Objective To observe the effect of Shoutai Pills on endometrial decidualization of mice with recurrent spontaneous abortion(RSA);To explore its possible mechanism in the treatment of RSA based on histone modification.Methods Totally 40 female CBA/J mice were divided into normal group,model group,Shoutai Pills low-dosage group(7.5 g/kg),Shoutai Pills high-dosage group(15 g/kg)and dydrogesterone group(3 mg/kg).The normal group were co housed with BALB/C male mice,while the other groups were co housed with DBA/2 male mice to establish an RSA mouse model.After modeling,the administration groups were given corresponding medication solution by gavage,while the normal group and model group were given equal volume of pure water by gavage for 10 consecutive days.The embryo condition was observed and the embryo loss rate was calculated,ELISA was used to detect serum prolactin(PRL)content,HE staining was used to observe the morphological changes of decidual tissue,RT-PCR was used to detect PRL mRNA expression in decidual tissue,Western blot was used to detect the protein expressions of H4ac,H3K27ac,H3K27me3.Results Compared with the normal group,the model group mice showed a significant increase in embryo loss rate,a significant decrease in serum PRL content,disordered arrangement of decidual cells,and extensive bleeding and necrosis;the expression of PRL mRNA and protein in decidual tissue significantly decreased,the protein expressions of H4ac and H3K27ac significantly decreased,while the expression of H3K27me3 protein significantly increased,with statistical significance(P<0.05).Compared with the model group,the embryo loss rate of Shoutai Pills low-and high-dosage groups and the dexamethasone group significantly decreased,the serum PRL content significantly increased,tightly arranged decidual cells,reduced necrosis,and intact glands;the expression of PRL mRNA and protein in decidual tissue of mice in Shoutai Pills high-dosage group and the dexamethasone group significantly increased,the protein expressions of H4ac and H3K27ac significantly increased,the expression of H3K27me3 protein significantly decreased,with statistical significance(P<0.05).Conclusion Shoutai Pills can promote endometrial decidualization in RSA mice,which is related to the changes of histone modification in endometrial stromal cells.

Objective: To investigate the factors affecting social alienation among elderly stroke patients, so as to provide the reference for the prevention of social alienation among elderly patients with chronic disease. Methods: The stroke patients aged ≥60 years who visited Hangzhou Hospital of Traditional Chinese Medicine from January to June 2024 were selected as subjects. Demographic information and disease status were collected through questionnaire surveys. Social alienation, stigma and social support were assessed using the General Alienation Scale, Stroke-Specific Stigma Scale and Perceived Social Support Scale, respectively. Factors affecting social alienation among elderly stroke patients were analyzed by using a multiple linear regression model. Results: Totally 283 elderly stroke patients were surveyed, including 165 males (58.30%) and 118 females (41.70%). The mean age was (69.55±8.72) years. The mean scores for social alienation, stigma and social support was (41.72±6.10), (43.70±8.96) and (59.86±10.22) points, respectively. Multiple linear regression analysis identified educational level (high school/technical secondary school, β' =-0.157; college degree or above, β' =-0.322), household monthly income per capita (≥3 000 yuan, β' =-0.260), number of stroke occurrences (recurrent stroke, β' =0.181), number of comorbid chronic diseases (≥2, β' =0.165), self-care ability (partially self-care, β' =0.142; unable to self-care, β' =0.308), stigma (β' =0.277) and social support (β' =-0.253) as factors affecting social alienation among elderly stroke patients. Conclusion Social alienation among elderly stroke patients is associated with educational level, household monthly income per capita, number of stroke occurrences, number of comorbid chronic diseases, self-care ability, stigma and social support.

Objective:To construct the "Internet+ Obstetrical Nursing Service" quality evaluation index system, so as to provide a basis for evaluation of quality of "Internet+ Obstetrical Nursing Service".Methods:The overall study period was from March 1 to July 10, 2021. Taking Donabedian three dimensional theory and service quality (SERVQUAL) evaluation model as the theoretical basis, through literature retrieval and referring to relevant policies of "Internet+ Nursing Service" in China, the quality evaluation index system of "Internet+ Obstetrical Nursing Service" was initially formulated. The Delphi method was used to conduct 3 rounds of correspondence to 16 experts and the weight of each indicator was determined based on analytic hierarchy process.Results:In the three rounds of letter inquiries, the effective recovery rates of the questionnaires were 100.0% (16/16) , 100.0% (16/16) and 93.8% (15/16) , respectively. The expert authority coefficients were 0.847, 0.838 and 0.842, respectively. The Kendall's coordination coefficients were 0.125, 0.094 and 0.135, respectively. After three rounds of expert correspondence, a quality evaluation index system of "Internet+ Obstetrical Nursing Service" was finally established, including 3 first-level indicators, 11 second-level indicators and 64 third-level indicators.Conclusions:The quality evaluation index system of "Internet+ Obstetrical Nursing Service" constructed in this study has good scientificity, reliability and operability. Experts have a high degree of agreement on the evaluation results of the index, which can provide reference for the standardization of "Internet+ Obstetrical Nursing Service".

Objective:To construct the "Internet +" nurse core competency evaluation index system.Methods:Combined with the policy analysis and literature research, a preliminary item pool was formed. The semi-structured interview was conducted to form a preliminary "Internet+" nurse core competency evaluation index system. From June to August 2021, the Delphi method was used to conduct three rounds of consultation with 19 experts, and finally determine the contents of the index system. The weights of indicators at all levels were calculated in combination with analytic hierarchy process.Results:Among three rounds of expert consultation, the questionnaire recovery rates were 100%, 100%, and 94.7% respectively, and the expert authority coefficients were 0.862, 0.857, and 0.841, and the Kendall coefficients were 0.228, 0.296, and 0.295 with statistical differences ( P<0.001) . The finally established "Internet +" nurse core competency evaluation index system included 4 first-level indicators, 16 second-level indicators and 59 third-level indicators of professional knowledge, professional skills, comprehensive ability and personal characteristics. Conclusions:The constructed "Internet +" nurse core competency evaluation index system is reliable, scientific and practical, and can be used as a basis for evaluating "Internet +" nurses' service capabilities.

Alfalfa(Medicago sativa L.)is the most important legume forage crop worldwide with high nutritional value and yield.For a long time,the breeding of alfalfa was hampered by lacking reliable information on the autotetraploid genome and molecular markers linked to important agro-nomic traits.We herein reported the de novo assembly of the allele-aware chromosome-level genome of Zhongmu-4,a cultivar widely cultivated in China,and a comprehensive database of genomic variations based on resequencing of 220 germplasms.Approximate 2.74 Gb contigs(N50 of 2.06 Mb),accounting for 88.39％of the estimated genome,were assembled,and 2.56 Gb contigs were anchored to 32 pseudo-chromosomes.A total of 34,922 allelic genes were identified from the allele-aware genome.We observed the expansion of gene families,especially those related to the nitrogen metabolism,and the increase of repetitive elements including transposable elements,which probably resulted in the increase of Zhongmu-4 genome compared with Medicago truncatula.Population structure analysis revealed that the accessions from Asia and South America had rela-tively lower genetic diversity than those from Europe,suggesting that geography may influence alfalfa genetic divergence during local adaption.Genome-wide association studies identified 101 sin-gle nucleotide polymorphisms(SNPs)associated with 27 agronomic traits.Two candidate genes were predicted to be correlated with fall dormancy and salt response.We believe that the allele-aware chromosome-level genome sequence of Zhongmu-4 combined with the resequencing data of the diverse alfalfa germplasms will facilitate genetic research and genomics-assisted breeding in variety improvement of alfalfa.

Objective: To evaluate the concordance of PD-L1 expression in various tissues using antibodies 28-8 and SP263 on their respective detection platforms. Methods: Three hundred seventy four specimens of surgical resection of pulmonary diseases in the First Affiliated Hospital of Nanjing Medical University from January 1, 2012 to January 31, 2017 were collected. Totally 374 cases were tested for PD-L1 expression using the two antibodies, 28-8 and SP263, by respective detection platforms (Dako and Ventana). Finally, 336 cases were used for further evaluation, and the results were statistically analyzed for concordance. Results: For non-small cell lung carcinoma (NSCLC), the positive rate of PD-L1 was 57.5% (177/308) using SP263, and 57.5% (177/308) using 28-8 antibody. The correlation coefficient was 0.97 (P<0.01). The positive rate of both benign lung diseases and paracancerous tissues was about 10.7% (3/28), and the positive concordance rate was 100.0%. The distribution of both antibodies was also relatively consistent. Conclusions The expression levels of 28-8 and SP263 antibodies in NSCLC and other tissues are relatively consistent, suggesting both antibodies may be complementary and substitute for each other, which may be useful in guiding clinical management.

Objective: To study the application effect of information-based health education WeChat platform on the cognition, attitude and behavior of pelvic floor muscle training (pelvic floor muscle training, PFMT) of puerpera, in order to provide an effective intervention method and scientific basis to improve the compliance level of PFMT. Methods: Full-term birth 329 cases of vaginal delivery have been chosen from August to September in 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University. They were divided into 3 groups: control group, audio group, video group by computer random digital table method. The number of the cases of the corresponding groups were 108,113, 108 cases. Control group was given general postpartum health education, audio group and video group were given continuation of voice remind audio guide and continuation of voice remind video guide respectively from postpartum 1 week to 7 weeks. The compliance level of PFMT of the three groups would be evaluated before and after the intervention. Results: The KAP(Knowledge, Altitude and Practice, KAP) scores of PFMT of control group, audio group and video group were 9.0(7.0,10.0), 11.0(8.0,12.0), 12.0 (11.0,13.0) points, respectively. There were significant differences between the video group and the control group, between the video group and the audio group and between the audio group and the control group (Z =-4.302, -10.233, -6.429, P<0.01). Comparison of the PFMT scores before and after the three groups, there was a visibility significant statistical difference in KAP scores (Z =-5.596, -11.762. -15.061, P< 0.01). Conclusions The maternals' knowledge level and physical activity level of PFMT are relatively low. Health care workers should enhance their knowledge about PFMT and improve their understanding of PFMT. WeChat platform to continue voice remind audio guide and continue voice remind video guide way of health education, could improve the KAP level of maternal PFMT and adherence. The KAP level of video guide health education is superior to the audio guide way of health education, which has clinical significance, and is worth popularizing.

evaluate the concordance of PD?L1 expression in various tissues using antibodies 28?8 and SP263 on their respective detection platforms. Methods Three hundred seventy four specimens of surgical resection of pulmonary diseases in the First Affiliated Hospital of Nanjing Medical University from January 1, 2012 to January 31, 2017 were collected. Totally 374 cases were tested for PD?L1 expression using the two antibodies, 28?8 and SP263, by respective detection platforms (Dako and Ventana). Finally, 336 cases were used for further evaluation, and the results were statistically analyzed for concordance. Results For non?small cell lung carcinoma (NSCLC), the positive rate of PD?L1 was 57.5% (177/308) using SP263, and 57.5% (177/308) using 28?8 antibody. The correlation coefficient was 0.97 (P<0.01). The positive rate of both benign lung diseases and paracancerous tissues was about 10.7% (3/28), and the positive concordance rate was 100.0%. The distribution of both antibodies was also relatively consistent. Conclusions The expression levels of 28?8 and SP263 antibodies in NSCLC and other tissues are relatively consistent, suggesting both antibodies may be complementary and substitute for each other, which may be useful in guiding clinical management.

Objective To explore knowledge-attitude-practice of the pelvic floor muscle function training in puerperium women and the current situation of its needs, providing reference for carrying on clinical propaganda and education of the puerperal pelvic floor rehabilitation and therapies. Methods The self-designed"Pelvic Floor Muscle Function Training Knowledge-Attitude-Practice and Its Needs in Puerperium Women Questionnaire"was applied. One hundred and fifty lying-in women who were enrolled for the reexamination at 42 days after delivery in the out-patient service of the department of obstetrics and gynecology in Beijing classⅢ grade A hospital from April to June 2017 were investigated with the questionnaire. Results The incidence of puerperium urinary leakage was 14.7%. The occurrence of pelvic floor dysfunction disease in lying-in women after delivery was significantly different in women with different delivery methods (P< 0.05). The occurrence of pelvic floor dysfunction disease in lying-in women after delivery was not significantly different in women with different delivery times (P>0.05). The total score of the pelvic floor muscle function training knowledge-attitude-practice in puerperium women was(66.6±11.97), which was at the middle level. The knowledge score, the attitude score and the practice score of the pelvic floor muscle function training were significantly different in the lying-in women with different baseline data and different pregnant and puerperal status (P<0.05), but there was no significant difference in the total score (P>0.05). There were 83.3% of lying-in women who would like to understand the related knowledge of the pelvic floor muscle function training. There were 72.0% of lying-in women who preferred the animated video mode for propaganda and education. Conclusions The level of lying-in women' pelvic floor muscle function training knowledge-attitude-practice needs strengthening. It is imperative to establish and improve the propaganda and education system of the puerperal pelvic floor muscle function rehabilitation.

Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.