevention and control measures.Methods All the hospitalized patients were investigated,data collection used by nosocomial infection surveillance system,the results were statistically analyzed.Results Nosocomial infections occurred in 46 case-times with the infection rate of 3.04％,the top 3 prevalence rates were in ICU(46.15％),department of hematology(21.87％),department of neurosurgery (1 1.76％).The main infection sites were lower respiratory tract (36.96％) and upper respiratory tract (28.26％).The utilization rate of antibiotics was 44.09％.There were 183 patients who received etiology examination with the submission rate of 32.28％.Conclusion The investigation of prevalence of nosocomial infections can contribute to understanding of the incidence of nosocomial infections,and taking interventions to the key departments,strengthening the clinical specimens submission,and standardizing the reasonable use of antibiotics can decrease the incidence of nosocomial infections.

Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.

Objective:To understand the research hotspots and development directions of the core competence of nursing students in China by reviewing the published literature so as to provide a reference for follow-up research.Methods:Using "nursing students" and "core competence" as search terms, we retrieved documents collected by the China National Knowledge Infrastructure (CNKI) , WanFang Database and China Biology Medicine from database establishment to March 2020, and carried out bibliometric analysis.Results:A total of 233 documents met the inclusion and exclusion criteria. The number of published articles increased slowly over time. There were 122 articles supported by the fund. The first authors were distributed in 30 regions, and articles were cited 1 170 times. Among the type of literature studies, intervention studies were the most with 88 articles in total; qualitative studies were the least with only 3 articles.Conclusions:The core competence literature of nursing students in China is on the rise. Fund investment should be increased, cooperation in multiple regions should be strengthened, and the scope of research types and research content should be expanded so as to promote the development of the discipline.

Objective:To explore the correlation among stigma, self-compassion and social support in patients with type 2 diabetes, and analyze the mediating role of self-compassion between the two, so as to provide theoretical basis for reducing stigma in patients with diabetes.Methods:From July 2022 to February 2023, 176 inpatients with type 2 diabetes in the Department of Endocrinology of the Guangdong Second Chinese Medicine Hospital were selected by convenience sampling. The patients were investigated with the General Information Questionnaire, Type 2 Diabetes Stigma Assessment Scale, Perceived Social Support Scale and Self-Compassion Scale. Pearson correlation was used to analyze the correlation between variables, and the Bootstrap method was used to test the mediating effect.Results:The total scores of social support, self-compassion and stigma in patients with type 2 diabetes were (54.64±12.63), (89.36±12.81) and (45.15±9.73) respectively. Correlation analysis showed that social support was negatively correlated with stigma ( r=-0.539, P<0.01), and positively correlated with self-compassion ( r=0.434, P<0.01), and there was a negative correlation between self-compassion and stigma ( r=-0.583, P<0.01), and the differences were statistically significant. The mediating effect analysis indicated that self-compassion played a mediating role between social support and stigma in patients with type 2 diabetes. The mediating effect value was -0.113, accounting for 32.66% of the total effect. Conclusions:The stigma in patients with type 2 diabetes is at the lower middle level. Social support and self-compassion negatively predict stigma, and self-compassion plays a mediating role between social support and stigma in type 2 diabetes patients.

Objective:To integrate the stigma experience of diabetes patients in the process of life, treatment and self-management, and understand their real feelings, so as to implement targeted interventions for diabetes patients.Methods:Qualitative research on stigma experience of diabetes patients was retrieved in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) , VIP, WanFang Data, and China Biomedical Literature Database. The search period was from the establishment of the database to June 2022. The method of aggregative integration was used to organize and analyze the included literature.Results:A total of 6 studies were included. A total of 37 results were extracted, forming 7 new categories, which were integrated into three integrated results (negative experience brought by stigma, peer support promoted positive coping with stigma, comparison of stigma and experience of patients with type 1 and 2 diabetes) .Conclusions:There are many forms of stigma in diabetes patients. It is necessary to pay attention to the different experiences of patients' stigma, take effective individualized interventions to reduce their stigma, enhance their self-management ability, and improve the quality of life.

Objective:To explore the research trends, research advances and future orientations in the field of inflammatory bowel disease (IBD), so as to inform future researches.Methods:Web of Science database was searched from 2000 to 2021. CiteSpace software was used for visual and quantitative analysis.Results:A total of 3 582 articles were included. Publications on nutrition science in IBD showed a rising trend. The United States ranked first according to number of publications by country, the University of Toronto ranked first by institution, Inflammatory Bowel Diseases ranked first by journal and Li J from Nanjing University was the very author with the highest number of relevant publications. Research hotspots mainly focused on risk, gut microbiota and pediatric population. Research fronts mainly focused on the gut microbiota. Conclusion:Visual analysis shows the research trend in the field of nutrition in IBD, with gut microbiota as the research hotspots in the future.

Objectives: . Considerable research has been focused on independent predictors of difficult laryngeal exposure (DLE) during suspension laryngoscopy. However, previous studies have yielded inconsistent results and conclusions. Consequently, we performed a meta-analysis of the existing literature with the aim of identifying significant parameters for a standardized preoperative DLE prediction system. Methods: . We systematically retrieved articles from the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang databases up to October 2022. Data from eligible studies were extracted and analyzed using the R programming language. The effect measures included odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous variables and mean differences (MDs) with 95% CIs for continuous variables. Results: . The search yielded 1,574 studies, of which 18 (involving a total of 2,263 patients) were included. Pooled analysis demonstrated that patients with DLE during microsurgery tended to be male (OR, 1.73; 95% CI, 1.16–2.57); were older (MD, 5.47 years, 95% CI, 2.44–8.51 years); had a higher body mass index (BMI; MD, 1.19 kg/m2; 95% CI, 0.33–2.05 kg/m2); had a greater neck circumference (MD, 2.50 cm; 95% CI, 1.56–3.44 cm); exhibited limited mouth opening (MD, −0.52 cm; 95% CI, −0.88 to −0.15 cm); had limited neck flexibility (MD, −10.05 cm; 95% CI, −14.10 to −6.00 cm); displayed various other anatomical characteristics; and had a high modified Mallampati index (MMI) or test score (OR, 3.37; 95% CI, 2.07–5.48). Conclusion . We conducted a comprehensive and systematic analysis of the factors relevant to DLE. Ultimately, we identified sex, age, BMI, neck circumference, MMI, inter-incisor gap, hyomental distance, thyromental distance, sternomental distance, and flexion-extension angle as factors highly correlated with DLE.

Objective:To investigate the role of ferroptosis in bone marrow mesenchymal stem cells (BMMSCs) combine with normothermic machine perfusion (NMP) in repairing steatotic liver donor after cardiac death (DCD) in SD rats.Methods:BMMSCs were derived from SD rats to establish the DCD model of rats steatotic liver. A total of 24 rats were randomly divided into four groups: simple steatotic liver model group (Sham), static cold storage group (SCS), NMP, BMMSCs combine with NMP preservation group (BNMP), and the preservation time was 4 hours. The donor liver function was evaluated by liver structure, liver enzymes and lactic acid content of perfusion fluid, bile secretion and inflammatory cytokines; furthermore, in order to evaluate the occurrence of liver ferroptosis, the content of Fe 2+, malondialdehyde and glutathione (GSH) in liver tissue, as well as the mRNA or protein expression changes of cyclooxygenase-2 (COX-2), prostaglandin-endoperoxide synthase 2 (Ptgs2), glutathione peroxidase 4 (GPX4) and ferritin heavy chain 1 (FTH1) were detected. Results:After DCD steatotic donor liver was preserved for 4 hours, the liver injury, pro-inflammatory and anti-inflammatory cytokines expression in the BNMP and NMP groups were better than those in the SCS group. During the machine perfusion preservation period, alanine aminotransferase [(189.0±12.5)U/L vs. (227.7±16.2)U/L], aspartate aminotransferase [(207.3±18.6)U/L vs. (247.0±11.8)U/L] and lactic acid [(2.3±0.3)mmol/L vs. (2.9±0.2)mmol/L] in the BNMP group is lower than those in NMP group, moreover, the amount of hepatic bile secretion in the BNMP group [(1 245.7±46.8) μl vs. (1 014.3±67.9) μl] was more than that in NMP group, the difference was statistically significant (all P<0.05). The content of Fe 2+ and malondialdehyde in the liver tissue of BNMP group was significantly lower than those of SCS and NMP groups, on the contrary, the content of GSH was significantly higher than those of SCS and NMP groups. In addition, in the BNMP group, the mRNA level of Ptgs2 and protein level of COX-2 in the liver were significantly reduced, and expression of GPX4 and FTH1 were significantly higher than those of NMP and SCS groups, the differences were statistically significant (all P<0.05). Conclusion:BMMSCs combine with normothermic machine perfusion can better repair SD rats DCD steatotic donor liver and its mechanism of action may be related to its regulation on liver ferroptosis.

Objective To explore the mediating effect of sleep duration on the relationship between qi stagnation constitution and anxiety/depression in junior high school students.Methods From March 20 to March 31,2020,a total of 10,325 students from 6 junior high schools in Henan,Liaoning,Shaanxi,Shandong,and Fujian provinces were sampled by cluster sampling.Firstly,the general conditions(age,gender,grade,hometown,whether they are an only child)and sleep duration were collected,and their qi stagnation constitution,depression and anxiety status were evaluated by using the Qi Stagnation Subscale in the"TCM Constitution Classification and Judgment Scale",the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder(GAD-7).Secondly,Spearman correlation analysis was used to explore the correlation between qi stagnation constitution,sleep duration,and anxiety/depression.Then,linear regression analysis and mediating effect test were used to explore the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect of sleep duration was analyzed,and the results were verified.Results(ⅰ)The detection rate of anxiety in non-only children was higher than that of only children(x2=11.198,P=0.001);The detection rate of anxiety(x2=106.967,P＜0.001)or depression(x2=84.692,P＜0.001)was higher among senior students than those in lower grades,while those of girls with anxiety(x2=100.441,P＜0.001)or depression(x2=71.418,P＜0.001)were higher than those of boys.The detection rates of anxiety(x2=1 092.298,P＜0.001)and depression(x2=866.740,P＜0.001)in qi stagnation constitution students were higher than those of non-qi stagnation constitution students,and the detection rates of anxiety(x2=1 076.716,P＜0.001)and depression(x2=1 099.725,P＜0.001)in students whose sleep duration less than 8 h were higher than those of whose sleep duration more than 8 h,and the shorter the sleep duration,the higher the detection rate.(ⅱ)Qi stagnation constitution positively predicted anxiety/depression(β=0.679,P＜0.001;β=0.718,P＜0.001),and sleep duration had a negative predictive effect on anxiety/depression(β=-0.403,P＜0.001;β=-0.439,P＜0.001).(ⅲ)Sleep duration played a partial mediating role in the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect accounted for 13.40％and 13.79％of the total effect,respectively.Conclusion Although qi stagnation constitution mainly affects anxiety/depression through direct effect,it can still be partially indirectly realized through the mediating variable of sleep duration,that is,the shorter the sleep duration,the higher the risk of anxiety/depression in junior high school students.Therefore,the mental health problems of junior high school students can be prevented and improved by regulating qi stagnation constitution and ensuring adequate sleep duration.