Objective To evaluate the role of p38 mitogen-activated protein kinase (p38MAPK)-heat shock protein 27 (HSP27) signaling pathway in attenuation of lipopolysaccharide (LPS)-induced acute lung injury (ALl) by dexmedetomidine in mice.Methods Forty male Kunming mice,aged 2 months,weighing 20-25 g,were equally and randomly divided into 4 groups using a random number table:control group (group C),LPS group,low-dose dexmedetomidine + LPS group (group D1),and high-dose dexmedetomidine + LPS group (group D2).Dexmedetomidine 25 and 50 μg/kg were injected intraperitoneally in D1and D2 groups,respectively,and 1 h later LPS 5 mg/kg was injected intraperitoneally.At 6 h after LPS injection,the left lung was lavaged,and broncho-alveolar lavage fluid (BALF) was collected for determination of concentrations of protein,tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β).The right lung was removed for examination of the pathological changes (under the light microscope) and for detection of expression of phosphorylation of p38MAPK (p-p38MAPK),p38MAPK,phosphorylation of MAPK-activated protein kinase 2 (p-MAPKAPK-2),MAPKAPK-2,phosphorylation of HSP27 (p-HSP27) and HSP27 in lung tissues.The wet to dry lung weight (W/D) ratio was calculated.The ratios of p-p38MAPK/p38MAPK,p-MAPKAPK-2/MAPKAPK-2 and p-HSP27/HSP27 were calculated.Results Compared with group C,the W/D ratio,concentrations of protein,TNF-α and IL-1β in the BALF,and ratios of p-p38MAPK/p38MAPK,p-MAPKAPK-2/MAPKAPK-2 and p-HSP27/HSP27 were significantly increased in group LPS.Compared with group LPS,the W/D ratio,concentrations of protein,TNF-α and IL-1β in the BALF,and ratios of p-p38MAPK/p38MAPK,p-MAPKAPK-2/MAPKAPK-2 and p-HSP27/ HSP27 were significantly decreased in D1 and D2groups.The pathological changes of the lung were significantly reduced in D1 and D2 groups as compared to LPS group.Conclusion Dexmedetomidine attenuates LPS-induced ALI in mice possibly through inhibiting p38MAPK-HSP27 signaling pathway.

Objective To explore the significance of ADC value combined with MRI signs on identifying benign and malignant breast lump lesions with the type of TICⅡ.Methods 187 patients with breast lump lesions of TICⅡ,which were confirmed by surgical pathology,proceeded MRI.The ADC value,early-phase enhancement rate,length of lesions,lobulated appearance and spiculation, inverted nipple,thickening of the skin and the length of ipsilateral axillary lymph nodes were analyzed and recorded.T-tests was used to analyzed the measurement data,χ2test was used to analysis the attribute data.The ROC curves were used to evaluate the diagnostic efficiency of ADC value and MRI signs.Results The ADC value was (1.418±0.299)×10-3mm2/s and(0.860±0.142)× 10-3mm2/s (P<0.01)for breast benign and malignant lesions respectively,while the early-phase enhancement rate were (170.387± 74.580)% and (160.778±39.786)%(P=0.258)respectively.When ADC values were used for differential diagnosis of breast benign and malignant lesions with a threshold of 1.017×10-3mm2/s,the area under the sensitivity and specificity were 89.0% and 98.0% The sensitivity and specificity of lobulated appearance,spiculation,inverted nipple and thickening of the skin were 92.6% and 33.3%, 88.2% and 88.2%,20.5% and 94.1%,35.3% and 88.2%,respectively.When the 1.0 cm was used as the threshold of the length of ipsilateral axillary lymph,its sensitivity and specificity were 47.8% and 80.4%.The ROC curve of early-phase enhancement rate showed no diagnostic capability(P>0.05).Conclusion ADC value combined with MRI features are helpful to improve the sensitivity and specificity in breast lesions with the type of TICⅡ.

Objective To investigate the risk factors and improvement measures of thrombosis in internal arteriovenous fistula in maintenance hemodialysis patients .Methods Case control studies were performed in this study . Totals of 100 maintenance hemodialysis patients with thrombosis in internal arteriovenous fistula from January 2009 to June 2015 in Lishui Central Hospital were included in observation group, while another 100 patients with maintenance hemodialysis who did not have thrombosis in internal arteriovenous fistula were involved as control group .The related clinical and nursing data were collected , and the correlation between the thrombosis in internal arteriovenous fistula and related factors were analyzed to improve targeted nursing .Results Prevalence of diabetes , puncture failure rate , hematoma occurrence rate , high intensity in site-directed oppression , tightly binding after hemodialysis rate , oppression time longer than 30 min after hemodialysis rate, ultrafiltration rate, hemoglobin, high-sensitivity C-reactive protein, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol , calcium-phosphorus product and D-dimer in observation group were higher than those in control group .The differences were statistically significant ( P<0.05 ) .There were statistically significant differences in the systolic pressure and low molecular weight heparin usage between two groups (P<0.05).The multi-factor logistic regression analysis showed that the diabetes[OR=1.417, 95%CI (1.196 -1.803), P =0.001], puncture failure[OR=1.393, 95%CI (1.185 -1.638), P =0.000], tightly binding after hemodialysis [OR=1.249, 95%CI (1.101-1.416), P=0.001], oppression time longer than 30 min after hemodialysis[OR=8.369, 95%CI (1.725 -40.596), P=0.008], systolic pressure[OR=1.031, 95%CI (1.001 -1.061), P =0.040], ultrafiltration rate[OR =1.490, 95%CI (1.146-1.937), P=0.003], high-sensitivity C-reactive protein[OR=1.594, 95%CI(1.085-2.342), P=0.017], low-density lipoprotein cholesterol [OR=9.456, 95%CI (2.534 -55.040), P=0.007] and D-dimer[OR=11.711, 95%CI (5.310-69.231), P=0.005] were independent risk factors for thrombosis in internal arteriovenous fistula in maintenance hemodialysis patients .Usage of low molecular weight heparin [ OR=0.101, 95%CI (0.017 -0.590), P=0.011] was protective factor.Conclusions Thrombosis in internal arteriovenous fistula in patients with maintenance hemodialysis is not only related to metabolic factors , but also related to nursing factors .We should strictly control the ultrafiltration rate , improve puncture success rate , strengthen the health education and nursing observation post operation so as to early spot and prevent the thrombosis in internal arteriovenous fistula .

Objective:To explore the effects of empathic nursing combined with therapeutic communication on self-burden, negative emotions and coping styles in elderly inpatients with coronary heart disease.Methods:Using the convenient sampling, a total of 135 elderly patients with coronary heart disease who were admitted to Second Hospital of Shanxi Medical University from February 2020 to May 2021 were selected as the research objects. The patients were divided into the observation group ( n=67) and the control group ( n=68) by the random number table method. The control group was given empathy nursing and routine psychological intervention, while the observation group was given empathy nursing combined with therapeutic communication intervention. Self Perceived Burden Scale (SPBS) , Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) and Medical Coping Modes Questionnaire (MCMQ) were used to evaluate self-burden, negative emotions and coping styles of patients before and after intervention. Results:After the intervention, scores of SPBS, SAS and SDS of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The face dimension score in the MCMQ of the observation group was higher than that of the control group, and the avoidance and yield dimension scores were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Empathy nursing combined with therapeutic communication in elderly inpatients with coronary heart disease can help relieve the patients' sense of self-burden and improve negative emotions and coping styles, which has high application values.